DDx of common gastric presenting complaints

Question 1

(4) Commonly Forgotten Causes of Vomiting

Answer 1

• Drugs
• Uremia
• CNS Disease
• Pregnancy

Question 2

(3) DDx of nausea/vomiting + abdo pain relieved by vomiting

Answer 2

• Gastric outlet obstruction
• Small bowel obstruction
• GERD (regurgitation more
  common)

Question 3

(5) DDx of nausea/vomiting + abdo pain NOT relieved by vomiting

Answer 3

• Gallbladder disease
• Pancreatitis
• Myocardial infarction
• Hepatitis
• Infectious gastroenteritis

Question 4

(4) DDx of nausea/vomiting + headache/dizziness

Answer 4

• Cerebral tumour
• Migraine
• Vestibular disease
• Increased ICP

Question 5

(6) DDx of nausea/vomiting + NO other symptoms

Answer 5

• Drugs
• Uremia
• Pregnancy
• Metabolic (e.g. hypercalcemia)
• Gastroparesis (e.g. diabetes)
• Ketoacidosis

Question 6

(5) DDx of mechanical (solids) dysphagia

Answer 6

• Peptic stricture/cancer
• Eosinophilic esophagitis
• Extrinsic compression
• Schatzki ring/esophageal web
• Zenker’s diverticulum

Question 7

(3) DDx of motility (solids & liquids) dysphagia

Answer 7

• Achalasia
• Diffuse esophageal spasm
• Scleroderma

Question 8

(3) DDx of odynophagia due to infection

Answer 8

• Candida
• Herpes
• CMV (common only in those who are immunosuppressed)

Question 9

(2) DDx of odynophagia due to inflammation/ulceration

Answer 9

• Caustic damage

- Eosinophilic esophagitis

Question 10

(5) Drugs that can cause odynophagia

Answer 10

• Quinidine
• Iron
• Vitamin C
• Antibiotics (e.g. tetracycline)
• Bisphosphonates

*note: radiation can also cause odynophagia

Question 11

(6) DDx of abdominal distension due to ascites

Answer 11

Portal HTN:

• Cirrhosis
• Cardiac failure
• Hepatic vein thrombosis

Normal portal pressure:

• Cancer (esp. ovarian)
• Pancreatitis
• TB