MRCP2-1681

MRCP2-1681

A 65-year-old man with a known history of alcohol dependency presents with a 4-hour history of haematemesis and abdominal discomfort. He has no history of upper GI bleed but does report several previous episodes of passing black stools. He has hypertension and a family history of coronary artery disease. A previous abdominal ultrasound has shown hepatic cirrhosis.

Today, he appears unwell. He continues to vomit small amounts of blood. On examination, his blood pressure is 130/90 mmHg and pulse rate is 80 beats per minute. His chest is clear and his abdomen is soft, though he has some epigastric tenderness. Rectal examination reveals melaena.

An intravenous cannula is inserted and blood is taken.

Blood tests show:

Hb 100 g/l
Platelets 170 * 109/l
WBC 7.0 * 109/l

Fibrinogen 2.5 g/L
APTT 32 seconds
PT 13 seconds

Na+ 140 mmol/l
K+ 4.5 mmol/l
Urea 12 mmol/l
Creatinine 95 µmol/l

What should be administered prior to endoscopy?