CMN 568 - Unit 4 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS

CMN 568 - Unit 4 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS Acute onset of severe pain and vomiting suggests what? - ANSWER + Peritoneal irritation + Acute gastric or intestinal obstruction + Pancreaticobiliary disease (McPhee p 588) Persistent vomiting suggests what? - ANSWER + Pregnancy + Gastric outlet obstruction + Gastroparesis + Intestinal dysmotility + Psychogenic disorders + CNS or systemic disorders (McPhee p 589) 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) 3) Intussisception (6 - 18 months of life, sausage-shaped mass and "currant jelly" stools) 4) Regurgitation ("spitting up") -- usually normal and usually resolves b