 Mallory Weiss-Tair versus Borhov syndrome. Hey guys, I'm Boris. I'm a physician assistant. This is gonna be day three of 30 days of PANTS review. Physician assistant, national certifying exam, PANTS, whereas some people like to say PANTS-C, PANTS review every day for the next 30 days. So let's choose another no-card at random. I guess I just did for my gigantic stack of no-cards here that I personally use to study for the PANTS. And this question is going to be, give me the differences between a Mallory Weiss-Tair and Borhaves or Borhov's syndrome. So Mallory Weiss-Tair versus Borhov syndrome. I'm gonna shut up for five seconds and let you think of an answer. Okay, I hope that was five seconds. So Mallory Weiss-Tair. So these are both esophageal tears, okay? Tears in the wall of the esophagus. Mallory Weiss and Borhovs are both esophageal tears. Mallory Weiss-Tairs are partial thickness, whereas Borhovs are full thickness. That's the main difference. Partial thickness versus full thickness. So a little bit of bleeding versus a lot of bleeding, okay? Partial thickness-Tair, Mallory Weiss, full thickness-Tair Borhovs. Also, differences usually in how you get these things. So a Mallory Weiss-Tair is usually due to retching and or vomiting. So the classic presentation, which you might get in a test or on the pants, is gonna be, I don't know, 28 year old person, 28 year old male, was at a bachelor party, had too much to drink, mixed too many different kinds of liquor, and spent the entire night retching. And now he's coming to you with blood in his vomit and some pain in his chest, okay? So usually from retching, vomiting, that's where you'll get your Mallory Weiss-Tair. And even on my note card here, I have the classic presentation as a patient drank too much alcohol, spent the night vomiting, and now has hemoptysis, he metemesis, they're either coughing or vomiting up some blood. And again, don't forget, a Mallory Weiss-Tair is a partial-Tair in the wall of the esophagus. A Borhovs-Tair, Borhovs syndrome, is, excuse me, it's a full thickness esophageal-Tair usually due to an EGD. Forget what the heck EGD stands for, but it's an upper scope where they stick a camera down your throat to check out your stomach and esophagus and whatnot. So it's actually usually iatrogenic, iatrogenic means caused by a healthcare provider. So it's a disease caused by a healthcare procedure or treatment or of some sort. So iatrogenic means that people like me, people like us healthcare providers gave you this problem. So Borhovs is usually iatrogenic with an EGD. So they're doing this scope, this camera down the throat and they pierce the esophagus all the way through. It's a full thickness-Tair. And the way this presents is a lot of pain, hemoptysis, you're coughing up blood, coffee grounds emesis because so much blood is going down the esophagus that's bleeding so much and the blood is going down the esophagus, you're swallowing it and then it's getting digested and then it comes back up as black kind of coffee grounds emesis because it's blood that's already been digested by the stomach and now on its way back up the other way up the esophagus. Also hematocasia, melanin, so either purple or kind of dark black stools, not bright red blood in the stool, that's a lower GI bleed, this is an upper GI bleed. Remember, this is an upper GI bleed so it's gonna be dark stools or purple stools, usually kind of dark black, not bright red, okay? Bright red is gonna be in the vomit, so hematemesis. So one more last time, what is the difference between a Mallory Weiss-Tair and a Borhovs syndrome? Mallory Weiss-Tair is a partial thickness-Tair of the esophagus, Borhovs syndrome is a full-Tair of the wall of the esophagus, full thickness. Mallory Weiss, usually the presentation is due to too much alcohol, throwing up, retching, vomiting all night and now you got some blood in your vomit slash you're coughing up some blood plus probably some pain up here. Borhovs, it's usually itrogenic, usually caused by an EGD, a procedure where we put the camera down the throat and it's usually due to a mistake during one of those procedure, it pierces the esophagus and you get a lot of pain, it's much more painful than a Mallory Weiss-Tair. Hemoptysis, you're coughing up blood just like a Mallory Weiss-Tair, coffee grounds emesis, usually Borhovs versus Mallory Weiss, you'll get coffee grounds emesis, melanin, hematokesia, so black or bloody stools, black or bloody vomit is gonna be Borhovs. So they both could have hemoptysis, hematomesis, coughing or vomiting up blood but there is just gonna be more of it in Borhovs syndrome and you're more likely to have the coffee ground emesis, the melanin and the hematokesia in Borhovs versus Mallory Weiss-Tair. See you guys in the next video, peace.