A 58-year-old man presents with melaena and orthostatic hypotension. Hb is 78 g/L. He is on aspirin for secondary prevention. What is the most appropr...

Question

A 58-year-old man presents with melaena and orthostatic hypotension. Hb is 78 g/L. He is on aspirin for secondary prevention. What is the most appropriate initial management?

Accepted Answer

Start high-dose IV proton pump inhibitor and arrange urgent endoscopy after resuscitation

Answer

Discharge with outpatient endoscopy

Answer

Give oral PPI and schedule endoscopy in 4 weeks

Answer

Avoid endoscopy because of bleeding risk

Answer

Start NSAIDs for pain control

ca-mccqe1 MCQ (SBA): Upper gastrointestinal bleed

A 58-year-old man presents with melaena and orthostatic hypotension. Hb is 78 g/L. He is on aspirin for secondary prevention. What is the most appropriate initial management?