The question number 121 in the document is:
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**Question 121**
A 45-year-old male patient presented to the ER with repeated vomiting and hematemesis. His past medical history is unremarkable. His labs are remarkable for mild anemia and elevated urea levels. What is the most likely diagnosis?
A. Esophageal varices
B. Mallory-Weiss tear
C. Erosive gastritis
D. Peptic ulcer disease
E. Gastroesophageal reflux disease (GERD)
**Answer:** B (Mallory-Weiss tear)
**Explanation:** The patient's presentation of repeated vomiting and hematemesis, along with mild anemia and elevated urea levels, is consistent with a Mallory-Weiss tear, which is a mucosal laceration at the gastroesophageal junction usually caused by severe vomiting or retching.
**Specialty:** Gastroenterology