Mr. Chandran, aged 52, was admitted to your ward for hematemesis. He had two episodes of severe epigastric pain for the past 3 days before this current admission. He verbalized a history of eating irregular meals due to frequent meetings with clients at work. This morning, Mr. Chandran vomited a cupful of bright red blood and felt weak and giddy. 

Alert and conscious but complains of fatigue and weakness. His skin is cold and pale looking

Temp 36.5 C, PR 109/min, RR 25/min, BP 92/65mmHg, SpO2 93% (room air),

He also noticed that he passed smelly black sticky stools yesterday evening.

Current medication: PO Aspirin 100mg OM, Plavix, Atenolol 50mg.

Family History: Father: Peptic Ulcer Disease; Mother: MI, passed away; One sibling: Hypertension. 

Social history: Mr. Chandran works as a lawyer at a law firm. He is married with three children who are studying in the university and junior college. His wife is a teacher in a primary school. He smokes one packet of cigarettes per day. He claims smoking relieves him of his stress. He verbalized that he drinks 1 can of beer every night to help him sleep better.

Alert and conscious but complains of fatigue and weakness. His skin is cold and pale looking

Temp 36.5 C, PR 109/min, RR 25/min, BP 92/65mmHg, SpO2 93% (room air),

 Abdomen: Tenderness felt on deep palpation at epigastric region

Bowel sounds: +

Per rectal examination: stale melena but no mass felt

He also noticed that he passed smelly black sticky stools yesterday evening.