Vomiting (malabsorption) Flashcards
(45 cards)
Pre-ejection phase features
pallor
nausea
tachycardia
Ejection Phase
Retch
Vomit
When the vomiting centre is stimulated what is triggered?
the chemoreceptors trigger zone dopamine and serotonin receptors
chemotherapy receptors trigger?
muscarinic receptors in the vomiting centre
where is the CTZ?
outside the blood brain barrier.
Where does the labrynth send signals?
vestibular nuclei in the pons which contains histamine and muscarinic receptors during motion sicknesss, these send signals to CTZ which inturn sends message to vomiting centre in medulla oblongata
triggers for vomiting (6)
= Enteric pathogens - GI triggers - impulses to vom centre through the vagus nerve
- infection
- Visual/olfactory stimuli
fear - Head injury/raised ICP/ - encephalitis, brain tumours
- Inner ear stimuli
- Metabolic derangements/
chemotherapy
Retching involves?
deep inspiration against a closed glottis - contraction of the abdomen - pressure difference between abdo and thoracic cavities
easy morning retching associated with?
intracranial pathology
Causes of Haemetemesis
peptic ulcers
portal hypertension
infants - common causes of vomiting (4)
GOR
cow’s milk allergy
infection
intestinal obstruction
Children - common causes of vomiting (6)
Gastroenteritis Infection Appendicitis Intestinal obstruction Raised ICP Coeliac disease
young adults - common causes of vomiting (7)
Gastroenteritis Infection H.Pylori infection Appendicitis Raised ICP DKA Cyclical vomiting syndrome Bulimia
150ml per kilo a day
neonates
1 month - 12 months - 100mls per kilo per day
infants
cows protein milk allergy can present with
irritability and vomiting
Lots of vomiting tends to lead to a?
metabolic alkalosis
Hypokalemic, hypochloremic
pyloric stenosis management?
fluid resuscitation
- feeds are stopped and nasogastric tube put in for free fluid
- Ramstedt’s pyloromyotomy
Pyloric stenosis presenting features
Babies 4-12 weeks
Boys > Girls
project non-bilious vomiting
- weight loss
Features a baby will have with pyloric stenosis
Weight loss
Dehydration +/- shock
Characteristic electrolyte disturbance
Metabolic alkalosis (↑pH)
Hypochloraemia (↓Cl)
Hypokalaemia (↓K)
Effortless vomiting is always due to?
common in?
gastro-oesophageal reflux
- infants
Exceptions of effortless vomiting (4)
- Cerebral palsy
- Progressive neurological problems
- Oesophageal atresia +/- TOF operated
- Generalised GI motility problem
when are solid foods introduced?
6 months
