GERD, peptic ulcers, gastritis, and stomach cancer Quiz: Ace Your Exams
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A 62-year-old woman presents to the emergency department with significant abdominal pain. The patient reports intermittent, worsening upper abdominal pain after eating. She initially saw her primary care physician when the symptoms began several months ago and had a negative work up that included a normal urea breath test, liver function tests, and lipase. Yesterday, the patient noticed that her stools were darker than normal, and she felt like she was going to faint at home. Past medical history is significant for rheumatoid arthritis, hypertension, and hyperthyroidism. Medications include naproxen, synthroid, and hydrochlorothiazide. Temperature is 37°C (98.6°F), pulse is 107/min, respirations are 17/min, and blood pressure is 100/82 mmHg. Physical examination shows tenderness to palpation in the epigastrium. Laboratory values are shown below:
Which of the following best summarizes the pathophysiology of this patient’s disease process?
| Laboratory value | Result |
| CBC, Serum | |
| Hemoglobin | 11.2 g/dL |
| Hematocrit | 33.6% |
| Leukocyte count | 12,100 /mm3 |
| Platelet count | 149,000/mm3 |
| MCV | 72 fL |
| RDW | 11.5-14.5% |
| Serum | |
| Sodium | 134 mEq/L |
| Potassium | 4.2 mEq/L |
| Chloride | 97 mEq/L |
| BUN | 40 mg/dL |
| Creatinine | 2.2 mg/dL |
| Albumin | 3.1 g/dL |
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