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What does melena indicate?

  1. Black stools

  2. Paresthesia

  3. Air under the skin

  4. Shock symptoms

The correct answer is: Black stools

Melena refers specifically to the presence of black, tarry stools, which indicate gastrointestinal bleeding that has occurred further up in the digestive tract, typically in the esophagus, stomach, or the first part of the small intestine. The dark color results from the digestion of blood as it moves through the intestines, undergoing various chemical changes. This condition often suggests a serious underlying issue, such as a bleeding ulcer or a serious gastrointestinal condition, and it requires prompt medical evaluation and intervention. The other choices describe different medical phenomena: paresthesia refers to abnormal sensations such as tingling or numbness, air under the skin is a sign of subcutaneous emphysema, and shock symptoms encompass a range of signs indicating inadequate blood flow and oxygen delivery to tissues, but none of these directly pertain to the specific condition represented by melena. Understanding the clear association between black stools and internal bleeding is crucial for any EMT in assessing and prioritizing patient care.