GI bleeding: variceal bleed: practice question

A General Surgery 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 Surgery · GI bleeding: variceal bleed

Sample item

A cirrhotic patient has massive haematemesis. After resuscitation, which pharmacological therapy should be started immediately along with antibiotics?

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

The answer and the reasoning

A. Terlipressin or octreotide

Splanchnic vasoconstrictors such as terlipressin or octreotide lower portal pressure and are started before endoscopy for suspected variceal bleeding. Endoscopic band ligation follows, and prophylactic antibiotics reduce infections and mortality. A TIPS procedure is considered for rebleeding.

Option by option

  • A. Terlipressin or octreotide (correct)

    Correct. Vasoactive drugs reduce portal flow and control the bleed.

  • B. Intravenous propranolol bolus

    Beta blockers are for secondary prophylaxis and not acute bleeding with shock.

  • C. Oral omeprazole alone

    A PPI does not treat varices.

  • D. Intravenous heparin

    Heparin would worsen 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 Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Terlipressin or octreotide. Splanchnic vasoconstrictors such as terlipressin or octreotide lower portal pressure and are started before endoscopy for suspected variceal bleeding.

Why is "Intravenous propranolol bolus" not the answer?

Beta blockers are for secondary prophylaxis and not acute bleeding with shock.

Why is "Oral omeprazole alone" not the answer?

A PPI does not treat varices.

Why is "Intravenous heparin" not the answer?

Heparin would worsen bleeding.

What concept does this question test?

It tests GI bleeding: variceal bleed in General Surgery. Endoscopic band ligation follows, and prophylactic antibiotics reduce infections and mortality. A TIPS procedure is considered for rebleeding.

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 GI bleeding: variceal bleed?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.