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	<owl:Ontology rdf:about="https://www.wikidoc.org/index.php/Special:ExportRDF/WBR0809">
		<swivt:creationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2026-07-31T07:49:25+00:00</swivt:creationDate>
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		<rdfs:label>WBR0809</rdfs:label>
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		<property:AnswerA rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Transmural rupture of the esophagus wall.</property:AnswerA>
		<property:AnswerAExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Boerhaave syndrome is characterized by the transmural rupture of the esophagus wall. Boerhaave syndrome is considered an emergency with a high mortality rate.</property:AnswerAExp>
		<property:AnswerB rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Basal cell hyperplasia, papillary elongation, and inflammatory cell infiltrate in the distal esophagus</property:AnswerB>
		<property:AnswerBExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Gastroesophageal reflux disease (GERD) is characterized by basal cell hyperplasia, papillary elongation, and inflammatory cell infiltrate in the distal esophagus.</property:AnswerBExp>
		<property:AnswerC rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Increase in portal blood flow with venous congestion at the level of the esophagus</property:AnswerC>
		<property:AnswerCExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Variceal bleeding is caused by portal hypertension commonly due to advanced liver disease.  It is characterized by an increase in portal blood flow with venous congestion that eventually causes painless upper GI  bleeding.</property:AnswerCExp>
		<property:AnswerD rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Longitudinal mucosal lacerations in the gastric cardia</property:AnswerD>
		<property:AnswerDExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Mallory-Weiss syndrome is characterized by the longitudinal mucosal lacerations in the gastric cardia.</property:AnswerDExp>
		<property:AnswerE rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pseudohyphae and budding spores in the esophageal squamous debris</property:AnswerE>
		<property:AnswerEExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Candida esophagitis is characterized by pseudohyphae and budding spores in the esophageal squamous debris.</property:AnswerEExp>
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		<property:Explanation rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Mallory-Weiss syndrome (MWS) is a frequent cause of hematemesis. It is characterized by upper GI bleeding due to the longitudinal mucosal laceration of the distal part of the esophagus or the proximal part of the stomach, the gastric cardia, that causes hematemesis following a submucosal arterial bleed.  MWS is commonly caused by violent vomiting and retching in alcoholics and bulimics that cause an increase in intra-abdominal pressure, which is strong enough to cause the gastric cardia to protrude into the thoracic cavity through the hiatus and cause a longitudinal laceration. MWS tear accounts for approximately 15% of all cases of upper GI bleeding. Blood is classically arterial in origin and is bright red. The presentation of patients can vary from one episode of hematemesis to hypotension and progressive shock. depending on the extent of bleeding. Initial management is supportive as the majority of these tears resolve without intervention. Endoscopic ligation is reserved for patients with prolonged bleeding.&lt;br/&gt;
'''Educational Objective:''' Mallory-Weiss syndrome (WMS) is characterized by the longitudinal laceration in the distal esophagus or the gastric cardia.  It is a common cause of hematemesis in alcoholics and bulimics.&lt;br/&gt;
'''References:''' Morales P, Baum A. Therapeutic alternatives for the Mallory-Weiss tear. Curr Treat Options Gastroenterol. 2003;6(1):75-83.</property:Explanation>
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		<property:Prompt rdf:datatype="http://www.w3.org/2001/XMLSchema#string">A 42-year-old patient presents to the emergency department with painful episodes bright red blood-tinged vomiting.  Upon questioning, the patient denies any past medical or surgical history, intake of any medications, or any allergies. He explains that his symptoms began after an initial episode of violent retching he attributed to recent binge drinking.  The patient's vital signs are stable and his physical examination is unremarkable.  Following initial work-up, the patient undergoes endoscopy.  Which of the following best characterizes the pathological process responsible for this patient's hematemesis?</property:Prompt>
		<property:RightAnswer rdf:datatype="http://www.w3.org/2001/XMLSchema#string">D</property:RightAnswer>
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		<property:WBRKeyword rdf:resource="&wiki;Transmural_tear"/>
		<swivt:wikiPageModificationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2020-10-28T01:46:18Z</swivt:wikiPageModificationDate>
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