QuestionSBA
QuestionChoice
This answer is incorrect. Whilst a perforated peptic ulcer can cause significant upper GI bleeds, the examination findings and chronic excess alcohol intake make a diagnosis of ruptured oesophageal varices from chronic liver disease more likely.
10007407
b
Perforated peptic ulcer
QuestionChoice
This answer is incorrect. Alcoholic gastritis typically presents with a long-standing history of epigastric pain and vomiting without haematemesis. The acute presentation of this patient, with signs of chronic liver disease, points more toward a diagnosis of ruptured oesophageal varices.
10007410
e
Alcoholic gastritis
QuestionChoice
This answer is incorrect. Gastric cancer is more commonly associated with occult upper GI bleeding rather than severe haematemesis.
10007409
d
Gastric cancer
QuestionChoice
This answer is correct. This patient presents with an upper GI bleed which is most likely secondary to ruptured oesophageal varices. His examination findings and chronic excess alcohol intake point toward a diagnosis of chronic liver disease. Portal hypertension resulting from chronic liver disease causes the development of oesophageal varices which are friable and easily rupture, causing major haemorrhage.
10007406
a
Ruptured oesophageal varices
QuestionChoice
This answer is incorrect. A Mallory-Weiss tear is a superficial tear in the oesophageal lining which typically occurs after prolonged episodes of vomiting. This patient's examination findings and chronic excess alcohol intake make a diagnosis of ruptured oesophageal varices from chronic liver disease more likely.
10007408
c
Mallory-Weiss tear
Concept
Chapter
2693
4592
Variceal bleeding
Topic
136
Gastroenterology
14028
A 58-year-old man is brought into A&E by ambulance as he is projectile vomiting blood.

On examination, he is noted to have a distended abdomen and a yellow tinge to his skin. His partner discloses that drinks 1L of whisky a day, which he has done for the last 8 years.

Which of the following is the most likely underlying pathology?
a