GERD and Peptic Ulcer Disease USMLE Step 1 Practice Question
A 44-year-old man with a history of GERD not on medication develops sudden severe chest pain radiating to the back after repeated violent retching and vomiting. Vital signs show temperature 38.9°C, heart rate 118/min, blood pressure 142/88 mmHg, and respiratory rate 24/min. Physical examination reveals subcutaneous crepitus over the neck and left shoulder. Chest X-ray demonstrates pneumomediastinum with air tracking along mediastinal structures. Esophageal perforation is suspected. Which diagnosis best explains these findings?
Answer choices
- AMallory-Weiss syndrome
- BPulmonary embolism
- CAortic dissection
- DAcute myocardial infarction
- EBoerhaave syndromeCorrect answer
- FSpontaneous pneumomediastinum
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