Hematemesis occurs in which of the following disease ?

UPPSC 2022

Medical Surgical Nursing

Easy

Appeared in: UPPSC 2022

Explanation

Hematemesis is defined as the vomiting of blood, which signifies bleeding from an upper gastrointestinal (GI) source, specifically proximal to the ligament of Treitz.
Peptic ulcer disease involves the formation of sores in the lining of the stomach or duodenum (parts of the upper GI tract).
Bleeding from these ulcers is a common cause of upper GI hemorrhage, which presents clinically as hematemesis or melena.

Option A: Lung cancer is a respiratory disease. Bleeding originates in the lungs or airways and is coughed up, a sign known as hemoptysis.
Option B: The small intestine is largely considered part of the lower GI tract. Bleeding from this area would result in blood passing through the digestive system, presenting as melena (black, tarry stools) or hematochezia (fresh blood in stools), not hematemesis.
Option D: Lung tuberculosis (T.B.) is an infectious disease of the lungs. Damage to lung tissue can cause bleeding that is coughed up (hemoptysis), not vomited.

Clinical Relevance

Nursing practice connection: Knowing Differentiating sources of bleeding based on clinical presentation (respiratory vs. gastrointestinal) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Accurately identifying and describing the type of bleeding (hematemesis vs. hemoptysis) is a critical nursing assessment skill that directly informs the medical team about the potential location of the problem (GI tract vs. respiratory tract), guiding subsequent diagnostic tests.
A patient presenting with hematemesis requires immediate nursing assessment for signs of hemodynamic instability (e.g., tachycardia, hypotension, pallor) and preparation for potential emergency interventions like IV fluid resuscitation and upper GI endoscopy.
What if? If the patient described coughing up frothy, bright red blood instead of vomiting it, the nursing priority would immediately shift to a respiratory assessment. The suspected cause would change to conditions like Lung T.B. or Lung Cancer, and interventions would focus on airway management and respiratory support.

How to Approach the Question

First, define the key medical term in the question: 'Hematemesis' means the vomiting of blood.
Recognize that the act of vomiting originates from the stomach. Therefore, hematemesis indicates bleeding in the upper part of the gastrointestinal (GI) tract (esophagus, stomach, or duodenum).
Systematically evaluate each option based on the anatomical location of the disease.
Eliminate 'Lung Cancer' and 'Lung T.B.' because they are respiratory diseases. Bleeding from the lungs is coughed up (hemoptysis), not vomited.
Eliminate 'Small Intestinal T.B.' because the small intestine is part of the lower GI tract. Bleeding from this far down would be digested and appear in the stool (as melena or hematochezia).
Identify 'Peptic Ulcer' as the correct answer because ulcers in the stomach or duodenum are a classic cause of upper GI bleeding, leading to hematemesis.

Concept Tested & Keywords

Concept Tested: Differentiating sources of bleeding based on clinical presentation (respiratory vs. gastrointestinal).
Stem keywords: Hematemesis, disease
Lead-in keywords: occurs in

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