Question

A 58-year-old man presents with melena and dizziness. BP is 92/60 mmHg, HR 112 beats/min. He takes daily naproxen for osteoarthritis but no anticoagulants. Examination suggests an upper gastrointestinal bleed. What is the most appropriate initial management step?

Accepted Answer

Start rapid IV crystalloid resuscitation and urgent blood tests

Answer

Schedule elective endoscopy within 48 hours

Answer

Administer high-dose IV proton pump inhibitor after endoscopy

Answer

Start oral proton pump inhibitor and discharge for outpatient endoscopy

Answer

Insert nasogastric tube and start enteral feeds

Practice question

A 58-year-old man presents with melena and dizziness. BP is 92/60 mmHg, HR 112 beats/min. He takes daily naproxen for osteoarthritis but no anticoagulants. Examination suggests an upper gastrointestinal bleed. What is the most appropriate initial management step?