A 47-Year-Old Man Comes to the Emergency Department After an Episode

question 306

Multiple Choice

A 47-year-old man comes to the emergency department after an episode of coffee ground emesis.  He has had upper abdominal discomfort for several months, which he describes as "burning and fullness" that is relieved by food.  Over the last week the patient has had black, tarry stools associated with weakness and fatigue.  His medical history is unremarkable.  He takes no prescription or over-the-counter medications.  The patient smokes a pack of cigarettes a day and occasionally drinks alcohol.  His blood pressure is 124/82 mm Hg while supine and 110/70 mm Hg while standing.  Pulse is 102/min.  On examination, the conjunctivae and palmar creases appear pale.  Abdominal examination is unremarkable.  Which of the following is most likely increased in this patient?

• A)Aldosterone/renin ratio
• B)Alkaline phosphatase
• C)Blood urea nitrogen/creatinine ratio
• D)Prothrombin time
• E)Urine sodium excretion

---

Definitions:

Norms And Procedures

Established guidelines and methods of operation within an organization or society that dictate expected behavior and actions.

External Party

An individual or group outside of an organization that interacts or has a relationship with it.

Resistance To Change

Opposition or reluctance to adapt to new conditions, innovations, or transformations.

Hierarchical Structure

An organizational setup where each level controls the level below, creating a pyramid-shaped system of control and authority.