Hyperemisis Grav Flashcards
(20 cards)
What are hallmark symptoms of hyperemesis gravidarum?
Severe persistent vomiting, weight loss, dehydration, orthostatic hypotension
How much weight loss qualifies as hyperemesis gravidarum?
> 5% of pre-pregnancy weight
What lab finding indicates starvation from hyperemesis gravidarum?
↑ Urine ketones
What are the key electrolyte abnormalities in hyperemesis gravidarum?
↓ Potassium, ↓ Chloride, ↓ Glucose
What liver enzymes may be elevated in hyperemesis gravidarum?
Mild ↑ ALT/AST
What causes ↑ hematocrit in hyperemesis gravidarum?
Hemoconcentration from dehydration
What imaging study should be performed to evaluate hyperemesis gravidarum?
Ultrasound to rule out molar pregnancy or multiple gestation
What distinguishes hyperemesis gravidarum from normal pregnancy nausea?
Weight loss and ketonuria
What vitamin must be given before glucose in hyperemesis gravidarum?
Thiamine
What serious neurologic complication can occur without thiamine?
Wernicke encephalopathy
What is the first-line pharmacologic treatment for hyperemesis gravidarum?
Pyridoxine ± doxylamine
What antiemetics are used if symptoms persist despite first-line therapy?
Promethazine or ondansetron
What is the first step in managing volume depletion in hyperemesis gravidarum?
IV fluids with dextrose and electrolytes
What is the clinical diagnosis of hyperemesis gravidarum based on?
Persistent vomiting, weight loss, ketonuria
What should you rule out with pelvic ultrasound in hyperemesis gravidarum?
Molar pregnancy
What nutritional support is used in refractory hyperemesis gravidarum?
Enteral or parenteral nutrition
What complication can result from prolonged vomiting and fluid loss?
Acute kidney injury
What acid-base disturbance is seen in hyperemesis gravidarum?
Hypochloremic metabolic alkalosis
What symptom suggests severe dehydration in hyperemesis gravidarum?
Orthostatic hypotension
When should a patient with hyperemesis gravidarum be hospitalized?
When unable to tolerate oral intake and with electrolyte abnormalities
