13. Nausea and Vomiting Flashcards Preview

YR3: MM FC Ed. > 13. Nausea and Vomiting > Flashcards

Flashcards in 13. Nausea and Vomiting Deck (22)
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1
Q

What are the 4 main input systems that can activate the vomiting centre?

A

Vestibular system
CNS
Chemoreceptor trigger zone
Cranial nerves IX + X

2
Q

What broad questions should you ask about in the presenting complaint in someone who has been vomiting?

A

details of the cotnent
timing + duration
association with eating

3
Q

What does undigested vomit suggest?

A

Oesophageal disorders: achalasia, pharyngeal pouch

4
Q

What does partially digested vomit suggest?

A

Gastric outlet obstruction

Gastroparesis

5
Q

What does faeculent vomit suggest?

A

Distal intestinal or colonic obstruction

6
Q

What does vomiting within an hour of eating suggest?

A

Obstruction high in the GI tract

7
Q

What does vomiting a few hours after eating?

A

Obstruction lower in the GI tract

8
Q

What other symptoms should you ask about in someone who has presented with vomiting?

A

Fever
Headache, visual disturbance, other neuro symptoms
Vertigo

9
Q

What questions should you ask about in the social history in someone who presents with vomiting?

A

Any close contacts suffering from nausea + vomiting?
Living in close quarters?
Recent foreign travel?
Unusual meals recently?

10
Q

What is the immediate management for small bowel obstruction?

A

Nil by mouth
‘Drip + suck’ IV fluid + aspiration of gastric contents by nasogastric tube
Analgesia
Antiemetics

11
Q

List 4 vertigo/ vestibular system related causes of nausea and vomiting

A

BPPV
Labyrinthitis
Motion sickness
Menieres disease

12
Q

List 5 chemical/ CTZ related causes of nausea and vomiting

A
Medication
Alcohol
Hormones
Electrolytes
Toxins
13
Q

List 5 CNS related causes of nausea and vomiting

A
Pain
Anxiety
Raised ICP
Meningitis
Encephalitis
14
Q

List 4 abdo + heart (CN9+10) related causes of nausea and vomiting

A

GI obstruction
GI infection
Inflammation of diaphragm
Inflammation of liver, pancreas, gallbladder, peritoneum

15
Q

What does bile/ green vomit suggest?

A

Small bowel obstruction (distal to ampulla of vater)

16
Q

What is early morning sickness associated with?

A

Pregnancy

Raised ICP

17
Q

What condition is suggested by a motionless patient with a rigid abdomen and absent bowel sounds?

A

Peritonitis

18
Q

What condition is suggested by bilious/ faeculent vomiting, distended abdome, absolute constipation and abdominal pain?

A

Bowel obstruction

19
Q

What condition is suggested by early morning vomiting, headache worse when lying down and 6th nerve palsy?

A

Raised ICP

20
Q

What may absence of bowel sounds or high pitched tinkling sounds suggest?

A

Absence: Ileus
Tinkling: Mechanical obstruction

21
Q

What causes transaminitis (raised ALT + AST)?

A

Hepatitis

22
Q

What is a postoperative adhesion caused by? What may this result in?

A

Postsurgical inflammatory response leads to formation of fibrous adhesions between the bowel + parietal peritoneum
Bowel obstruction if loop of bowel gets twisted around adhesion