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Nausea and vomiting

Nausea and vomiting. intro. Primary GI: bowel obstruction, gastroenteritis CNS - increased intracranial pressure, tumor psychiatric conditions - bulimia nervosa, anxiety endocrine or metabolic abnormalities - diabetic ketoacidosis, hyponatremia iatrogenic causes - medications, toxins

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Nausea and vomiting

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  1. Nausea and vomiting

  2. intro • Primary GI: bowel obstruction, gastroenteritis • CNS - increased intracranial pressure, tumor • psychiatric conditions - bulimia nervosa, anxiety • endocrine or metabolic abnormalities - diabetic ketoacidosis, hyponatremia • iatrogenic causes - medications, toxins • MCC is US – viral gastroenteritis

  3. pathophys • Coordinated in medulla oblongata • Chemoreceptive trigger zone in fourth ventricle • Also a vagal afferent pathway • Nausea, retching, emesis

  4. Clinical features • History • Timing • Severity • Prior surgeries • Physical exam

  5. Diagnostic tests • Labs • Cbc • Cmp • Lipase • UA • Drug levels in overdose • Imaging • AXR • CT • US

  6. references • Tintinalli, ch 75

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