History and examination in patient with vomiting Flashcards
What is the definition of vomiting
Involuntary forcefull expulsion of stomach contents through the mouth
Organized automic response
What is the definition of nausea
A feeling of sickness with an inclination to vomit.
What is the pathophysiology of vomiting
Stimulated by the vomiting center located in the medulla oblongata
Induces a vomiting response
The lower oesophageal sphincter relaxes
What stimulates the vomiting center
Gastrointestinal system
Vestibular system
Higher cortical areas
What are common causes for vomiting
CNS - head injury, elevated ICP
GI- Infectious and non-infectious
Vestibular - Acute otitis media, BPPV, motion sickness
Medications - Antibiotics, chemotherapy, ethanol overdose
Metabolic - DKA, adrenal disorders, uremia, hyponetreamia, hypercalcemia
Psychiatric disorders - anorexia nervossa, pannic attack
Miscellaneous - pain, pregnancy, MI
What is the 3 step history approach in vomiting
1 - Attempt
What is the difference between:
- Vomiting
- Regurgitation
- Rumination
What causes do the following timing of symptoms indicate
What causes does the following nature of vomited matter indicate
What causes do the following abdominal pain indicate
What causes do the following associated symptoms indicate
What are the common signs found on the physical exam
Signs of dehydration
Hypotension
Orthostatic changes
Look for jaundice
Lymphadenopathy
Fingers - calluses on dorsal aspect
Loss of tooth enamel
Evaluate for signs of anxiety/depression
What is important to look for during abdominal inspection
