DSA19 - Nausea and Vomiting

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21 Terms

1
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Nausea

Define Symptom:

> Unpleasant sensation of impending vomiting

> A/w

>> Hyper-salivation (water brash)

>> Sweating

>> Anxiety

2
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Vomiting/Emesis

Define Symptom:

Forceful expelling of intestinal contents via mouth

> Type of Reverse esophageal motility

3
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Regurgitation

Define Symptom:

Effortless and spontaneous reflux of gastric contents into or out through the mouth

> Type of Reverse esophageal motility

4
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Rumination

Define Symptom:

Repetitive effortless regurgiation of recent ingested food into mouth, followed by re-chewing and re-swallowing

> Functional Disorder

> Type of Reverse esophageal motility

5
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Vomiting Center

What part in the brainstem (specifically in the Medulla Oblongata) triggers vomiting?

<p>What part in the brainstem (specifically in the Medulla Oblongata) triggers vomiting?</p>
6
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Brainstem Activation d/t Pregnancy, Toxins, Meds, or Metabolic Disorders

Morning vomiting on an empty stomach implies what cause?

7
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Surgery

Bilious vomiting may often happen after what?

8
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Intestinal Obstruction

Feculent vomiting implies what cause?

9
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Bowel Obstruction

Abdominal Distenstion + Abdominal Tenderness + Vomiting hours after eating all imply what cause?

10
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Vestibular/Middle Ear Issue

N/V + Nystagmus + Vertigo imply what cause?

11
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Intracranial event

Abrupt vomiting WITHOUT NAUSEA implies what cause?

12
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> Sepsis signs (Fever, Tachycardia, Hypotension + elevated WBCs)

> Hematemesis

> Melena

> Hematochezia

> Abd guarding, rebound tenderness

> Imaging (free air, obstruction)

> Acute Renal Failure

What are ALARM Sx that may accompany N/V?

13
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Mallory-Weis Tear

Identify this complication of N/V:

Mucosal Tear at EG Junction

<p>Identify this complication of N/V:</p><p>Mucosal Tear at EG Junction</p>
14
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Boerhaaves Syndrome

Identify this complication of N/V:

Trans-mucosal tear with perforation

**CATASTROPHIC**

-PE:

> Subcutaneous crepitus

> Emphysema

-Dx: (CXR)

> Free air in mediastinum

<p>Identify this complication of N/V:</p><p>Trans-mucosal tear with perforation</p><p>**CATASTROPHIC**</p><p>-PE:</p><p>&gt; Subcutaneous crepitus</p><p>&gt; Emphysema</p><p>-Dx: (CXR)</p><p>&gt; Free air in mediastinum</p>
15
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> Malnutrition

> Fluid/Electrolyte & Metabolic Alterations

> Aspiration Pneumonia

What are some other complications of N/V?

16
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Acute Vomiting

Identify the Sx you are Assessing:

-Possible Causes/Hx:

> Infex (Pancreatitis)

> Post-Op

> Neuro (Migraine, Meningitis, Middle Ear issues)

> Gastric Outlet Obstruction (ulcers, malignancies)

> Intestinal obstruction (bowel ischemia, neoplasia, adhesions)

> Organ Perforation

> Toxins

-Labs:

> CBC

> CMP

> Lipase

-Imaging:

> KUB

> Abd US

> CT

-Concerns:

> Shock

> Hypotension

> Dehydration

17
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Pregnancy

What should be r/o with Acute Vomiting?

18
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Gastroparesis

Define Condition causing N/V:

Type of Motility Disorder in which stomach becomes "paralyzed"

-Hx:

> MC = Idiopathic or Diabetes

> Meds

>> Opiates

>> Anti-Cholinergics

>> Dopamine agonists

>> Cannabinoid agonists

>> Glucagon-like peptide agonists

> Past Surgery

> CTDs

> Vascular Disorders

> Malignancy

> Radiation

> Other (Previous Infex, Endocrine Disorders, Neuro Disorders, Chronic Pancreatitis)

19
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Cannabinoid Hyperemesis Syndrome

Define Condition:

-Hx:

> Regular Marijuana use

-Sx:

> Abdominal pain & Regular Nausea/Vomiting (Sx relieved w/ hot baths and showers)

-Dx: (+) Drug Screen

-Tx: Cessation of THC

20
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Cyclic Vomiting Syndrome (CVS)

Define Condition:

Clustered, recurrent episodes of N/V - Asx btwn episodes

-Hx:

> White Males

> Hx of FHx of Migraines

-Sx:

> Episodes < 1 wk

21
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Functional Vomiting

Define Condition:

Vomtiing x1/w for 3 mo - Dx of Exclusion

-Hx:

> Onset = 6 mo prior

-Sx:

> Heartburn

> Regurgitation