🏥 USMLE Exam Prep

A 55-year-old male presents with hematemesis and melena. He is hypotensive (BP 90/60 mmHg) and tachycardic (HR 115 bpm). Initial labs show hemoglobin 7.0 g/dL. After initiating fluid resuscitation, what is the most appropriate next step?

A Order a barium swallow study
B Administer intravenous proton pump inhibitor (PPI)
C Prepare for emergent exploratory laparotomy
D Schedule a colonoscopy

✓ Correct Answer: Option B

After hemodynamic stabilization, intravenous PPIs are crucial for patients with suspected upper GI bleeding to reduce rebleeding risk and improve endoscopic visibility. This is a critical step prior to urgent upper endoscopy, which is the definitive diagnostic and therapeutic procedure.

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