skip to main content

Acute variceal upper gastrointestinal bleeding — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardGastroenterology and hepatologyAcute variceal upper gastrointestinal bleedingSCE Acute Medicine

A patient with cirrhosis has haematemesis, shock, ascites and jaundice. Variceal bleeding is suspected. What is the immediate bundle?

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

Reveal the answer and explanation

Correct answer: B — Resuscitate, give terlipressin and antibiotics, then perform endoscopy

The best answer is “Resuscitate, give terlipressin and antibiotics, then perform endoscopy”. This is correct because suspected acute variceal haemorrhage requires simultaneous haemodynamic care, early vasoactive therapy, infection prophylaxis and endoscopic control after stabilisation. Over-transfusion can raise portal pressure, while balloon tamponade is a temporary rescue for uncontrolled bleeding rather than routine first-line treatment.

Reference: NICE CG141 acute upper-gastrointestinal-bleeding recommendations: https://www.nice.org.uk/guidance/cg141/chapter/Recommendations