Difference between revisions of "Nausea and vomiting"

(Peds)
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==Clinical Features==
 
==Clinical Features==
  
== DDX by organ system ==
+
==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
  
==DDx by Severity==
+
===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

Nausea and Vomiting Algorithm

Clinical Features

Differential Diagnosis

By organ system

GI

Neurologic

Infectious

  • Bacterial toxins
  • PNA
  • SBP
  • UTI
  • Viruses (adeno, norwalk, rota

Drugs/Toxins

  • Toxic doses
    • Digoxin
    • ASA
    • APAP
  • NSAIDs
  • Opiates
  • ETOH
  • Anticonvulsants
  • Abx
  • Antiarrhythmics
  • Toxins
    • Organophosphates
    • CO
    • Ricin

Endocrine

Miscellaneous

By Severity

Critical

Emergent

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

See Also

References