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Esophageal variceal hemorrhage — ABEM Board MCQ

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HardGI/Abdominal emergenciesEsophageal variceal hemorrhageABEM Board

A 55-year-old man with cirrhosis arrives as triage level 1 vomiting blood. BP is 82/44 mm Hg, HR 132/min, hemoglobin is 7.1 g/dL, INR 1.8, and exam shows ascites and spider angiomas. Which of the following is the most appropriate initial action?

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

Reveal the answer and explanation

Correct answer: C — Activate massive transfusion as needed and give ceftriaxone plus octreotide

Suspected variceal bleeding requires resuscitation, vasoactive therapy, and antibiotic prophylaxis early; balloon tamponade is a bridge for uncontrolled hemorrhage.

Reference: AASLD variceal hemorrhage guidance; ABEM EM Model