Nausea/vomiting

Question 1

Key history in nausea/vomiting

Answer 1

Acuity of onset
\+/- Abdominal pain
Relation to meals
Sick contacts
Possible food poisoning
Possible pregnancy
Neurologic symptoms (HA, stiff neck, vertigo, focal numbness or weakness)
Urinary symptoms
Other symptoms (GI, chest pain)
Exacerbating and alleviating factors
Medications
History of prior abdominal surgery

Question 2

Key physical exam in nausea/vomiting

Answer 2

Vital signs
ENT exam
Consider fundoscopic exam (increased ICP)
Complete abdominal exam
Consider heart, lung and rectal exams

Question 3

20 yo F with nausea, vomiting (especially in morning), fatigue and polyuria
+ LMP was six weeks ago
+ breast fullness and tenderness
+ sexually active but uses condoms occasionally

Answer 3

Pregnancy
Gastritis
Hypercalcemia
DM
UTI

Urine hCG, pelvic exam, US - pelvis, CBC, electrolytes, calcium, glucose, UA, urine culture, HIV antibody