3 Hours Of Large-volume in Medicine / Internal Medicine — 58yo Woman | Gastroenterology | SMLE Q#11990
SMLE Question #11990
Medicine / Internal Medicine
Gastroenterology
Objective: OBJ-433
Last updated: February 2026
A 58-year-old woman with alcohol-related liver cirrhosis presents with 3 hours of large-volume hematemesis and presyncope. She has abdominal distension and bilateral ankle swelling. Examination shows jaundice, palmar erythema, tense ascites, and splenomegaly. She receives initial IV crystalloids and packed red blood cells. Urgent upper GI endoscopy confirms active esophageal variceal bleeding. Which of the following is the most appropriate intravenous pharmacological treatment to control the acute variceal hemorrhage?
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