CMN 568 Unit 4 exam (2025 updated) QUESTIONS
AND ANSWERS (DETAILED & ELABORATED) fully
solved
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 by 6 - 12
months.
(Shimp)
Medications associated with N/V - (ANSWER)+ Antidepressants
--SSRIs
--venlafaxine
+ Cardiac meds
--antiarrhythmics
--anti-HTN meds (diuretics, beta blockers, CCBs)
-- ↓ CHO meds (statins, gemfibrozil, niacin)
-- Digoxin
+ Chemotherapy agents
AND ANSWERS (DETAILED & ELABORATED) fully
solved
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 by 6 - 12
months.
(Shimp)
Medications associated with N/V - (ANSWER)+ Antidepressants
--SSRIs
--venlafaxine
+ Cardiac meds
--antiarrhythmics
--anti-HTN meds (diuretics, beta blockers, CCBs)
-- ↓ CHO meds (statins, gemfibrozil, niacin)
-- Digoxin
+ Chemotherapy agents
