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Gyneco-Obstetrics III, Dr. Khor Hoksunn > Lesson 1: Hyperemesis Gravidarum > Flashcards

Lesson 1: Hyperemesis Gravidarum Flashcards

1
Q

Hyperemesisgravidarum(HG)isararedisordercharacterizedby _________and __________ nausea and vomiting duringpregnancythatmayrequirehospitalization

  • Characterizedby(Triadof):⭐
    1. D______⭐
    2. Vitaminandmineraldeficit(E________⭐)
    3. Body________>5%(Prepregnancy_________⭐)
A

Hyperemesisgravidarum(HG)isararedisordercharacterizedby Severe and persistent nausea and vomiting duringpregnancythatmayrequirehospitalization

  • Characterizedby(Triadof):⭐
    1. Dehydration⭐
    2. Vitaminandmineraldeficit(Electrolyteimbalance⭐)
    3. Bodyweightloss>5%(Prepregnancyweightloss⭐)
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2
Q

Etiology: _________

A

Etiology: Unknown

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3
Q

Etiology: More common in

  1. __________
  2. __________
  3. __________
  4. __________
  5. __________
  6. __________
  7. __________
  8. ___________
  9. __________
A
  1. Trophoblasticdisease
  2. Multiplepregnancy
  3. Nulliparity
  4. Femalefetus
  5. Maternalage>30yearsold(firstborn)
  6. Maternalobesity
  7. Smoking
  8. HasHyperemesisgravidarum(HG)inpreviouspregnancy
  9. FamilialhistoryofHG
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4
Q

Pathogenesis: _____________⭐

A

Pathogenesis: Unknown ⭐

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5
Q

Pathogenesis theories

  1. __________
  2. __________
  3. __________
  4. __________
  5. __________
  6. __________
  7. __________
  8. ___________
  9. __________
A
  1. HighhCG(hormoneimbalances)⭐
  2. VitaminBdeficiency(B1,B6)
  3. Hyperthyroidism
  4. Gastroesophagealreflux
  5. HelicobacterPyloriinfections
  6. Psychologicalfactors(rejectionofunwantedpregnancyorfearoflabour)
  7. Disturbancesincarbohydratemetabolism
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6
Q

Hormonal Theory⭐

  1. ↑______&________→triggervomitingcenter
  2. ↑_________-→relaxationofcardiacsphincter→retentionofgastricfluid
A

Hormonal Theory⭐

  1. ↑hCG&estrogen→triggervomitingcenter
  2. ↑Progesterone→relaxationofcardiacsphincter→retentionofgastricfluid
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7
Q

Vomiting in pregnancy: > __________⭐

A

Vomiting in pregnancy: > 50%⭐

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8
Q

Hyperemesis gravidarum (HG) occur __________.

A

Hyperemesis gravidarum (HG) occur 1/1000.

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9
Q

Risk factor: ________ or __________ pregnancies⭐ (caused by ↑ hCG)

A

Risk factor: multiple or molar pregnancies⭐ (caused by ↑ hCG)

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10
Q

Diagnosis & Investigation:

  1. __________
  2. __________
  3. __________
A
  1. Clinicalevaluation
  2. Detailedpatienthistory
  3. Identificationofcharacteristicsymptom
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11
Q

Symptoms and signs:

Rapid development within ___________or gradually over _________________.

A

Symptoms and signs:

Rapid development within a few weeks or gradually over a few months

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12
Q

Symptoms and signs:

Occur from ___ to ___ week of pregnancy, peak at _____ weeks.

A

Symptoms and signs:

Occur from 6th to 20th week of pregnancy, peak at 9th weeks

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13
Q

Hyperemesis Gravidarum should only be diagnosed when on set is in ________ trimester of pregnancy (exclude other causes).

A

Hyperemesis Gravidarum should only be diagnosed when on set is in first trimester of pregnancy (exclude other causes).

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14
Q

Symptoms and signs:

Increase of ______ body (Ketosis)

A

Symptoms and signs:

Increase of ketone body (Ketosis)

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15
Q

Types of ketone body:

  1. A______
  2. B_______
  3. A________
A

Types of ketone body:

  1. Acetoacetate
  2. Beta-hydroxybutyrate
  3. Acetone
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16
Q

Differential Diagnosis:

  1. __________
  2. __________
  3. __________
  4. __________
  5. __________
  6. __________
  7. __________
  8. ___________
  9. __________
A

Differential Diagnosis:

  1. Morning sickness typically continues from 4th week to 16th week (ឆាប់ចេញឆាប់បាត់)
  2. Cholecystitis
  3. Appendicitis
  4. Pyelonephritis
  5. Gastroenteritis
  6. Gall bladder disease
  7. Pancreatitis
  8. Migraine
  9. Complicated ovarian tumors
17
Q

Pregnancy Unique-Quantification of Emesis (PUQE) Score:
__to ___: mild nausea and vomiting of pregnancy.
___to ___: moderate nausea and vomiting of pregnancy.
>= __: severe nausea and vomiting

A

Pregnancy Unique-Quantification of Emesis (PUQE) Score:
4 to 6: mild nausea and vomiting of pregnancy.
7 to 12: moderate nausea and vomiting of pregnancy.
>= 13: severe nausea and vomiting

18
Q

Dry heaving, sometimes called retching, refers tovomit-like feelings without __________.

A

Dry heaving, sometimes called retching, refers tovomit-like feelings without any substance.

19
Q

Investigations:
Urinalysis: ____________

A

Investigations:
Urinalysis: to detect ketones in urine

20
Q

Investigations:

Midstream urine culture (MSU): ____________

A

Investigations:

Midstream urine culture (MSU): to exclude UTI

21
Q

Investigations:

Fullbloodcount(FBC):_______________

A

Investigations:

Fullbloodcount(FBC):↑hematocrit(Ht)

22
Q

Investigations:

Urea & electrolytes: _____________

A

Investigations:

Urea & electrolytes: ↓ K+, ↓ Na+

23
Q

Investigations:

Liver function test: ___________, _______

A

Investigations:

Liver function test: ↑ transaminases, ↓ albumin

24
Q

Investigations:

Ultrasound for reassurance & to exclude ______ and _______ pregnancies.

A

Investigations:

Ultrasound for reassurance & to exclude multiple and molar pregnancies.

25
Q

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, _____&________.
2. Hyponatremia and rapid reversal of hyponatremia → central pontine myelinosis⭐
3. Thiamine deficiency → Wernicke’s encephalopathy⭐
4. Vitamin K deficiency → Maternal coagulopathy⭐
5. Mallory Weiss tears & Boerhaave syndrome⭐

A

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, liver & renal failure
2. Hyponatremia and rapid reversal of hyponatremia → central pontine myelinosis⭐
3. Thiamine deficiency → Wernicke’s encephalopathy⭐
4. Vitamin K deficiency → Maternal coagulopathy⭐
5. Mallory Weiss tears & Boerhaave syndrome⭐

26
Q

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, liver & renal failure
2. Hyponatremia and rapid reversal of hyponatremia → _________________⭐
3. Thiamine deficiency → Wernicke’s encephalopathy⭐
4. Vitamin K deficiency → Maternal coagulopathy⭐
5. Mallory Weiss tears & Boerhaave syndrome⭐

A

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, liver & renal failure
2. Hyponatremia and rapid reversal of hyponatremia → central pontine myelinosis⭐
3. Thiamine deficiency → Wernicke’s encephalopathy⭐
4. Vitamin K deficiency → Maternal coagulopathy⭐
5. Mallory Weiss tears & Boerhaave syndrome⭐

27
Q

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, liver & renal failure
2. Hyponatremia and rapid reversal of hyponatremia → central pontine myelinosis⭐
3. Thiamine deficiency → ___________________⭐
4. Vitamin K deficiency → Maternal coagulopathy⭐
5. Mallory Weiss tears & Boerhaave syndrome⭐

A

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, liver & renal failure
2. Hyponatremia and rapid reversal of hyponatremia → central pontine myelinosis⭐
3. Thiamine deficiency → Wernicke’s encephalopathy⭐
4. Vitamin K deficiency → Maternal coagulopathy⭐
5. Mallory Weiss tears & Boerhaave syndrome⭐

28
Q

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, liver & renal failure
2. Hyponatremia and rapid reversal of hyponatremia → central pontine myelinosis⭐
3. Thiamine deficiency → Wernicke’s encephalopathy⭐
4. Vitamin K deficiency → _________________⭐
5. Mallory Weiss tears & Boerhaave syndrome⭐

A

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, liver & renal failure
2. Hyponatremia and rapid reversal of hyponatremia → central pontine myelinosis⭐
3. Thiamine deficiency → Wernicke’s encephalopathy⭐
4. Vitamin K deficiency → Maternal coagulopathy⭐
5. Mallory Weiss tears & Boerhaave syndrome⭐

29
Q

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, liver & renal failure
2. Hyponatremia and rapid reversal of hyponatremia → central pontine myelinosis⭐
3. Thiamine deficiency → Wernicke’s encephalopathy⭐
4. Vitamin K deficiency → Maternal coagulopathy⭐
5. ______________ tears & Boerhaave syndrome⭐

A

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, liver & renal failure
2. Hyponatremia and rapid reversal of hyponatremia → central pontine myelinosis⭐
3. Thiamine deficiency → Wernicke’s encephalopathy⭐
4. Vitamin K deficiency → Maternal coagulopathy⭐
5. Mallory Weiss tears & Boerhaave syndrome⭐

30
Q

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, liver & renal failure
2. Hyponatremia and rapid reversal of hyponatremia → central pontine myelinosis⭐
3. Thiamine deficiency → Wernicke’s encephalopathy⭐
4. Vitamin K deficiency → Maternal coagulopathy⭐
5. Mallory Weiss tears & ____________syndrome⭐

A

Complications:
Maternal risks
1. Dehydration⭐→ electrolyte imbalance, liver & renal failure
2. Hyponatremia and rapid reversal of hyponatremia → central pontine myelinosis⭐
3. Thiamine deficiency → Wernicke’s encephalopathy⭐
4. Vitamin K deficiency → Maternal coagulopathy⭐
5. Mallory Weiss tears & Boerhaave syndrome⭐

31
Q

Complications
Fetal risks
1. _____________ (IUGR)
2. Fetal death ← fetal intracranial bleeding , Wernicke’s encephalopathy⭐

A

Complications
Fetal risks
1. Growth restriction (IUGR)
2. Fetal death ← fetal intracranial bleeding , Wernicke’s encephalopathy⭐

32
Q

Complications
Fetal risks
1. Growth restriction (IUGR)
2. Fetal death ← fetal intracranial bleeding , Wernicke’s encephalopathy⭐

A

Complications
Fetal risks
1. Growth restriction (IUGR)
2. ______________ ← fetal intracranial bleeding , Wernicke’s encephalopathy⭐

33
Q

Complications
Fetal risks
1. Growth restriction (IUGR)
2. Fetal death ← __________________ , Wernicke’s encephalopathy⭐

A

Complications
Fetal risks
1. Growth restriction (IUGR)
2. Fetal death ← fetal intracranial bleeding , Wernicke’s encephalopathy⭐

34
Q

Complications
Fetal risks
1. Growth restriction (IUGR)
2. Fetal death ← fetal intracranial bleeding , ___________________⭐

A

Complications
Fetal risks
1. Growth restriction (IUGR)
2. Fetal death ← fetal intracranial bleeding , Wernicke’s encephalopathy⭐

Gyneco-Obstetrics III, Dr. Khor Hoksunn (1 decks)

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