Complications of pregnancy: hyperemesis gravidarum: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Complications of pregnancy: hyperemesis gravidarum

Sample item

A woman at 9 weeks has persistent vomiting, weight loss of 6 per cent, ketonuria and dehydration. Which is the appropriate first step in addition to IV fluids?

APlan immediate terminationBStart high-dose oral steroids immediatelyCGive thiamine before or with dextrose-containing fluidsDRestrict all oral intake for 7 days

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Give thiamine before or with dextrose-containing fluids

Hyperemesis gravidarum is managed with IV normal saline or Ringer lactate, antiemetics such as doxylamine-pyridoxine or ondansetron, and thiamine supplementation to prevent Wernicke encephalopathy. Dextrose without thiamine can precipitate Wernicke encephalopathy.

Option by option

A. Plan immediate termination
Termination is not indicated for hyperemesis in the absence of life-threatening complications.
B. Start high-dose oral steroids immediately
Steroids are reserved for refractory cases and are not first-line.
C. Give thiamine before or with dextrose-containing fluids (correct)
Correct. Thiamine prevents Wernicke encephalopathy during refeeding or dextrose infusion.
D. Restrict all oral intake for 7 days
Prolonged nil by mouth does not help and worsens nutritional state.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Give thiamine before or with dextrose-containing fluids. Hyperemesis gravidarum is managed with IV normal saline or Ringer lactate, antiemetics such as doxylamine-pyridoxine or ondansetron, and thiamine supplementation to prevent Wernicke encephalopathy.

Why is "Plan immediate termination" not the answer?

Termination is not indicated for hyperemesis in the absence of life-threatening complications.

Why is "Start high-dose oral steroids immediately" not the answer?

Steroids are reserved for refractory cases and are not first-line.

Why is "Restrict all oral intake for 7 days" not the answer?

Prolonged nil by mouth does not help and worsens nutritional state.

What concept does this question test?

It tests Complications of pregnancy: hyperemesis gravidarum in OBG. Dextrose without thiamine can precipitate Wernicke encephalopathy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications of pregnancy: hyperemesis gravidarum?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.