Emergency Medical Technician (EMT) Intermediate Practice Exam

A 67-year-old male complains of a burning sensation in his abdomen and hematemesis. During your assessment, you note pain to palpation of his left upper quadrant; his vital signs are suggestive of shock. Which of the following conditions should you suspect?

1. Bleeding peptic ulcer

2. Pancreatitis

3. Myocardial infarction

4. Gastritis

The correct answer is: Bleeding peptic ulcer

The presentation of a burning sensation in the abdomen combined with hematemesis (vomiting blood) is highly suggestive of a bleeding peptic ulcer. Peptic ulcers typically result from the erosion of the stomach lining or the first part of the small intestine due to the action of stomach acids, often exacerbated by factors like NSAID use or H. pylori infection. The left upper quadrant pain further aligns with this condition, as bleeding due to an ulcer can lead to referred pain or discomfort in this area. In addition, the vital signs indicating shock suggest significant blood loss or internal bleeding, which commonly accompanies severe peptic ulcer disease if it progresses to a bleeding episode. The presence of hematemesis is particularly critical; this symptom indicates that there is bleeding in the upper gastrointestinal tract, often associated with ulcers. While other conditions might also cause abdominal pain and similar symptoms, the specific combination of hematemesis, left upper quadrant pain, and signs of shock distinctly point toward a bleeding peptic ulcer as the most probable diagnosis.