Gastroenterology: primary prophylaxis of varices: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Gastroenterology: primary prophylaxis of varices

Sample item

Endoscopy in a cirrhotic patient shows large oesophageal varices that have never bled. What is the recommended primary prophylaxis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Nonselective beta blocker or endoscopic band ligation

For large varices without bleeding, nonselective beta blockers such as propranolol or carvedilol, or band ligation if beta blockers are not tolerated, reduce first bleeding. Carvedilol also lowers portal pressure through alpha blockade. Anticoagulants do not prevent variceal bleeding.

Option by option

  • A. Warfarin

    Warfarin raises bleeding risk.

  • B. Sclerotherapy

    Sclerotherapy has been replaced by ligation.

  • C. Nonselective beta blocker or endoscopic band ligation (correct)

    Correct. NSBB or EVL is standard.

  • D. Octreotide infusion

    Octreotide is for acute bleeding.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Nonselective beta blocker or endoscopic band ligation. For large varices without bleeding, nonselective beta blockers such as propranolol or carvedilol, or band ligation if beta blockers are not tolerated, reduce first bleeding.

Why is "Warfarin" not the answer?

Warfarin raises bleeding risk.

Why is "Sclerotherapy" not the answer?

Sclerotherapy has been replaced by ligation.

Why is "Octreotide infusion" not the answer?

Octreotide is for acute bleeding.

What concept does this question test?

It tests Gastroenterology: primary prophylaxis of varices in General Medicine. Carvedilol also lowers portal pressure through alpha blockade. Anticoagulants do not prevent variceal bleeding.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology: primary prophylaxis of varices?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.