Cyclic vomiting syndrome
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Gastrointestinal system
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Cyclic vomiting syndrome
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 27-year-old woman comes to the clinic with a 6-year history of intermittent vomiting. She reports that the episodes occur every 2-3 months and last for roughly one day at a time. The episodes are preceded by a typical sequence of generalized abdominal pain, nausea, and a throbbing headache, followed by the onset of vomiting, several times per hour for the next several hours. Physical examination is unremarkable, and she does not seem to be under any apparent distress. She reports that she has visited doctors a handful of times regarding her vomiting, but a diagnosis has never been reached because she is completely symptom-free between episodes. One year ago, she discontinued eating lactose and gluten, but has still experienced several episodes of vomiting since then. Given the most likely diagnosis, which of the following would you prescribe this patient to prevent further episodes of vomiting?