A 22-Year-Old Woman, Gravida 1 Para 0, Comes to the Office

A 22-year-old woman, gravida 1 para 0, comes to the office for a prenatal visit at 16 weeks gestation.  The patient, who has not gained weight since her last visit 4 weeks ago, has occasional nausea with vomiting twice a week.  She has little appetite, which she attributes to mild indigestion, and her food consumption has decreased.  However, the patient craves ice and has been consuming it throughout the day for the last few months.  Medications include daily prenatal vitamins.  The patient was prescribed twice-daily iron for anemia but does not take it because it causes constipation.  She has no diarrhea, dysuria, chills, or fever.  She does not use tobacco.  Uterine fundus is consistent with a 16-week pregnancy.  Fetal heart tone is 140-149/min.  The patient's vital signs are within normal limits.  Which of the following is the most likely diagnosis?

A) Anorexia nervosa
B) Avoidant/restrictive food intake disorder
C) Bulimia nervosa
D) Hyperemesis gravidarum
E) Normal pregnancy craving
F) Pica

Correct Answer:

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