Differential Diagnosis for Patient with History of BPD, Increased Nausea and Vomiting, and Need to Shower

• Single Most Likely Diagnosis
  • Pregnancy: Given the symptoms of increased nausea and vomiting, and considering the patient's history of borderline personality disorder (BPD) which may not directly relate to the physical symptoms but could influence reporting and coping mechanisms, pregnancy is a common cause of these symptoms, especially if the patient is of childbearing age and sexually active.
• Other Likely Diagnoses
  • Gastroenteritis: This condition, often caused by viral or bacterial infections, can lead to nausea, vomiting, and potentially an increased need to shower due to frequent vomiting or diarrhea.
  • Food Poisoning: Similar to gastroenteritis, food poisoning can cause severe nausea and vomiting, leading to the need for more frequent showering.
  • Medication Side Effects: Certain medications can cause nausea and vomiting as side effects. If the patient has recently started a new medication, this could be a contributing factor.
• Do Not Miss Diagnoses
  • Appendicitis: Although less common, appendicitis can present with nausea and vomiting. It's crucial to consider this diagnosis due to the potential for severe consequences if appendicitis ruptures.
  • Diabetic Ketoacidosis (DKA): Especially in patients with diabetes, DKA can cause nausea, vomiting, and changes in hygiene habits due to the illness's severity.
  • Eating Disorders: Given the patient's history of BPD, there might be an increased risk of eating disorders such as bulimia nervosa, which involves self-induced vomiting and could lead to an increased need to shower.
• Rare Diagnoses
  • Cyclic Vomiting Syndrome: A rare condition characterized by recurrent episodes of severe vomiting, which could explain the patient's symptoms.
  • Neurological Disorders: Certain neurological conditions, such as brain tumors or migraines, can cause nausea and vomiting, though these would be less common causes of the patient's symptoms.