GERD and Peptic Ulcer Disease USMLE Step 1 Practice Question
A 54-year-old man with 20-year history of alcohol use disorder presents with massive hematemesis. Vital signs show BP 92/58, HR 118, RR 22, temp 37.2°C. Laboratory studies reveal hemoglobin 7.2 g/dL and elevated AST/ALT ratio. Upper endoscopy demonstrates dilated tortuous veins in the distal esophagus with recent bleeding. Abdominal examination reveals no acute distension. Which portosystemic venous connection is responsible for development of these esophageal lesions?
Answer choices
- AInferior mesenteric vein to gonadal vein
- BSplenic vein to left renal vein
- CParaumbilical veins to superficial epigastric veins
- DLeft gastric vein to esophageal veinsCorrect answer
- ESuperior rectal vein to middle rectal vein
- FRight gastric vein to gastroduodenal vein
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