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Oesophageal varices secondary prophylaxis — SCE Acute Medicine MCQ

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ModerateAcute GI PresentationsOesophageal varices secondary prophylaxisSCE Acute Medicine

A 55-year-old man is assessed on the acute medical unit. He has recovered from variceal haemorrhage and asks how rebleeding risk will be reduced before discharge. Initial assessment includes relevant observations, bedside tests and urgent blood results. What would you advise this patient?

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Reveal the answer and explanation

Correct answer: D — Explain endoscopic banding and non-selective beta-blocker follow-up

Explain endoscopic banding and non-selective beta-blocker follow-up is the best answer because secondary prophylaxis commonly combines variceal band ligation and non-selective beta-blocker therapy when tolerated. Discuss escalation preferences and document capacity and best interests is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Discharge planning after variceal bleed must include rebleeding prevention.

Reference: https://www.bsg.org.uk/clinical-resource/#acute-medicine-order-55-1