National Physical Therapy Examination (NPTE) Practice Exam

What condition is most likely indicated by the presence of coffee-ground emesis in a patient taking heparin?

1. Diverticulitis

2. Gastroesophageal reflux

3. Peptic ulcer

4. Ulcerative colitis

The correct answer is: Peptic ulcer

The presence of coffee-ground emesis, which refers to vomiting material that resembles ground coffee, strongly suggests the presence of blood that has been digested in the stomach. In the context of a patient taking heparin, which is an anticoagulant that can increase the risk of gastrointestinal bleeding, peptic ulcer disease is the most likely condition indicated. Peptic ulcers can occur in the stomach or the duodenum and are often associated with the erosion of the gastric mucosa due to factors such as infection with Helicobacter pylori, the use of nonsteroidal anti-inflammatory drugs, and increased gastric acid secretion. When a peptic ulcer bleeds, the blood that enters the stomach can be partially digested, leading to the coffee-ground appearance of emesis. In this scenario, the use of heparin raises the concern for potential bleeding complications, making peptic ulcer disease a high-priority consideration for clinicians.