Hypertensive disorders: protein-creatinine ratio: 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 · Hypertensive disorders: protein-creatinine ratio

Sample item

A 28-week pregnant woman has a blood pressure of 150/96 mmHg on two occasions and a spot urine protein-to-creatinine ratio of 0.35 mg/mg. How is this interpreted?

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

The answer and the reasoning

C. Significant proteinuria, supporting pre-eclampsia

A spot urine protein-to-creatinine ratio of 0.3 mg/mg or more correlates with 300 mg or more of protein in a 24-hour collection and meets the criterion for significant proteinuria. Combined with new hypertension after 20 weeks, it diagnoses pre-eclampsia. The ratio is more convenient than the 24-hour collection.

Option by option

  • A. Normal finding in pregnancy

    The ratio exceeds the threshold, so it is not normal.

  • B. Nephrotic range proteinuria

    Nephrotic range would be much higher, around 3 or more.

  • C. Significant proteinuria, supporting pre-eclampsia (correct)

    Correct. A ratio of 0.3 or more equals significant proteinuria.

  • D. Contamination which cannot be interpreted

    The ratio is an accepted method and is not just contamination.

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 C, Significant proteinuria, supporting pre-eclampsia. A spot urine protein-to-creatinine ratio of 0.

Why is "Normal finding in pregnancy" not the answer?

The ratio exceeds the threshold, so it is not normal.

Why is "Nephrotic range proteinuria" not the answer?

Nephrotic range would be much higher, around 3 or more.

Why is "Contamination which cannot be interpreted" not the answer?

The ratio is an accepted method and is not just contamination.

What concept does this question test?

It tests Hypertensive disorders: protein-creatinine ratio in OBG. 3 mg/mg or more correlates with 300 mg or more of protein in a 24-hour collection and meets the criterion for significant proteinuria. Combined with new hypertension after 20 weeks, it diagnoses pre-eclampsia. The ratio is more convenient than the 24-hour collection.

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 Hypertensive disorders: protein-creatinine ratio?

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.