,Vomiting in the morning suggests what? - ANSWER +
Pregnancy
+ Uremia
+ ETOH intake
+ ↑ ICP
Vomiting after meals suggests what? - ANSWER + Bulimia
+ Peptic ulcer disease
+ Other psychogenic causes
(McPhee p 589, Shimp p 373)
Vomiting of undigested food 1-2 hours after a meal suggests what? - ANSWER
+ Gastroparesis
+ Small bowel obstruction
+ Gastric outlet obstruction
NOTE: Sucussion splash often heard on auscultation
(McPhee p 589, Shimp p 373)
,4 causes of nausea and vomiting - ANSWER 1) Visceral
afferent stimulation (seratonin receptors)
2) Vestibular disorders (fibers ↑ in histamine and muscarinic receptors)
3) CNS disorders
4) Irritation of chemoreceptor trigger zone
(McPhee Table 15.1)
Ways to stimulate the chemoreceptor trigger zone and cause vomiting -
ANSWER 1) Chemo
2) Medications and drugs
3) Radiation therapy
4) Systemic disorders
CNS disorders that can cause vomiting - ANSWER 1)
Migraine
2) ↑ ICP
3) Infections (e.g. meningitis, encephalitis)
, 4) Psychogenic
Vestibular disorders that can cause vomiting - ANSWER
Labyrinthitis, Meniere syndrome, motion sickness
Define RETCHING - ANSWER Strong, spasmodic, involuntary
effort to vomit without bringing up emesis.
(McPhee and Shimp)
Define REGURGITATION - ANSWER Effortless return of gas
or small amounts of food from stomach (McPhee and Shimp)
Common causes of vomiting in infants - ANSWER 1) Any
acute illness (esp gastroenteritis)
2) Hypertrophic pyloric stenosis (2 - 8 weeks of life, may feel an "olive" in
epigastric area after feeding)
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