Mallory-Weiss syndrome Quiz: Ace Your Exams
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A 24-year-old man presents to the emergency department after experiencing forceful vomiting and retching numerous times over the past six hours. He saw blood in the last vomitus. Temperature is 36.4°C (97.5°F), pulse is 95/min, blood pressure is 155/92 mmHg, and respirations are 22/min. The patient appears comfortable. He is awake and oriented. Cardiopulmonary examination is normal. Abdominal examination reveals no hepatomegaly or fluid wave. There is no peripheral edema. Blood work is obtained, and results are shown below. Which of the following additional historical features is most likely to be present?
| Laboratory Value | Result | Reference range |
| Leukocyte count | 13,500/mm3 | 4,500-11,000/mm3 |
| Hemoglobin | 15.2 g/dL | 13.5-17.5 g/dL |
| Sodium | 132 mEq/L | 136-146 mEq/L |
| Potassium | 3.2 mEq/L | 3.5-5 mEq/L |
| Bicarbonate | 27 mEq/L | 22-28 mEq/L |
| AST | 28 U/L | 8-40 U/L |
| Alkaline phosphatase | 57 U/L | 20-70 U/L |
| Total bilirubin | 1.0 mg/dL | 0.1-1 mg/dL |
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