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Year 3 Conditions > Nausea and vomiting > Flashcards

Nausea and vomiting Flashcards

1
Q

Whata re 4 things to think about as causes of N&V

A

Problems in the brain
Problems with heart and abdomen
Vertigo
Things in the blood

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2
Q

What does undigested food suggest about N&V

A

Oesophageal disorder- achalasia, pharyngeal pouch

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3
Q

What does slightly digested food suggest about cause of N&V

A

Gastric outflow obstruction- cancer, pyloric, stenosis and pancreatic pseudocyst
Gastroparesis

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4
Q

What is gastroparesis

A

Delayed gastric emptying

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5
Q

Who is gastroparesis seen in

A

Diabetics

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6
Q

What does bilous vomit suggest about cause

A

Bowel obstruction distal to ampulla of vater

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7
Q

What 2 things can cause feculent vomit

A

Distal bowel obstruction

Gastrocolonic fistula

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8
Q

Why is timing of vomit relevant

A

In morning suggests raised ICP

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9
Q

What does vomiting within an hour of eating suggest about cause of N&V

A

Obstruction proximal to gastric outlet

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10
Q

Why is peptic ulcer history relevant in N&V history

A

Can lead to scarring and ultimatly pyloric stenosis

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11
Q

What does vomiting a long time after eating suggest about cause of N&V

A

Small bowel obstruction

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12
Q

What symptoms tend to present with gastroparesis and gastric outflow obstruction

A

Early satiety
Bloating
Abdo discomfort

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13
Q

What does early satiety suggest about vomiting cause

A

Gastric outflow obstruction

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14
Q

What does fever suggest with nausea and vomiting cause

A

Any inflammation or infection of abdo organ

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15
Q

Why is focal neurology relevant with nausea and vomiting

A

Migraine
Meningitis
Encephalitis
Motility disorder

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16
Q

What questions to ask about for exposure to pathogens in suspected gastroenteritis

A

Travel
Living in close quarters
Close contacts have something similair
Unusual meals recently

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17
Q

First thing to think about with cause of nausea and vomiting

A

Is it acute (under 1 month)

Or chronic

18
Q

If acute vomiting what symptoms help narrow down differentials

A

Vertigo
Abdo pain
Headache

19
Q

What are categories of acute N&V differentials

A 
Vertigo
Abdo pain
Headache
Shortly after food
None of these symptoms
20
Q

Causes of vertigo and nausea and vomiting

A

Menieres
Vestibular neuritis
BPPV
Acoustic neuroma

21
Q

Causes of headache nausea and vomiting

A

ICP SOL
Meningitis
Encephalitis
Migraine

22
Q

Causes of abdo pain with fever and nausea and vomiting

A 
Appendicits
Cholecystitis
Hepatitis
Mesenteric adenitis
Pancreatitis
Food poisoning
23
Q

Causes of abdo pain with no fever and nausea and vomiting

A 
UTC
MI
SBO
DKA
LBO
Mesenteric ischaemia
Testicular torsion
Drug overdose
24
Q

Causes of chronic nausea and vomiting

A

Upper GI obstruction- mechanical and functional
Coeliac disease
Oesophagitis
Pharyngeal pouch

25
Q

Problems in brain leading to nausea and vomiting

A

SOL
Migraine
Meningitis
Encephalitis

26
Q

Things in blood leading to nausea and vomiting

A

Drug overdose
Uraemia from renal failure
Excess of hormones
Electrolyte abnormalities

27
Q

Reduced consciousness with nausea and vomiting

A

DKA
Meningitis
ICP

28
Q

What looking for on inspection of nausea and vomiting

A 
Hydration status- vomiting loses fluids
Abdo distension- SBO
Scars- SBO
Jaundice- hepatobiliary cause
Hernias- SBO
29
Q

Bloods ordered nausea and vomiting

A 
FBC- infective cause
U&Es- electrolyte abnormalities from those lost
VBG- lactate and electrolytes
Amylase- exclude pancreatitis
Liver enzymes- hepatobiliary picture
Group and save- off to surgery
30
Q

How long must patient be sat up before erect CXR

A

10mins

31
Q

Investigations for nausea and vomiting if young woman

A

Pregnancy

32
Q

What analgesia shouldnt be given in dehydrated patients

A

NSAIDS

33
Q

What anti-emetic shouldnt be given in context of SBO

A

Metoclopramide

Cyclizine or ondensatron are better options

34
Q

Managment plan for SBO

A 
NBM
Drip and suck
Analgesia
Antiemetics
Trial conservative management provided no strangulation signs
If hasnt resolved go to surgery
35
Q

What would make you definetely go to surgery in SBO

A

Strangulation or peritonism signs
Conservative trial hasnt worked
No history of abdo surgery meaning sinister causes more likely
Patient is in a lot of pain

36
Q

Main clinical sign is gastroenteritis not food poisoning

A

Food poisoning lasts less than 24 hours generally

37
Q

What does ketonuria suggest in gastroenteritis

A

In state of starvation as not eating

38
Q

Why would patient with DKA have hyponatraemia

A

Pseudohyponatraemia from high glucose

39
Q

In DKA how is insulin given

A

Infusion

40
Q

If have burst appendix what is done in surgery

A

Appendicectomy and wash out of any contents

Year 3 Conditions (33 decks)

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