GERD and Peptic Ulcer Disease USMLE Step 1 Practice Question
A 58-year-old man presents to the emergency department with severe chest pain following repeated forceful vomiting after heavy alcohol intake. Vital signs show temperature 38.5°C, heart rate 128/min, blood pressure 92/58 mmHg, respiratory rate 22/min, and SpO2 92% on room air. Subcutaneous crepitus is noted over the neck and chest. Chest X-ray reveals pneumomediastinum. He denies dysphagia. Which of the following is the most likely diagnosis?
Answer choices
- AAcute coronary syndrome
- BAchalasia
- CSliding hiatal hernia
- DBoerhaave syndromeCorrect answer
- EMallory-Weiss tear
- FIatrogenic esophageal perforation
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