🏥 USMLE Exam Prep

A 60-year-old male with a history of alcoholic cirrhosis presents with massive hematemesis. Initial management includes establishing two large-bore IVs, fluid resuscitation, and ordering packed red blood cells. In addition to these measures, what is the most critical initial pharmacological intervention to manage suspected variceal hemorrhage?

A Intravenous proton pump inhibitor (PPI)
B Intravenous octreotide
C Oral tranexamic acid
D Intravenous ceftriaxone

✓ Correct Answer: Option B

Octreotide is critical for variceal bleeding as it causes splanchnic vasoconstriction, reducing portal pressure and variceal blood flow. PPIs are for non-variceal bleeds, and ceftriaxone is for SBP prophylaxis, not initial bleeding control.

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