Author: Prasanth Ravinthiran / Editor: Sarah Edwards / Codes: CP1, RP1, SLO1, SuC15, SuP7 / Published: 10/08/2023
A 47-year-old man presents to the Emergency Department (ED) complaining of Epigastric discomfort since last 8 hours that is radiating to upper back which is preceded by three episodes of vomiting. He also tells you he is having a change in voice for few hours.
He denies any chest pain, speech or visual disturbances, hematemesis, syncope, breathing difficulty, or anything else out of the ordinary.

He has no other past medical history. He has undergone haemorrhoidectomy surgery two months before.
His initial observations are:
- Heart rate – 92 beats per minute
- Blood pressure – 120/90mmHg (right arm)
- Respiratory rate – 16 per minute
- SpO2 – 98% on air
- Temperature – 99.6 F
On examination patient had diffuse neck swelling which extends to bilateral parotid region which had crackling sensation on palpation. Clinical examination is otherwise unremarkable.
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
Which of the following is the most likely diagnosis in this case?
CorrectIncorrect -
Question 2 of 3
2. Question
What is the best early physical sign/finding to suspect a Boerhaave’s syndrome after multiple episodes of vomiting?
CorrectIncorrect -
Question 3 of 3
3. Question
Which of the following is indicated as a best test in this condition?
CorrectIncorrect
Module Content
Related Posts
Chest Pain Syndromes
Chest pain is caused by a spectrum of pathology ranging from the innocent to the extremely serious.
Neonatal Nuggets Part 2: tummy troubles
This session will explore common neonatal presentations that could be safely discharged from the ED without necessarily involving the on-call paediatric team.
TERN Christmas Cases 2022
HO HO HO! Merry Christmas! TERN Education is Back! We have picked our way through 1196 case reports from the last twelve months to bring you 12 fascinating ED cases, each with a festive theme.
2 responses
Interesting , thank you.
Great learning