A 14 year old has episodes of severe episodic vomiting over the last week

Question Number 0622

Question:
A 14 year old has episodes of severe episodic vomiting over the last week. These symptoms appear to have been present over the last week and the mother remembers that these started with a runny nose and sneezing. His mother notes that the vomiting follows cough paroxysms consists of a series of short expiratory bursts, followed by an inspiratory gasp and cyanosis. These episodes number more than 20 per in the last 24 hours and appear to be worse at night. Investigations reveal a leukocytosis with lymphocyte predominance. A likely cause is

a) psychogenic
b) achalasia
c) cyclical vomiting
d) mesenteric adenitis
e) Pertussis syndrome


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