Question

Which of the following is the first-line treatment for acute variceal bleeding in cirrhosis?

• A. Propranolol
• B. Endoscopic band ligation
• C. Octreotide infusion
• D. Transjugular intrahepatic portosystemic shunt (TIPS)

Hint:

In portal hypertension emergencies, start with vasoactive agents before endoscopy.

Answer 1

The Correct Option is C

Step 1: Understanding the question.
The question is about initial management of acute variceal bleeding, focusing on pharmacologic therapy to reduce portal pressure.
Step 2: Analyzing the options.
(A) Propranolol: Used for prophylaxis, not acute bleeding.
(B) Endoscopic band ligation: Definitive but not first-line in acute setting.
(C) Octreotide infusion: Correct — It is the first-line vasoactive drug for controlling bleeding.
(D) TIPS: Reserved for refractory cases.
Step 3: Conclusion.
The correct answer is (C) Octreotide infusion, as it is the first-line treatment for acute variceal bleeding.