Vomiting or regurgitation?

Question 1

Regurgitation

Answer 1

passive
no prodromal nausea
undigested food / froth
soon after eating
may be apinful
coughing
nasal discharge
dysphagia
anorexia uncommon

Question 2

Investigating regurgitation causes?

Answer 2

unsedated chest rads
contrast rads
endoscopy

Question 3

Regurgitation DDX?

Answer 3

Anatomic - vascular ring anomaly, cricopharyngeal disease, hiatal hernia, diverticulum

obstruction - stricture, luminal FB, extraluminal mass

Oesophagitis - trauma, reflex, irritation

Motility disorders - megoesophagus, neuropathy, myopaths

Question 4

Most common causes of regurgitation?

Answer 4

Foreign body - lodge where physiological narrowing, remove/push to stomach

oesophagitis - chemical injury, medication (doxy in cats) , gastro - oesophageal reflux (anaesthesia, vom, feeding tube), use sucralfate and inhibit gastric acid

megaoesophagus - idiopathic, myasthenia gravis, thymoma, hypoadrenocorticism

Question 5

Vomiting

Answer 5

abdominal effort
prodromal nausea
digested food
no swallowing pain
forceful expulsion
symptom - not disease

Question 6

What can the vomiting centre in the brainstem be influenced by?

Answer 6

cortex

vagal and symp afferents from abdomen/stomach

chemoreceptor trigger zone in brainstem which detects blood borne substances

Question 7

primary causes of vomiting

Answer 7

dietary
infection - parasites, parvo
inflammatory disease - IBD, ulcers
Neoplasia
Obstruction
motility disorders

mainly acute except neoplasia and infl disease

Question 8

Secondary causes of vomiting

Answer 8

uaemia
addisons disease = hypoadrenocorticism
hepatic disease
pancreatitis (dog)
toxin ingestion
drugs
Acute renal disease

all chronic except toxin ingestion

Question 9

Types of drugs to treat vomiting?

Answer 9

proton - pump inhibitors (stop HCl in stomach)

Anti-collinergics (stop vagus input)

Anti histamines (block parietal cells)

Question 10

What is the guide used for how dilated the int is?

Answer 10

1.6 x the height of L5 = localised dilation = 90% sure of obstruction

Question 11

Different types of contrast radiography (5)

Answer 11

pneumogastrogram - identify stomach, FB

food and barium gastogram - assess gastric emptying

Double contrast gastrogram - identify mucosal lesions

Upper GI contrast study - identify stomach, int, assess GI motility, identify obstruction

Barium enema - identify colon, intussesception, mural lesions