Hyperemesis Gravidarum Flashcards
1
Q
Pathophysiological theories of hyperemesis gravidarum
A
- hormonal changes
- gastrointestinal dysfunction
- hepatic dysfunction
- metabolic derangement
- lipid alteration
- infection
- vestibular and olfactory hyperacuity
- genetic
- psychological
2
Q
Differential diagnosis of hyperemesis gravidarum
A
- drug toxicity
- eating disorder
- migrains
- ovarian torsion
- vestibular lesion
- DKA
- GORD
- IBS
- PUD
- Preeclampsia
3
Q
Complications of hyperemesis gravidarum
A
- oesophageal rupture or perf
- pneumothorax or pneumomediastinum
- Wernickes encephalopathy
- hepatic disease
- seizure, coma, death
- low birth weight, preterm delivery
4
Q
Treatment of hyperemesis gravidarum
A
- Vit B
- metoclopramide 5-10mg PO 8hrly
- ondansetron
- methylprednisone
5
Q
Describe Wernickes encephalopathy
A
Thiamine (B1) deficiency
- ocular findings
- cerebellar dysfunction
- confusion
6
Q
How to rehydrate
A
Give saline before thiamine and glucose
- if you give glucose first, cause lactic acidaemia and acidosis
7
Q
How to re-introduce food
A
- small frequent meals
- high carb, high protein content
