study_ing
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the question asked about a lady with an otherwise uncomplicated pregnany but Clinical features suggestive of hyperemesis gravidarum.
after initial fluid rresuscitation, the q asked as to what shud be the next step. these were the options i was confused about.
a.measure HCG
b. US pelvis.
i chose b, coz we knew the lady is pregnant, hence we'd like to see if there is a hydatidiform mole. a high hcg level wud be suggestive of but not diagnostic of a mole. however the answer given was a. cud anyone please comment.
if hcg levels are normal in hyperemesis, is a mole ruled out?
the answer given was a
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| juanma0
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I suspect it is because high BhCG levels are closely related to Hyperemesis gravidarum and there are a couple of diseases that are the culprit, such as Graves Disease, Molar pregnancy, choriocarcinoma and something called Transient Hyperthyroidism of Hyperemesis Gravidarum. So in measring the BhCG we can narrow down the options before USG.
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| juanma0
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Good time to review Hyperemesis Gravidarum,
1. Onset 4-8 weeks gestation and persists throughout pregnancy (may get better by 14-16 weeks)
2. Must rule out : pancreatitis, cholecystitis, hepatitis, and thyroid disease
3. Hospitalization with intravenous replacement of fluids and electrolytes is often needed.
4. MEDS : promethazine, chlorpromazine, prochlorperazine, metoclopramide, droperidol, oral methylprednisolone.
CAUTION: do not mix metoclopramide with the 1st three as there is an increased risk of extrapyramidal side effects.
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| study_ing
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thanx,
u're amazing
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| tolito
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interesting 
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| ram3
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Hyperemesis Gravidum is intractable nausea and vomitting beyond
fourteen to sixteen weeks gestation when bhcg levels are supposed
to fall this is seen in molar pregnancy
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