Ms. W. is a 55-year-old patient who
consulted her physician because of recurrent epigastric pain and
nausea and two recent episodes of vomiting, in which the emesis was
dark-colored and granular in appearance. Her history includes heavy
alcohol use, cigarette smoking, and persistent headaches. She has
not followed all her physician’s previous recommendations but has
been controlling her headaches by taking two aspirins every few
hours. Following tests, a bleeding gastric ulcer was diagnosed.
Discuss the factors contributing to Ms....