Nausea and vomiting: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
== | ==Differential Diagnosis== | ||
===GI=== | ===By organ system === | ||
====GI==== | |||
*[[Peptic ulcer disease]] | *[[Peptic ulcer disease]] | ||
*Obstruction | *Obstruction | ||
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*[[Pyloric Stenosis]] | *[[Pyloric Stenosis]] | ||
===Neurologic=== | ====Neurologic==== | ||
*Head injury | *Head injury | ||
*[[CVA]] | *[[CVA]] | ||
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*[[Cannabinoid hyperemesis syndrome]] | *[[Cannabinoid hyperemesis syndrome]] | ||
===Infectious=== | ====Infectious==== | ||
*Bacterial toxins | *Bacterial toxins | ||
*[[PNA]] | *[[PNA]] | ||
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*[[UTI]] | *[[UTI]] | ||
*Viruses (adeno, norwalk, rota | *Viruses (adeno, norwalk, rota | ||
===Drugs/Toxins=== | ====Drugs/Toxins==== | ||
*Toxic doses | *Toxic doses | ||
**Digoxin | **Digoxin | ||
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**CO | **CO | ||
**Ricin | **Ricin | ||
===Endocrine=== | ====Endocrine==== | ||
*Pregnancy | *Pregnancy | ||
*[[Hyponatremia]] | *[[Hyponatremia]] | ||
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*[[Uremia]] | *[[Uremia]] | ||
===Miscellaneous=== | ====Miscellaneous==== | ||
*[[ACS]] | *[[ACS]] | ||
*Gonadal torsion | *Gonadal torsion | ||
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*Depression | *Depression | ||
== | ===By Severity=== | ||
=== Critical === | ==== Critical ==== | ||
*[[Esophageal Perforation|Boerhaave's]] | *[[Esophageal Perforation|Boerhaave's]] | ||
*Ischemic bowel | *Ischemic bowel | ||
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*[[Sepsis]] | *[[Sepsis]] | ||
=== Emergent === | ==== Emergent ==== | ||
*Gastric outlet obstruction | *Gastric outlet obstruction | ||
*[[Pancreatitis]] | *[[Pancreatitis]] | ||
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*CO | *CO | ||
*[[Electrolyte Disorders]] | *[[Electrolyte Disorders]] | ||
===Nonemergent=== | ====Nonemergent==== | ||
*[[Gastritis]] | *[[Gastritis]] | ||
*Gastroparesis | *Gastroparesis | ||
Revision as of 15:33, 23 June 2015
Background
Clinical Features
Differential Diagnosis
By organ system
GI
- Peptic ulcer disease
- Obstruction
- Adhesion
- Small bowel obstruction/LBO
- Gastric outlet obstruction
- Pancreatitis
- Gastroparesis
- Appendicitis
- Cholecystitis
- Cholangitis
- Acute Hepatitis
- IBD
- Intussusception
- Tumor
- Strangulated hernia
- Volvulus
- Mesenteric ischemia
- Esophageal disorders (e.g. achalasia)
- Functional disorders
- Psychogenic
- IBS
- Pyloric Stenosis
Neurologic
- Head injury
- CVA
- Pseudotumor
- Hydrocephalus
- Mass lesion
- Meningitis
- Migraines
- Labyrinthitis
- Meniere disease
- Motion sickness
- Cannabinoid hyperemesis syndrome
Infectious
Drugs/Toxins
- Toxic doses
- Digoxin
- ASA
- APAP
- NSAIDs
- Opiates
- ETOH
- Anticonvulsants
- Abx
- Antiarrhythmics
- Toxins
- Organophosphates
- CO
- Ricin
Endocrine
- Pregnancy
- Hyponatremia
- Adrenal insufficiency
- DKA
- Thyroid/parathyroid disorders
- Uremia
Miscellaneous
- ACS
- Gonadal torsion
- Nephrolithiasis
- Pain
- Acute glaucoma
- Anorexia/bulimia
- Depression
By Severity
Critical
- Boerhaave's
- Ischemic bowel
- ICH
- Meningitis
- DKA
- AMI
- Sepsis
Emergent
- Gastric outlet obstruction
- Pancreatitis
- Cholecystitis
- Bowel obstruction/ileus
- Ruptured viscus
- Appendicitis
- Peritonitis
- Migraine
- CNS tumor
- raised ICP
- Adrenal insuffciency
- Hyperemesis gravidarum
- Tylenol
- Digoxin
- ASA
- Theophyline
- Gonadal torsion
- CO
- Electrolyte Disorders
Nonemergent
- Gastritis
- Gastroparesis
- PUD
- Gastroenteritis
- Biliary colic
- Hepatitis
- Thyroid
- Pregnancy
- Erythromycin
- Ibuprofen
- Chemotherapy
- Narcotics/wdwl from
- ETOH
- UTI
- Renal colic
- Motion sickness
- Labyrinthitis
Diagnosis
Work-Up
- CBC
- Chemistry
- Urine pregnancy
- LFTs
- Lipase
- APAP, ASA, digoxin levels
- UA
- ?Abd xray
- ?CT
- ?US
Evaluation
Management
Disposition
Complications
- Hypovolemia
- Metabolic alkalosis
- Hypokalemia
- Mallory-Weiss (tear)
- Boerhaave (rupture)
- Aspiration