Vomitting Flashcards
Qaulity
What colour was your vomit? Is there any blood in your vomit? Is there any mucous in your vomit? What colour is the blood/mucous? How much blood/mucous Is the vomiting forceful or does it just come out (regurgitation/vomitting) If blood in vomit then ask: Have you passed a bowl motion since the bleeding started? Did it look normal?
Frequency/Severity
How often do you vomit?
How many times have you vomited this week?
Time course
Did it start suddenly? Did you feel sick before? How long have you been vomiting for? Is the vomiting getting worse/more frequent? Do you vomit first thing in the morning? Has this ever happened before?
Context?
Have you been taking any medication?
Did you feel nauseous before you vomit?
Have you been in contact with anybody else who has been sick?
Have you travelled anywhere recently?
Is there a possibility you could be pregnant? (females only :P)
Relieving factors
Normal
Aggravating factors
Normal
Associated features
Do you notice anything else with the vomiting?
- Bowels (diarrhoea)
- Abdominal pain
- Headache (increased abdominal pressure)
Past history
Normal
Fam history
Normal
Social hist
Normal
Occupational hist
Normal
What are some of the associated features?
Nausea Abdominal pain Diarrhoea Fever Headache Anaemia (if vomiting blood) Vertigo Dehydration Weight loss Pain (hepatitis, gallstones, MI)
What are we looking for in the questions about quality?
Dark or bright red (coffeegrounds) Yellowish green = bile
What things are important in context?
- Prescribed medication
- Alcohol
- Any recreational drug
Differential diagnosis
Gastroenteritis – fever, fatigue, pain
Pregnancy – context, loss of periods, frequent urination, breast enlargement
Medication – context, recent chemotherapy Heart Attack – chest pain (+ radiation), sweating, past and family history of heart problems
Alcohol – context, alcohol history
