hyperemesis gravidarum

Question 1

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Answer 1

Hyperemesis gravidarum is severe vomiting with onset before 20 weeks of gestation.

It is severe enough to require admission to hospital and is a diagnosis of exclusion.

Question 2

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Answer 2

Fluid replacement therapy

Potassium chloride as excessive vomiting usually causes hypokalaemia

Anti-emetic medications such as cyclizine (first line), metoclopramide or prochlorperazine. Ondansetron or domperidone may be used in severe cases.

Thiamine and folic acid to prevent development of Wernicke’s encephalopathy

Antacids to relieve epigastric pain

Thromboembolic (TED) stockings and low molecular weight heparin as there is increased risk of venous thromboembolism. This is due to the combination of pregnancy, immobility and dehydration.

Question 3

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Answer 3

dehydration
weight loss
hypotension
hypersalivation
hyperflexion
ketonuria