This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
[{'content': 'A 26-year-old women in the first trimester of pregnancy has been admitted with retching and repeated vomiting with large hematemesis. Her pulse rate is 126/minute and blood pressure is 80 mm Hg systolic. The most likely diagnosis is: \nSelect and explain. \nA. Mallory-Weiss syndrome, B. Bleeding from oesophageal varices, C. Peptic ulcer, D. Hiatus hernia', 'role': 'user'}, {'content': "Answer: A \nExplanation: Upper gastrointestinal bleeding:\n“Occasionally, persistent vomiting may be accompanied by worrisome upper gastrointestinal bleeding. The obvious concern is that there is a bleeding peptic ulceration, however, most of these women have minute linear mucosal tears near the gastroesophageal junction. Women with these co called Mallory-Weiss tears usually respond promptly to conservative measures.”\nRef. Williams 23/e, p 1053\nWith persistent retching the less common but more serious oesophageal rupture – ‘Boerhaave syndrome'\xa0may develop.", 'role': 'assistant'}]