Question

Our case patient is a IVDA (high risk for HCV) and alcoholic with jaundice and distended abdomen on exam; he is a high risk patient for chronic liver disease, likely cirrhosis. He's presenting with hematemesis and hemodynamic instability, suggestive of acute significant UGIB. This patient likely has variceal hemorr

A. can cause acute UGIB, however patient's social history and abdominal exam finding makes variceal hemorrhage more likely
B. can also cause acute UGIB but choice C is more likely for same reason as above
C. is incorrect as erosion doesn't cause acute UGIB to the degree as in this case
D. Choice D can also cause acute UGIB, however to the degree as in this case (hemodynamic instability) would be unusual, mus tbe coughing a lot)

Answer 1

The patient's high risk for chronic liver disease, likely cirrhosis, and presentation of jaundice, a distended abdomen, hematemesis, and hemodynamic instability suggest variceal hemorrhage as the cause of the acute upper gastrointestinal bleeding (UGIB).

Step-by-step explanation:

In this case, the patient is a high risk for chronic liver disease, likely cirrhosis, due to alcoholism and intravenous drug abuse (IVDA). The patient presents with jaundice, a distended abdomen, and hematemesis, which are suggestive of acute significant upper gastrointestinal bleeding (UGIB). Given the patient's social history and abdominal exam finding, variceal hemorrhage is more likely as the cause of the acute UGIB.