A 63-year-old man with haematemesis and melaena
A branching clinical case simulation for a patient presenting with haematemesis and melaena. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 4medium20 min5 stages
- Patient
- 63 years, male
- Presenting complaint
- Haematemesis and melaena
- Decision stages
- History, Examination, Investigations, Treatment, Monitoring
The presentation
You are a fourth-year medical student in the emergency department of a district general hospital. A 63-year-old man has just been brought in by ambulance with two episodes of vomiting fresh blood and three days of black, tarry stools. He looks pale, sweaty, and is distressed. Your task is to assess and manage him. Please choose the most appropriate actions at each stage.
What this case teaches
Resuscitate with fluids and blood by targets; risk-score with Glasgow-Blatchford; hold and reverse the culprit drugs appropriately; time endoscopy; know when a proton pump inhibitor helps.
How the case unfolds
- 1Initial HistoryHistory
- 2Focused ExaminationExamination
- 3Investigations and Risk StratificationInvestigations
- 4Initial Resuscitation and ManagementTreatment
- 5Monitoring and Ongoing CareMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
Log in to run "A 63-year-old man with haematemesis and melaena"
A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.