Gastroenterology MCQ 072

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Endoscopic Sclerotherapy of Esophageal Varices (Gastroenterology)A 49-year-old man presents to the emergency room because of melena of 3 days' duration. He denies abdominal pain. Vital signs reveal a resting pulse of 104 per minute and a 25-mm Hg orthostatic drop in BP. Physical findings include bilateral temporal wasting, pale conjunctivae, spider angiomas on his upper torso, muscle wasting, hepatosplenomegaly, and hyperactive bowel sounds without abdominal tenderness to palpation. His stool is melenic. Nasogastric tube aspiration reveals coffee grounds material. Hematocrit is 31%. The appropriate next step in the management of this man's illness would be to

A. Pass a Sengstaken-Blakemore tube.
B. Obtain an upper GI series.
C. Insert a transjugular intrahepatic portosystemic shunt (TIPS).
D. Obtain immediate visceral angiography.
E. Perform upper endoscopy.

Category: Gastroenterology MCQs



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