03-27-2009, 08:59 PM
A 58-year-old homeless man is brought to the emergency department with severe hematemesis. He has a history significant for severe alcohol abuse and significant esophageal varices with bleeding in the past. You notice in his old chart that it was recommended that he take a multivitamin, folate, and thiamine. His blood pressure is 100/50 mmHg, pulse is 105/min, and respiratory rate is 26/min. Physical examination shows coarse breath sounds and a protuberant abdomen. Nasogastric lavage yields fresh blood. Given that you strongly suspect another variceal bleed, the most appropriate next step in the management of this patient is
A. administration of amiodarone, intravenously
B. administration of nadolol, orally
C. administration of nitroglycerin, intravenously
D. administration of octreotide, intravenously
E. administration of phenylephrine, intravenously
Explanation:
see below
A. administration of amiodarone, intravenously
B. administration of nadolol, orally
C. administration of nitroglycerin, intravenously
D. administration of octreotide, intravenously
E. administration of phenylephrine, intravenously
Explanation:
see below