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Question: A 28-year-old woman is rushed to the emergency department because of diffuse abdominal pain, tachycardia, and tachypnea. She says that the pain began suddenly and has worsened. She has a history of smoking cigarettes, binging on alcohol, and taking relatively large doses of nonsteroidal anti-inflammatory drugs (NSAIDs). She has a past medical history of a duodenal ulcer. Physical examination shows diffuse abdominal tenderness and rebound tenderness. An X-ray is ordered which shows free gas under the diaphragm. Which of the following is the most appropriate next step in the management of this patient?
1) prescribe proton pump inhibitors, prescribe metronidazole, request a surgery consult, prescribe IV H2 blockers
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