Chapter 72: Nausea and Vomiting

Question 1

Where is the vomiting center in brain?

Answer 1

Chemoreceptor trigger zone, located in the area postrema of the fourth ventricle

Question 2

Chronic nausea and vomiting is define as?

Answer 2

Symptoms of > 1month

Question 3

True or False

Pain preceding the nausea and vomiting is most particularly associated with an obstructive process

Answer 3

True

Pain preceding the nausea and vomiting is most particularly associated with an obstructive process

Question 4

Major risk factor for bowel obstruction?

Answer 4

Prior abdominal surgery

Question 5

It is an serotonin receptor antagonist that have been first0line therapy for undifferentiated nausea and vomiting in all age group

Answer 5

Ondansetron

Question 6

Safety advisory after giving Ondansetron?

Answer 6

QT prolongation

hypokalemia and hypomagnesemia

Question 7

Delayed gastric emptying in the absence of an obstruct- ing lesion

Answer 7

Gastroparesis

Question 8

Most common cause of gastroparesis?

Answer 8

Idiopathic

Question 9

Treatment for gastroparesis

Answer 9

Metoclopramide (dopamine antagonist, 5 to 20 milligrams) - 1st line
Erythromycin (motilin receptor agonist, 40 to 250 milligrams) - 2nd line due to tachyphylaxis

Question 10

Can treat symptoms of nausea, vomiting, and pain. May be administered IV or IM

Answer 10

Haloperidol 5mg IV

Question 11

Characteristic of cyclic vomiting syndrome?

Answer 11

• Predisposing mitochondrial DNA mutations
• Female > Male
• Hifher incidence of opiate and tobacco

Question 12

Is the standard for medical prophylaxis for cyclic vomiting syndrome and has shown response rates as high as 86%

Answer 12

Amitriptyline

Question 13

Mitochondrial-targeted therapies that showed excellent efficacy in combination with Amitriptyline and aline

Answer 13

• L-carnitine
• Coenzyme Q10
• Riboflavin