Nausea and Vomiting

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5 • 795 Ratings

🗓️ 4 March 2018

⏱️ 8 minutes

🔗️ Recording | iTunes | RSS

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Summary

The hardest part about this chief complaint is expanding your differential beyond gastritis!!! Step 1: Expand Your Differential Diagnosis Early appendicitis Bowel obstructions Myocardial infarction Elevated ICP Diabetic Ketoacidosis Step 2: Give a Testing Plan High yield tests to consider EKG – older adults Pregnancy test – women of child bearing age Electrolytes – most […]

Transcript

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0:00.0	Hello, med students. My name is Zach Olson, and thank you for downloading this week's
0:06.2	episode of the EM Clerkship Podcast. I received an email a few weeks ago from Janice in Germany,
0:14.8	who wrote requesting a really good episode idea. I was kind of surprised that I hadn't done
0:20.2	this one yet, actually actually because it's so
0:22.0	common. So here we go. This week, we are talking about nausea and vomiting, definitely core high-yield
0:28.9	material. The most important thing to know about nausea and vomiting is that you have to expand your brain out from just GI causes because the differential
0:41.5	truly is huge.
0:44.8	Toxins, huge list, prescription drugs, alcohol, inseds, infections can trigger this,
0:52.2	pylinoffritis comes to mind.
0:54.6	Neuro.
0:55.2	What about brain masses?
0:56.8	Pseudotumor.
0:58.4	Cardiovascular, M.I.
1:01.3	Electrolites, D.K.A.
1:03.0	Thyroid stuff.
1:04.1	Pain itself.
1:05.1	All can trigger vomiting.
1:07.1	The differential is massive.
1:10.0	So you absolutely must expand your brain out past GI and take a good history and do your screening exam.
1:18.7	It's true. The most likely cause of somebody with nausea and vomiting is gastritis. No big deal. But it's a mistake to lock down on that too early. So with that said,
1:31.2	step one, you're presenting this patient, giving your history and the abnormals from your exam,
1:36.4	and it's time to explain your differential. But it's so big. So how do you do this? Here's what you
	...

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