Hepatobiliary Disease USMLE Step 1 Practice Question
A 55-year-old man with alcohol-related cirrhosis presents with hematemesis. Vitals show BP 94/58 mmHg, HR 118 bpm, RR 22/min, and SpO2 98% on room air. Temperature is 36.8°C. Upper endoscopy confirms actively bleeding esophageal varices. Laboratory studies reveal hemoglobin 7.2 g/dL and INR 2.1. He denies abdominal pain. He takes no current medications. Which pharmacologic agent is most appropriate for initial management?
Answer choices
- AOctreotide infusion and antibioticsCorrect answer
- BVasopressin without nitroglycerin
- CPropranolol initiation
- DCeftriaxone without vasoactive drugs
- EFresh frozen plasma alone
- FTerlipressin infusion and tranexamic acid
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