The Clinical Problem Solvers
Episode 298: Spaced Learning Series – Nausea, Vomiting, & Abdominal Pain
Episode guests
Podcast summary created with Snipd AI
Quick takeaways
- Pregnancy should not bias clinical reasoning when evaluating nausea and vomiting in a pregnant patient; consider conditions unrelated to pregnancy as potential causes.
- Serial monitoring of labs, imaging, and expanding serological testing are essential in the diagnostic evaluation of a pregnant patient with abnormal liver function tests and elevated creatinine.
Deep dives
Approaching Nausea and Vomiting in a Pregnant Patient
When encountering a pregnant patient with nausea and vomiting, it is important to not let the pregnancy bias clinical reasoning, as there may be conditions unrelated to pregnancy causing these symptoms. Nausea and vomiting without associated symptoms can be assessed based on severity and triggers. Severe episodic symptoms triggered by food may indicate partial gastrointestinal obstruction, while constant severe symptoms should prompt consideration of central nervous system or cardiac causes. Constant but low-grade intensity symptoms may indicate metabolic causes. Examination of the abdomen, particularly the right upper quadrant, is important to investigate hepatobiliary conditions or complications of pregnancy. Imaging and further serological testing can guide the diagnostic process.
