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* Mallory-Weiss syndrome
 #133656  
  bijjar - 10/29/06 22:08
 
  Mallory-Weiss syndrome is one of the recognized causes of acute upper gastrointestinal (GI) bleeding. It occurs as a longitudinal tear or breakdown in the mucosa of the distal esophagus or proximal stomach. Most patients have a history of retching or vomiting prior to the onset of upper GI bleeding. The syndrome is usually associated with conditions causing a sudden and repeated rise in intraabdominal pressure. Some common precipitating factors include repeated retching or vomiting, straining at defecation, frequent coughing, and hiccups. Advancing age, history of heavy alcohol abuse, and the presence of hiatal hernia also predispose the patient to the development of Mallory-Weiss tears.
The hematemesis is usually mild and self-limited, and most lesions will heal with conservative therapy. Proton-pump inhibitors are given to all patients to prevent further damage and to promote healing.
Which of the following is the most appropriate next step in management of Mallory-Weiss syndrome ?

A. Observation in the hospital for 48 hours

B. Obtaining a stat PA and lateral chest x-ray

C. Prepare the pt for emergent surgery

D. Prepare the patient for an upper GI endoscopy

E. Obtaining a CT scan of the chest
 
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* Re:Mallory-Weiss syndrome
#534693
  logic - 10/29/06 22:29
 
  if MWS is formal diagnose than do Upper gi endo to confirm it, if already done than just observe in the hosp.  
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* Re:Mallory-Weiss syndrome
#534809
  ss - 10/30/06 00:15
 
  B. Obtaining a stat PA and lateral chest x-ray
 
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* Re:Mallory-Weiss syndrome
#535121
  union_station - 10/30/06 09:22
 
  d.  
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* Re:Mallory-Weiss syndrome
#535367
  drzx - 10/30/06 11:05
 
  despite the significant clues in the history a tear only in mucosa as a source of bleeding cannot be confirmed unless an endoscopy is done therefore it is D  
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* Re:Mallory-Weiss syndrome
#535391
  img2007 - 10/30/06 11:15
 
  its b,theres no need to confirm the dx as it is alreday mentioned in the scenario.  
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* Re:Mallory-Weiss syndrome
#535500
  3stepstomle - 10/30/06 11:53
 
  d upper gi endoscope sometimes bleeding can be severe that only treatment possible will be endoscopic.  
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* Re:Mallory-Weiss syndrome
#536178
  erythro - 10/30/06 16:35
 
  d..  
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* Re:Mallory-Weiss syndrome
#536776
  depdoc - 10/30/06 22:15
 
  d.  
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* Re:Mallory-Weiss syndrome
#537312
  medicos - 10/31/06 10:04
 
  a.  
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* Re:Mallory-Weiss syndrome
#537420
  yas - 10/31/06 10:42
 
  agree D final ans.  
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