UPPER GI BLEEDING

Question 1

45 yo F presents with coffee-ground
emesis for the last three days. Her stool is
dark and tarry. She has a history of
intermittent epigastric pain that is
relieved by food and antacids.

Answer 1

Bleeding peptic ulcer
Gastritis
Gastric cancer
Esophageal varices

Rectal exam
CBC, electrolytes
AST/ALT/bilirubin/alkaline
phosphatase
Endoscopy (including H. pylori
testing if ulcer is confi rmed)

Question 2

40 yo F presents with epigastric pain and
coffee-ground emesis. She has a history
of rheumatoid arthritis that has been
treated with aspirin. She is an alcoholic.

Answer 2

Gastritis
Bleeding peptic ulcer
Gastric cancer
Esophageal varices
Mallory-Weiss tear

Rectal exam
CBC, electrolytes
AST/ALT/bilirubin/alkaline
phosphatase
Barium swallow
Endoscopy