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CMN 568 - Unit 4: Questions With Solutions (100%)
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CMN 568 - Unit 4: Questions With Solutions (100%)
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CMN 568 - Unit 4: Questions With Solutions (100%)Acute onset of severe pain and vomiting suggests what? Right Ans - +
Peritoneal irritation
+ Acute gastric or intestinal obstruction
+ Pancreaticobiliary disease
(McPhee p 588)
Persistent vomiting suggests what? Right Ans - + Pregnancy
+ Gastric outlet obstruction
+ Gastroparesis
+ Intestinal dysmotility
+ Psychogenic disorders
+ CNS or systemic disorders
(McPhee p 589)
Vomiting in the morning suggests what? Right Ans - + Pregnancy
+ Uremia
+ ETOH intake
+ ↑ ICP
Vomiting after meals suggests what? Right Ans - + 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? Right
Ans - + 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 Right Ans - 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
Right Ans - 1) Chemo
2) Medications and drugs
3) Radiation therapy
4) Systemic disorders
CNS disorders that can cause vomiting Right Ans - 1) Migraine
2) ↑ ICP
3) Infections (e.g. meningitis, encephalitis)
4) Psychogenic
Vestibular disorders that can cause vomiting Right Ans - Labyrinthitis,
Meniere syndrome, motion sickness
Define RETCHING Right Ans - Strong, spasmodic, involuntary effort to
vomit without bringing up emesis.
(McPhee and Shimp)
Define REGURGITATION Right Ans - Effortless return of gas or small
amounts of food from stomach (McPhee and Shimp)
Common causes of vomiting in infants Right Ans - 1) Any acute illness (esp
gastroenteritis)
2) Hypertrophic pyloric stenosis (2 - 8 weeks of life, may feel an "olive" in
epigastric area after feeding)
3) Intussisception (6 - 18 months of life, sausage-shaped mass and "currant
jelly" stools)
4) Regurgitation ("spitting up") -- usually normal and usually resolves by 6 -
12 months.
, (Shimp)
Medications associated with N/V Right Ans - + Antidepressants
--SSRIs
--venlafaxine
+ Cardiac meds
--antiarrhythmics
--anti-HTN meds (diuretics, beta blockers, CCBs)
-- ↓ CHO meds (statins, gemfibrozil, niacin)
-- Digoxin
+ Chemotherapy agents
+ GI meds
--sulfasalazine (for tx of UC)
--azathioprine (tx of Crohns or UC)
+ Meds to treat infectious diseases
-- Acyclovir
-- Anti-fungals
-- ABX
-- UTI meds
-- TB meds
+ Pain meds
-- Anti-gout meds
-- Aspirin
-- NSAIDs
-- Opioids
+ Others
-- Lithium
-- Metformin
-- BC pills
-- Quinidine
(Shimp Table 46-2)
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