Severe Vomiting in a Young Married Woman — A Clinical Reasoning Guide for General Practitioners
She’s 22, married, and has vomited 8 times in 12 hours. Before you reach for the ondansetron, one question must be answered first — and it changes everything.
Why This Guide Exists
This is the kind of patient who gets an injection of ondansetron and a prescription for pantoprazole — and walks out of the OPD without ever being asked when her last period was. The GP who misses early pregnancy gives teratogenic drugs. The GP who misses an ectopic loses a patient on the table. The GP who doesn’t ask about poisoning loses a life that could have been saved with one private question.
This guide teaches you the 10 strategic questions that split the differential, the 60-second emergency examination, the three bedside tests that take 3 minutes and change everything, and the decision pathways that tell you exactly what to do next — whether the UPT is positive or negative, whether there is pain or no pain.
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