Author: Molly Stewart / Editor: Sarah Edwards / Codes: GP6, RP3, SLO1, SLO2 / Published: 10/04/2025
A 24-year-old male presents following one episode of haematemesis. He has no past medical history but does drink ten cans of lager per day. He doesn’t report any abdominal pain, melaena or recent NSAID use.
Observations are as follows:
- Heart Rate 94 beats per minute – good radial volume
- Blood Pressure 136/72
- Respiratory Rate 18
- Oxygen saturations on room air 97%
- Temperature 36.6
On examination he looks pale and anxious. There is no melaena on PR examination and he has no abdominal tenderness.
Bloods, including full blood count and urea and electrolytes, are normal apart from a lactate of 4.1.
He has multiple episodes of witnessed haematemesis in the department and is referred to gastroenterology. He has ongoing haematemesis whilst awaiting gastroenterology and one episode of frank red blood seen mixed with clear sputum just prior to a vomiting episode. A chest x-ray is performed due to left midzone crepitations and wheeze heard on auscultation.
Exam Summary
0 of 3 Questions completed
Questions:
Information
You have already completed the exam before. Hence you can not start it again.
Exam is loading...
You must sign in or sign up to start the exam.
You must first complete the following:
Results
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- 2
- 3
- Current
- Review
- Answered
- Correct
- Incorrect
-
Question 1 of 3
1. Question
Image 1 via Radiopaedia
The chest x-ray is performed 4 hours after the first episode of vomiting and is shown. What is the most appropriate next step?
CorrectIncorrect -
Question 2 of 3
2. Question
Image 2 via Radiopaedia
The patient goes on to have a CT of the pulmonary arteries which is shown below. What is the most likely diagnosis?
CorrectIncorrect -
Question 3 of 3
3. Question
The patient is treated with Interventional Radiology embolisation. What further screening does this patient require after initial management? (Select all that apply)
CorrectIncorrect
Module Content
Related Posts
Pulmonary Embolism
Assessment and management of the patient presenting in the Emergency Department with a pulmonary embolism.
Pulmonary Hypertension
Pulmonary hypertension (PH) is an elevation in pulmonary vascular pressure that can be caused by an isolated increase in pulmonary arterial pressure.
Adult Cystic Fibrosis
Cystic Fibrosis is caused by a mutation in a gene that encodes cystic fibrosis transmembrane conductance regulator (CFTR) protein, which is expressed in many epithelial and blood cells.