🏥 USMLE Exam Prep

A 60-year-old male with a history of cirrhosis due to alcohol use presents with acute hematemesis and melena. He is hypotensive and tachycardic. After initial intravenous fluid resuscitation and blood product transfusion, what is the most appropriate next step in his management?

A Initiate an octreotide infusion
B Perform an urgent upper endoscopy
C Administer intravenous proton pump inhibitor (PPI)
D Insert a Sengstaken-Blakemore tube

✓ Correct Answer: Option B

After initial hemodynamic stabilization, urgent upper endoscopy is crucial for diagnosis and definitive treatment (e.g., banding for varices, cautery for ulcers) of upper GI bleeding, especially in a cirrhotic patient where variceal bleeding is common.

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