*HG

Question 1

Define hyperemesis gravidarum

Answer 1

Intractable vomiting during pregnancy leading to weight loss and volume depletion

…resulting in ketonuria and ketonaemia

Question 2

What are the consequences of HG?

Answer 2

Dehydration
Electrolyte imbalance
Thiamine deficiency

Question 3

(HG) Nausea and severe, constant vomiting VERSUS…

Answer 3

Nausea that sometimes results in vomiting

Question 4

Nausea and vomiting that does not subside VERSUS…

Answer 4

Nausea that usually subsides by 20 weeks

Question 5

Vomiting that causes severe dehydration and does not allow food to be kept down VERSUS…

Answer 5

Vomiting that does not cause dehydration and allows some food to be kept down

Question 6

What are the clinical features of HG?

SHOPS-KT

Answer 6

• Sunken eyes
• Hypotension
• Oliguria
• Parched mouth and lips
• Loss of skin elasticity
• Ketonuria
• Tachycardia

Question 7

What investigations for HG?

FELT U U

Answer 7

• FBC
• Electrolytes
• LFT
• TFT
• Urinalysis and MC&S
• Ultrasound to exclude multiple pregnancy or GTD

Question 8

Management of HG?

Answer 8

• Hospital admission
• IV fluids
• Consider TEDS and Clexane
• Rarely parenteral nutrition

Question 9

Treatment of HG?

Answer 9

Smaller amounts of food
Antiemetics: metoclopramide
Vitamin supplements

Question 10

What complications are associated with vitamin B1 (thiamine) deficiency?

Answer 10

Beri-Beri
Wernicke-Korsakoff’s encephalopathy