ROSH Gastrointestinal Practice Exam

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Study for the ROSH Gastrointestinal Test. Prepare with flashcards and multiple choice questions, each including hints and explanations. Ensure you are ready for the exam!

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What class of medication is recommended for primary prophylaxis to prevent variceal hemorrhage?

ACE inhibitor
Beta blocker
Antihistamine
Proton pump inhibitor

The correct answer is: Beta blocker

The recommended class of medication for primary prophylaxis to prevent variceal hemorrhage is beta blockers. This is due to their effectiveness in reducing portal hypertension, which is a key factor in the development of esophageal varices. Beta blockers, particularly non-selective agents like propranolol and nadolol, work by decreasing the heart rate and reducing cardiac output, which lowers the pressure in the portal vein. This decrease in portal pressure subsequently helps in preventing the formation and rupture of varices, thus significantly reducing the risk of hemorrhage in patients with liver cirrhosis. In contrast, ACE inhibitors do not have a direct role in controlling portal hypertension and are not typically used for this purpose. Antihistamines are primarily used for allergic reactions and not for managing portal hypertension or preventing variceal bleeding. Proton pump inhibitors are effective for reducing gastric acid secretion and may help with mucosal healing, but they do not have a direct effect on portal pressure or the prevention of variceal hemorrhage. Therefore, beta blockers are the most appropriate choice for this clinical scenario.