Question

Which of the following is the initial pharmacologic therapy for acute esophageal variceal bleeding in cirrhosis?

• A. Propranolol
• B. Endoscopic variceal ligation
• C. Vasoactive drugs like terlipressin or octreotide
• D. Balloon tamponade

Hint:

Acute variceal bleed: Resuscitate, vasoactive drugs + antibiotics, then urgent endoscopy.

Answer 1

The Correct Option is C

Step 1: Understanding the question.
The question focuses on the first-line pharmacologic management to reduce portal pressure in acute variceal bleeding.
Step 2: Analyzing the options.
(A) Propranolol: Used for prophylaxis, not acute bleeding.
(B) Endoscopic variceal ligation: Performed after stabilization but not initial pharmacologic.
(C) Vasoactive drugs like terlipressin or octreotide: Correct — Started immediately on suspicion of variceal bleed.
(D) Balloon tamponade: Rescue therapy for refractory cases.
Step 3: Conclusion.
The correct answer is (C) Vasoactive drugs like terlipressin or octreotide, as they are the initial therapy for acute variceal bleeding.