Peptic ulcer disease is the most common cause of iron deficiency anemia in (age and sex)
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 52-year-old man comes to the emergency department because of severe abdominal pain. He has felt this pain for months, but it has become intolerable over the last 7 hours. He has a history of gastroesophageal reflux disease (GERD), hypertension, and diabetes. He says that eating exacerbates the pain. He thought he was just having some indigestion and would take some antacids for relief. However, since the pain worsened, he is now having trouble moving. His temperature is 39.1°C (102.5°F), pulse is 115/min, and blood pressure is 135/75 mm Hg. He appears to be in severe distress, secondary to pain, and refuses to straighten his legs because it hurts too much. He has diffuse guarding and rebound tenderness. An upright chest radiograph shows free air under the right diaphragm. Which of the following is the most likely cause of the patient’s symptoms?