Contraception: hypertension: 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 · Contraception: hypertension

Sample item

A 38-year-old has a persistent blood pressure of 165/105 mmHg and asks for the combined pill. How is this classified under the WHO medical eligibility criteria?

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

The answer and the reasoning

D. Category 4, which means an unacceptable risk

Systolic blood pressure of 160 or more or diastolic 100 or more makes combined hormonal contraception category 4 because of stroke and myocardial infarction risk, and adequately controlled hypertension is category 3. Safer options include copper IUCD, LNG IUS and progestogen-only pills. Blood pressure is measured before prescribing.

Option by option

  • A. Category 1

    Category 1 is for no restriction.

  • B. Category 3 only for systolic above 200

    The category 4 threshold is 160/100, not 200.

  • C. Category 2

    Category 2 would mean advantages outweigh risks.

  • D. Category 4, which means an unacceptable risk (correct)

    Correct. Severe hypertension makes oestrogen unacceptable.

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.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Category 4, which means an unacceptable risk. Systolic blood pressure of 160 or more or diastolic 100 or more makes combined hormonal contraception category 4 because of stroke and myocardial infarction risk, and adequately controlled hypertension is category 3.

Why is "Category 1" not the answer?

Category 1 is for no restriction.

Why is "Category 3 only for systolic above 200" not the answer?

The category 4 threshold is 160/100, not 200.

Why is "Category 2" not the answer?

Category 2 would mean advantages outweigh risks.

What concept does this question test?

It tests Contraception: hypertension in OBG. Safer options include copper IUCD, LNG IUS and progestogen-only pills. Blood pressure is measured before prescribing.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Contraception: hypertension?

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.