A 54-Year-Old Man Comes to the Emergency Department After Vomiting

question 27

Multiple Choice

A 54-year-old man comes to the emergency department after vomiting blood.  He has also had melena, fatigue, and lethargy over the last 24 hours.  The patient emigrated from sub-Saharan Africa 20 years ago and occasionally returns to visit friends and family.  Temperature is 37.5 C (99.5 F) , blood pressure is 90/60 mm Hg, and pulse is 115/min.  Abdominal palpation reveals an enlarged liver and a spleen tip below the level of the umbilicus.  Laboratory results are as follows: Upper endoscopy reveals bleeding esophageal varices.  Which of the following is the most likely underlying cause of this patient's symptoms?

• A)Cysticercosis
• B)Hookworm infection
• C)Malaria
• D)Schistosomiasis
• E)Toxoplasmosis

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Definitions:

Appearance

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Audience's Attitudes

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Reader's Expectations

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Planning Stage

An initial phase in a project or process where objectives are defined, and strategies are developed to achieve them.