Question: You are worried about this patient especially with the above vital signs so you initiate rapid transportation to the hospital. Imagine a similar patient as above but with the following additional historical details: If you had a similar patient to the presentation in the preceding questions but they endorsed a 2 day history of hematemesis and melena. What additional detail in the patient's history or exam would make you much more concerned about esophageal varices as the source of bleeding? History of peptic ulcers Epigastric pain Jaundice History of recent abdominal surgery