Question

A 37-year-old woman presents with a 2-day history of melaena and presyncope. Her blood pressure is 90/55 mm Hg and heart rate 120 beats/min. She appears pale and diaphoretic. Haemoglobin is 72 g/L and BUN is elevated. What is the most appropriate immediate management step?

Accepted Answer

Start high-dose intravenous proton pump inhibitor, initiate resuscitation with IV fluids and packed red blood cells, and arrange emergent endoscopy

Answer

Arrange urgent outpatient endoscopy within 24 hours

Answer

Give oral proton pump inhibitor and observe

Answer

Start beta-blocker therapy to reduce portal pressure before resuscitation

Answer

Delay interventions until the INR is known

Practice question

A 37-year-old woman presents with a 2-day history of melaena and presyncope. Her blood pressure is 90/55 mm Hg and heart rate 120 beats/min. She appears pale and diaphoretic. Haemoglobin is 72 g/L and BUN is elevated. What is the most appropriate immediate management step?