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  #1  
Old 04-19-2015
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Default Repeated USMLE Question 33

An alcoholic 44 year-old man is brought to the emergency room because of severe abdominal pain and vomiting large amount of blood. The patient was throwing up frequently since yesterday but he didn't notice any blood until two hours ago. The last time he had alcohol was yesterday afternoon during a banquet. The patient had never complained of any related symptoms before. He doesn't smoke or take any recreational drugs.

What is the most likely diagnosis of this patient's condition?

A- Esophageal varices

B- Mallory-Weiss Syndrome

C- Cancer esophagus

D- Acute gastritis
http://medical-usmle.com/?p=1002
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Old 04-20-2015
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I am a bit confused between A and B
but since there have not been any symptoms before I am thinking it is B
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Old 04-20-2015
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B.. mallory-W syndrome
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Old 04-20-2015
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A. The fact that he's an alcoholic he probably developed Portal HTN due to cirrhosis that lead to esophageal varices. As far as I understand rupture of gastric vein cause massive bleeding and that can be the cause of abdominal pain as well along with hematemesis.
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