Hyperemesis Gravidarum

Each of the following clinical scenarios below relate to Management of women with Hypermesis gravidarum. For each patient select the single most appropriate management option from the list above. Each option may be used once, more than once or not at all.
Option List
A. Vitamin B1
B. Vitamin B12
C. Proton Pump Inhibitors
D. Hydrocortisone
E. Normal Saline With Pottasium Chloride
F. Ginger
G. Pyridoxine
H. Metcalopramide
I. Phenothiazine
J. Procycidine IV
K. Dextrose With Potassium Chloride
L. Termination Of Pregnancy

1. 32year-old primigravid woman having inpatient management of hyperemesis gravidarum. she is having an oculogyric crisis, tardive dyskinesia after she received fast Iv push of metaclopramide.

2. 24 year old referred from ambulatory care , as her PUQE index is 15 She is dehydrated , Ketonuria2+ ,Best rehydration regimen

3. 19 year old, presenting with 2 episode of nausea and vomiting , she is not dehydrated , able to tolerate orally,wishes to avoid anti Emetics

4. 30 year old women, admitted for inpatient management of Hypermesis , manged with rehydration, regimen , thiamine, Iv phenothiazine, Iv metaclopramide, diet according to dietician advise, she is still not responding to treatment

5. This medication to be given before giving dextrose infusion

6. 30 year old woman, presented with recurrent episodes of nause and vomiting , she complains of recurrent heart burn suggestive of women developing gastro-oesophageal reflux disease, additional medication along with antiemetics to be given

Each of the following clinical scenarios below relate to the complications of Hypermesis gravidarum For each patient select the single option which indicates incidence of that condition . Each option may be used once, more than once or not at all.
Option List
A. 80%
B. 10%
C. 48%
D. 40%
E. 18%
F. 30%
G. 3%
H. 100%
I. 66%

7. 22  year  old lady, admitted because of severe nausea and vomiting. For inpatient management. Her serum sodium is 128 mEQ/L, AST - 62IU/L. AlLT-54IU/L. Serum bilirubin is 1.3mg/dL alkaline phosphatase = 240 Urine dipstick shows 2+ketonuira This finding seen In what percentage of women.

8. 33year old . Primigravida admitted with severe nausea and vomitingshe is into her 10weeks of pregnancy, this is her third admission .clinically she is stable.
Free thyroxine (pmol/l)- 24( 10.0–16.0)normal values
Free triiodothyronine (pmol/l)- 14 ( 3.0–7.0)
TSH (mU/l)- 2.0. (0.1–2.5)

9. A 20-year primigravida ( prepregnancy weight is 75kgs ) come with nausea and vomiting episodes every day, she is able to eat and drink normally, urine ketones -Nil. Present weight is 73.5 kg.

10. 34 year old, primigravida, alcoholic admitted for severe nausea and vomiting developed ophthalmoplegia, diplopia, ataxia and confusion. All these symptoms developed after dextrose infusion. The overall pregnancy loss rate is

11. Number of pregnancies end by termination when all therapeutic options to treat hyperemesis have failed

12. Ideally Percentage of women in which Urea and serum electrolyte levels should be checked daily in women with HG requiring intravenous fluids

13. A 25-year-old pregnant woman with 9 weeks pregnancy (pre-pregnancy weight was 60kg )
Admitted for severe protractile vomiting, with ketonuria 1+, present weight is 56.5kg
This condition is seen in what percentage of women

14. 22year old women admitted for recurrent episodes of nausea and vomiting from beginning till now, now she is 26weeks pregnant. Her growth scan shows EFW and AC Less than 10thcentile.
This condition is seen in what percentage of women