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Variceal upper GI bleed — PARA MCQ

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HardSurgery - Gastrointestinal emergencyVariceal upper GI bleedPARA

A 46-year-old man with cirrhosis vomits fresh blood. Blood pressure is 92/60 mmHg, pulse is 122 beats/min and he has spider naevi. What is the most important next step?

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

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Correct answer: A — Resuscitate, activate major haemorrhage or upper GI bleed pathway and arrange urgent endoscopy

Haematemesis with shock in cirrhosis suggests variceal bleeding. Initial care is resuscitation, senior escalation, appropriate drugs and urgent endoscopy.

Reference: NICE CG141: Acute upper gastrointestinal bleeding; BSG variceal bleeding guidance