This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Trauma, Subject name: Surgery
[{'content': 'A 50 yr old male presented with history of hematemesis - 500 ml of blood and on examination shows BP - 90/60, PR -110/min and splenomegaly 5 cm below lower costal margin. Most probable diagnosis is \nSelect and explain. \nA. Mallory Weiss tear, B. Duodenal ulcer, C. Gastritis, D. Portal hypertension', 'role': 'user'}, {'content': "Answer: D \nExplanation: Ans. is 'd' i.e. Portal hypertension Causes of Hematemesis (in decreasing order)Peptic ulcerDuodenal ulcer (Most common cause)Gastric ulcerEsophageal varices (portal hypertension)Mallory Weiss tearGastroduodenal erosionsErosive esophagitisNeoplasm of esophagus, stomach & duodenum.Vascular ectasias Here in this patient, splenomegaly is suggestive of portal hypertension.Mallory-Weiss tear is suggested if the patient presents in the classic pattern - initially vomiting is without blood, after retching and vomiting with epigastric pain, hematemesis occurs.Gastritis is usually associated with history of intake of NSAIDS, alcohol, corticosteroids and oral potassium supplements.", 'role': 'assistant'}]