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Rim Halaby (talk | contribs) Created page with "{{WBRQuestion |QuestionAuthor={{Rim}} |ExamType=USMLE Step 1 |MainCategory=Pathology |SubCategory=Gastrointestinal |MainCategory=Pathology |SubCategory=Gastrointestinal |MainC..." |
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|MainCategory=Pathology | |MainCategory=Pathology | ||
|SubCategory=Gastrointestinal | |SubCategory=Gastrointestinal | ||
|Prompt=A 42 year old patient presents to the emergency department with painful hematemesis. Upon further questioning, the patient denies any past medical or surgical history, intake of any medication, or any allergies. | |Prompt=A 42 year old patient presents to the emergency department with painful hematemesis. Upon further questioning, the patient denies any past medical or surgical history, intake of any medication, or any allergies. The patient explains that before his symptoms began, he was binging on alcohol and had violent episodes of persistent vomiting after that. In the ED, the patient's vital signs are stable and his physical examination is unremarkable. Following appropriate work-up, the patient undergoes endoscopy. Which of the following best characterizes the pathological process causing this patient's hematemesis? | ||
|Explanation=Mallory-Weiss syndrome (MWS) is a frequent cause of hematemesis. It is characterized by upper GI bleeding due to the longitudinal mucosal laceration of the distal part of the esophagus or the proximal part of the stomach, the gastric cardia, that causes hematemesis following a submucosal arterial bleed. MWS is commonly caused by violent vomiting and retching in alcoholics and bulimics that cause an increase in intra-abdominal pressure, which is strong enough to cause the gastric cardia to protrude into the thoracic cavity through the hiatus and cause a longitudinal laceration. | |Explanation=Mallory-Weiss syndrome (MWS) is a frequent cause of hematemesis. It is characterized by upper GI bleeding due to the longitudinal mucosal laceration of the distal part of the esophagus or the proximal part of the stomach, the gastric cardia, that causes hematemesis following a submucosal arterial bleed. MWS is commonly caused by violent vomiting and retching in alcoholics and bulimics that cause an increase in intra-abdominal pressure, which is strong enough to cause the gastric cardia to protrude into the thoracic cavity through the hiatus and cause a longitudinal laceration. | ||