The document discusses how acute hyperemesis gravidarum (severe nausea and vomiting during pregnancy) can lead to malnutrition, especially thiamine deficiency, in the patient Velma. Thiamine deficiency can cause neurological symptoms like confusion and difficulty forming memories. If left untreated, it can progress to Wernicke's encephalopathy, a serious brain disorder, or death through spontaneous abortion. The clinician is right to be concerned about Velma's weight gain issues and new behaviors as they could indicate thiamine deficiency as a result of her hyperemesis gravidarum and lack of nutrient absorption.

1. Jordan Iness Michael Giovine Holly Royer Elsa C