Upper GI bleeding: Mallory-Weiss tear: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Surgery · Upper GI bleeding: Mallory-Weiss tear

Sample item

A 35-year-old man vomits repeatedly after heavy drinking, and then brings up fresh blood. He is stable. Endoscopy shows a linear mucosal tear at the gastro-oesophageal junction. What is the usual course?

AEmergency oesophagectomyBImmediate transjugular intrahepatic portosystemic shuntCLifelong beta-blockadeDMost tears stop bleeding spontaneously and need only supportive care, with endoscopic therapy if bleeding persists

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Most tears stop bleeding spontaneously and need only supportive care, with endoscopic therapy if bleeding persists

A Mallory-Weiss tear is a longitudinal mucosal laceration at the gastro-oesophageal junction caused by a sudden rise in intra-abdominal pressure with retching. Bleeding stops spontaneously in most patients. Endoscopic clips, adrenaline injection or banding are used for active bleeding. Surgery is rarely required.

Option by option

A. Emergency oesophagectomy
Oesophagectomy is not indicated for a mucosal tear.
B. Immediate transjugular intrahepatic portosystemic shunt
TIPS is used for refractory variceal bleeding.
C. Lifelong beta-blockade
Beta-blockers are used for portal hypertension, not for this lesion.
D. Most tears stop bleeding spontaneously and need only supportive care, with endoscopic therapy if bleeding persists (correct)
Correct. Most stop on their own and persistent bleeding is treated endoscopically.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Most tears stop bleeding spontaneously and need only supportive care, with endoscopic therapy if bleeding persists. A Mallory-Weiss tear is a longitudinal mucosal laceration at the gastro-oesophageal junction caused by a sudden rise in intra-abdominal pressure with retching.

Why is "Emergency oesophagectomy" not the answer?

Oesophagectomy is not indicated for a mucosal tear.

Why is "Immediate transjugular intrahepatic portosystemic shunt" not the answer?

TIPS is used for refractory variceal bleeding.

Why is "Lifelong beta-blockade" not the answer?

Beta-blockers are used for portal hypertension, not for this lesion.

What concept does this question test?

It tests Upper GI bleeding: Mallory-Weiss tear in General Surgery. Bleeding stops spontaneously in most patients. Endoscopic clips, adrenaline injection or banding are used for active bleeding. Surgery is rarely required.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Upper GI bleeding: Mallory-Weiss tear?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.