Medical disorders: gestational thrombocytopenia: 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 · Medical disorders: gestational thrombocytopenia

Sample item

A healthy 28-year-old at 34 weeks has an incidental platelet count of 112,000/microlitre, with a normal blood pressure, normal liver enzymes and no bleeding. Her count was normal at booking. What is the most likely diagnosis?

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

The answer and the reasoning

A. Gestational thrombocytopenia

Gestational thrombocytopenia is the commonest cause of low platelets in pregnancy, occurring in the late second or third trimester with counts usually above 70,000 and no pathological consequences. It resolves after delivery and needs only monitoring. HELLP requires hypertension or hepatic dysfunction, and ITP usually presents earlier with lower counts.

Option by option

  • A. Gestational thrombocytopenia (correct)

    Correct. A mild, late, asymptomatic fall in an otherwise healthy woman is gestational thrombocytopenia.

  • B. Immune thrombocytopenia requiring steroids

    ITP would usually show a lower count and a pre-pregnancy history.

  • C. HELLP syndrome

    HELLP needs haemolysis, raised liver enzymes and hypertension.

  • D. Thrombotic thrombocytopenic purpura

    TTP shows microangiopathic haemolysis, neurological signs and severe thrombocytopenia.

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.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Gestational thrombocytopenia. Gestational thrombocytopenia is the commonest cause of low platelets in pregnancy, occurring in the late second or third trimester with counts usually above 70,000 and no pathological consequences.

Why is "Immune thrombocytopenia requiring steroids" not the answer?

ITP would usually show a lower count and a pre-pregnancy history.

Why is "HELLP syndrome" not the answer?

HELLP needs haemolysis, raised liver enzymes and hypertension.

Why is "Thrombotic thrombocytopenic purpura" not the answer?

TTP shows microangiopathic haemolysis, neurological signs and severe thrombocytopenia.

What concept does this question test?

It tests Medical disorders: gestational thrombocytopenia in OBG. It resolves after delivery and needs only monitoring. HELLP requires hypertension or hepatic dysfunction, and ITP usually presents earlier with lower counts.

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 Medical disorders: gestational thrombocytopenia?

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.