Nausea and Vomiting

Question 1

When does Nausea and vomiting peak and resolve

Answer 1

Peak at 9 weeks
Resolves 16-20 weeks

Question 2

Define hyperemesis gravidarum

Answer 2

Severe persistent nausea and vomiting during pregnancy

Question 3

Triad of hyperemesis gravidarum

Answer 3

Dehydration
Electrolyte imbalance
Loss of more than 5% of pre pregnancy weight

Question 4

Hormones involved in pathophysiology of hyperemesis gravidarum x4

Answer 4

HCG
Estrogen
Progesterone
Thyroxine

Question 5

Effect of estrogen and progesterone on nausea and vomiting

Answer 5

Causes relaxation of GIT muscles > increased transit time> delayed gastric emptying

Question 6

Risk factors of nausea and vomiting x5

Answer 6

N&V in previous pregnancy
Primigravida
Multiple gestation
Molar pregnancy
Psychological stress

Question 7

Classification of nausea and vomiting by PUQE x3

Answer 7

Mild: <=6
Moderate: 7-12
Severe: 13-15

Question 8

Fetal complication of hyperemesis gravidarum x3

Answer 8

IUGR
LBW
Preterm birth

Question 9

Maternal complications of N&V x6

Answer 9

AKI
Hypokalemia
Miscarriage
Mallory Weiss tear
Wernicke’s encephalopathy
Korsakoff’s encephalopathy

Question 10

Triad of Wernicke’s encephalopathy

Answer 10

Ataxia
Confusion
Ophthalmoplegia

Question 11

Non pharmacological management of N&V x2

Answer 11

Diet and lifestyle modification

Question 12

Pharmacological management of N&V x3

Answer 12

Antihistamines - promethazine
5HT3 receptor antagonists
Dopamine receptor antagonists

Question 13

Treatment for mild N&V x3

Answer 13

Oral antiemetics
Oral rehydration
Dietary advice

Question 14

Management of moderate N&V x3

Answer 14

Parenteral antiemetics
Thiamine
IV fluids

Question 15

Management of severe N&V x3

Answer 15

IV fluids
Potassium gluconate
Thiamine