Which sign indicates NSAID-related bleeding?

• A. Bleeding gums, petechiae, and black stools
• B. Nausea only
• C. Headache
• D. Fever

Answer: (A)

NSAID-related bleeding shows up as actual bleeding signs, especially from mucosal surfaces and the GI tract. Bleeding gums, petechiae, and black stools indicate this kind of bleeding: bleeding gums and petechiae reflect abnormal bleeding tendency and mucosal or small-vessel bleeding, while black stools point to gastrointestinal bleeding (melena), which can occur with NSAID-induced gastric mucosal injury and ulceration. NSAIDs inhibit cyclooxygenase, reducing thromboxane A2 in platelets and impairing platelet aggregation, which raises bleeding risk. They can also irritate the gastric lining, increasing the chance of GI bleeding. By contrast, nausea, headache, or fever are not indicators of bleeding, even though they can accompany NSAID use.