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A 69 y/o woman is brought to the emergency room because of a complaint of feeling increasingly dizzy over the last 24hrs. She reports that she has noted dark stools for the last 3 days which earlier today became black and increasingly foul smelling. She has a history of hypertension for which she has been treted with a diuretic, and a history of naproxen sodium. Her family history is significant for two brothers who died of myocardial infarction and her father who died of colon cancer. Which of the following is the most likely cause of this patient's bleeding?
A. Increased gastric acid secretion
B. Impaired prostaglandin synthesis
C. Neoplastic change of the gastric mucosa
D. Increased portal pressure
E. Acute Helicobacter infection

d...isnt it?

I would go with B

colon cancer may have metastasis to liver which can lead to increased portal pressure in future.it can itself present with bleeding

this pt has upper GI :this is bleeding due to peptic ulcer
i will go with the most common
A. Increased gastric acid secretion

b.

sorry
this pt has upper GI :this is bleeding due to peptic ulcer
i will go with the most common PUD and in this case due to Naproxen which is
B. Impaired prostaglandin synthesis

B.

Pt has a pretty acute presentation, symptoms of inc portal vein pressure must be obvious in M. cancer( Ascite, neck vein...) .so, B. Gastric bleeding due to NSAIDs ( Naproxen)

B?