🏥 USMLE Exam Prep

A 65-year-old male presents to the ED with hematemesis and melena. He is hypotensive (BP 85/50 mmHg) and tachycardic (HR 118 bpm). Initial resuscitation has begun with two large-bore IVs and crystalloid infusion. What is the MOST appropriate next step in his management?

A Stat abdominal CT scan with contrast
B Type and crossmatch, transfusion of packed red blood cells
C Endotracheal intubation for airway protection
D Oral proton pump inhibitor initiation

✓ Correct Answer: Option B

In a hemodynamically unstable patient with active upper GI bleeding, stabilizing hemodynamics with blood products is critical after initial fluid resuscitation to prevent further deterioration and organ hypoperfusion.

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