vomiting

Question 1

how common is vomiting

Answer 1

80% preg f
very common in first trimester due to increased BHCG from syncytiotrophoblast

Question 2

when does vomiting normally resolve

Answer 2

16-24 weeks

Question 3

what is severe vomiting called

Answer 3

hyperemesis gravidarium

Question 4

what are the risk factors of HG

Answer 4

multiple pregnancy, molar pregnancy, hyperthyroidism, DKA

Question 5

what are the symptoms of HG vomiting

Answer 5

RCOG triad- > 5% of pre preg weight loss + dehydration ( decreased turgor, pallor, thirst)+ electrolyte abnormalities ( ketonaemia, other)
( decreased appetite and severe vomiting)

Question 6

how is HG diagnosed

Answer 6

blood- FBC, U + E, LFT, CLOTTING, OGTT, BPM BMI, ECG, urine dip, TVUSS+ SERUM BHCG ( MOLAR)
VBG- HYPOK, HYPOCL met alkilosis

Question 7

what is PUQE-24 score

Answer 7

used to determine the severity of nausea and vomiting in pregnant women.

Question 8

what is the tx for HG

Answer 8

1. antiemetics/ antihistamines - Prochlorperazine (stemetil)
   Cyclizine
2. Ondansetron ( 5HT3RI)
3. dompendone
4. metoclopramide

Question 9

how long can you take ondansetron for Hyperemesis gravidarium and why?

Answer 9

• MAX 5 DAYS DUE TO CLEFT PALATE RISK IN 1/3

Question 10

how does dompendone work and what are the risks ( for hyperemesis gravidarium)

Answer 10

• increased risk of cv arrthymias
  peripheral
• works as D2+ D3 dopamine Receptor antagonist - therefore decreased GI motility

Question 11

how long can you take metoclopramide for Hyperemesis gravidarium and why?

Answer 11

( DA2R-I) - dopamine and serotonin antagonist
max 5d due to Extrapyrimidal SE risk

Question 12

what are the other non med tx for vom

Answer 12

ginger
acupunture
hypnosis