Non-GI Causes of Vomiting

 

ABC's of Non- GI causes of vomiting
Acute renal failure
Brain (Increased ICP)
Cardiac (Inferior MI)
DKA
Ears (labyrinthitis)
Foreign substances (Tylenol, theo, etc)
Glaucoma
Hyperemesis Gravidarum
Infections (pyelonephritis, meningitis)

An approach to the evaluation and management of syncope in adults

Summary points

Syncope is common in all age groups, and it affects 40% of people during their lifetime
Few people with syncope seek medical attention
Neurally mediated syncope, which is benign, is the most common cause
Cardiac syncope as a result of arrhythmias or structural cardiopulmonary disease is more common with increasing age
Cardiac syncope is associated with increased mortality and must be excluded
Brain imaging, carotid Doppler ultrasound, electroencephalography, and chest radiography are not needed in patients with syncope

Tips for non-specialists

Syncope is the most common cause of transient loss of consciousness

Most cases of neurally mediated syncope can be treated effectively with lifestyle modification and medical reassurance

Transient ischaemic attacks do not present with loss of consciousness

Diagnosis can often be made after a clinical history, physical examination, 12 lead electrocardiogram, and lying or standing blood pressure measurements

Twenty four hour ambulatory electrocardiography monitoring has a low yield and will probably diagnose arrhythmias only in patients who have daily symptoms

Patients with suspected cardiac syncope or atypical neurally mediated syncope (particularly with injury or driving or occupational related implications) need referral to specialist services

An approach to the evaluation and management of syncope in adults -- Parry and Tan 340: c880 -- BMJ