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Acute variceal bleeding — RCPSC IM MCQ

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HardGastroenterology/HepatologyAcute variceal bleedingRCPSC IM

A 54-year-old man with alcohol-related cirrhosis presents with hematemesis and melena. Blood pressure is 92/58 mm Hg, heart rate 118 beats/min, hemoglobin is 72 g/L, INR is 1.8, and platelets are 62 x 10^9/L. He has tense ascites but no encephalopathy. What is the most appropriate management?

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

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Correct answer: A — Ceftriaxone, vasoactive therapy, resuscitation, and urgent endoscopy

Suspected variceal bleeding requires resuscitation, early vasoactive therapy, antibiotic prophylaxis, and urgent endoscopy. Correcting INR before endoscopy should not delay definitive treatment.

Reference: Canadian Association of Gastroenterology and cirrhosis guidance