🏥 USMLE Exam Prep

A 48-year-old man with known cirrhosis due to alcohol abuse presents with hematemesis. He is tachycardic (110 bpm) and hypotensive (85/50 mmHg). Endoscopy reveals actively bleeding esophageal varices. In addition to fluid resuscitation and blood transfusion, which medication should be administered immediately?

A Oral lactulose
B Intravenous octreotide
C Intravenous proton pump inhibitor
D Oral rifaximin

✓ Correct Answer: Option B

For actively bleeding esophageal varices, intravenous octreotide (a somatostatin analog) is crucial. It causes splanchnic vasoconstriction, reducing portal blood flow and pressure. Empiric antibiotics are also recommended to prevent infection.

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