Answer 26

26.  Choice D is the correct answer.  It is usual for healthy 21 year olds to develop varices.  With bleeding varices there tends to be no preceding non bilious emesis.  AV malformation would just likely start bleeding also.  Mallory Weiss tears typically have several episodes of non bilious emesis that precede the bright red emesis.  Endoscopy there is longitudinal mucosal lacerations in the distal esophagus and proximal stomach caused by retching.