| Pathophysiology | • ↑ Biliary cholesterol excretion (estrogen) • ↓ Gallbladder motility (progesterone) | | --- | --- | | Clinical features | • Recurrent, postprandial epigastric/RUQ pain • Acute onset Nausea and vomiting (may be the CC) | | Diagnosis | • RUQ ultrasound with echogenic foci (stones or sludge) | | Management | • Conservative (eg, pain control) • Cholecystectomy (for complicated, recurrent cases) |
does not cause hypertension or renal dysfunction.
Mild hypertension may be due to pain-related, and it can be reevaluated after administering antiemetics and an analgesic.
(Choice D) Elevated β-hCG levels (eg, twin gestation, hydatidiform mole) may contribute to hyperemesis gravidarum, a type of pathologic nausea/vomiting in pregnancy that can cause epigastric or RUQ discomfort due to persistent vomiting. However, patients typically have electrolyte abnormalities (eg, hypokalemia, hypochloremia) and ketonuria. In addition, this patient with a single fetal heart tone is unlikely to have a twin gestation or hydatidiform mole; therefore, a β-hCG level would not change management.