Question

A 52-year-old man presents with melaena and presyncope. Blood pressure is 90/60 mm Hg, heart rate 112/min. Hb is 82 g/L. He takes daily Ibuprofen for osteoarthritis. After establishing IV access and resuscitation, what is the most appropriate next step in management?

Accepted Answer

Start high-dose IV proton pump inhibitor and arrange urgent endoscopy within 24 hours

Answer

Start oral proton pump inhibitor and discharge

Answer

Delay endoscopy for 1 week until aspirin can be stopped

Answer

Order a CT abdomen before deciding on endoscopy

Answer

Begin iron supplementation and arrange outpatient gastroscopy

Practice question

A 52-year-old man presents with melaena and presyncope. Blood pressure is 90/60 mm Hg, heart rate 112/min. Hb is 82 g/L. He takes daily Ibuprofen for osteoarthritis. After establishing IV access and resuscitation, what is the most appropriate next step in management?