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Old 01-18-2013
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Default Liver Cirrhosis

A patient was taken to the ER because of large amount of bloody vomiting. He has a long history of liver cirrhosis and the bloody vomiting is because of esophageal varices. After initial stabilization with intravenous fluids and blood products, the patient develops another bout of bloody emesis. Which of the following peptides is most likely to immediately decrease the portal venous pressure in this patient?

A. Pentagastrin
B. Somatostatin
C. Glucagon
D. Secretin
F. Cholecystokinin

Confused by this question. Seems straightforward, but cannot understand the mechanism behind the right answer. Welcome to put your answer here and give out your explanation at the meantime. Thanks!
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Old 01-18-2013
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I'm pretty sure that the answer is b. I remember from med school that Octreotide is used to treat esophgeal varices. I just do not remember the exact mechanism.
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Old 01-18-2013
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B is correct I think. Octreotide causes a decrease in splanchnic blood flow, due to which there is a decrease in gastric blood flow.It is also used in Carcinoid syndrome,GIT Secretory tumors and in acromegaly
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Old 01-18-2013
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Quote:
Originally Posted by billy View Post
B is correct I think. Octreotide causes a decrease in splanchnic blood flow, due to which there is a decrease in gastric blood flow.It is also used in Carcinoid syndrome,GIT Secretory tumors and in acromegaly
Thanks to your answer!

Yup, the answer is B.

Somatostatin reduces splanchnic blood flow by constricting those arteries? I previously thought it constricts veins which will worsen the portal hypertension.
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Old 08-21-2016
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Answer is Somatostatin. It reduces Splanchnic Blood flow via vasoconstriction. For this reason, one of the Tx for Esophageal Varices is Octreotide, which is a Somatostatin analogue. See full explanation in the video below:

Please see the following video for full explanation:
https://www.youtube.com/watch?v=XwuvuovXFpA
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