A 46-years-old male who is a security guard by profession presented with the complaints of general weakness, one episode of epistaxis, one episode of coffee ground colored vomiting, progressive weakness, chills and increased sleeping time for 2 days. History of present illness – Patient had history of gradual onset of on and off epigastric pain with nausea and vomiting, progressive weakness and muscle pain for 1 month. Past medical history – Hypertension for 20 years. Past medication history - Metoprolol Social history – Smoker of 50 pack years.
The patient also used to drink alcohol. Nutritional and dietary history – Patient has no preferred food choices. But due to his job as a security guard, he wakes up early in the morning eating a cup of noodles and fried foods. Physical examination – Pale conjunctivae, pail nailbeds, blackish discoloration over posterior part of the tongue and a…
