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Variceal upper GI bleed with shock — RCPSC EM MCQ

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HardGI/Abdominal emergenciesVariceal upper GI bleed with shockRCPSC EM

CTAS 1: A 58-year-old with cirrhosis vomits large volumes of blood. Vitals are BP 82/48, HR 132, RR 26. He is jaundiced with ascites; haemoglobin is 72 g/L and INR is 2.1. Two large-bore IVs are in place and blood is available. What is the most appropriate initial management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Balanced transfusion with octreotide, ceftriaxone and urgent endoscopy

Suspected variceal bleed requires resuscitation, restrictive but prompt transfusion when shocked, vasoactive therapy, antibiotics and urgent endoscopic management.

Reference: Canadian Association of Gastroenterology UGIB guidance; cirrhosis emergency care