Complications of pregnancy: interpreting the 75 g OGTT: 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 · Complications of pregnancy: interpreting the 75 g OGTT

Sample item

A woman at 26 weeks undergoes a 75 g oral glucose tolerance test. Her fasting plasma glucose is 95 mg/dL, 1-hour value 170 mg/dL and 2-hour value 140 mg/dL. What is the interpretation using the 92, 180 and 153 mg/dL cut-offs?

AOvert diabetes in pregnancyBNormal, because two of the three values are below the cut-offsCGestational diabetes mellitus, because one value reaches the thresholdDGestational diabetes only if all three values are raised

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

The answer and the reasoning

C. Gestational diabetes mellitus, because one value reaches the threshold

With the IADPSG cut-offs of 92, 180 and 153 mg/dL, one abnormal value is enough to diagnose gestational diabetes. Here the fasting value of 95 mg/dL exceeds 92. Diet advice and glucose monitoring follow.

Option by option

A. Overt diabetes in pregnancy
Overt diabetes requires a fasting value of 126 mg/dL or more, which is not reached here.
B. Normal, because two of the three values are below the cut-offs
These criteria do not require two abnormal values, so normal values elsewhere do not cancel the fasting result.
C. Gestational diabetes mellitus, because one value reaches the threshold (correct)
Correct. A single value at or above a threshold establishes the diagnosis.
D. Gestational diabetes only if all three values are raised
All three values do not have to be abnormal for the diagnosis.

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.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Gestational diabetes mellitus, because one value reaches the threshold. With the IADPSG cut-offs of 92, 180 and 153 mg/dL, one abnormal value is enough to diagnose gestational diabetes.

Why is "Overt diabetes in pregnancy" not the answer?

Overt diabetes requires a fasting value of 126 mg/dL or more, which is not reached here.

Why is "Normal, because two of the three values are below the cut-offs" not the answer?

These criteria do not require two abnormal values, so normal values elsewhere do not cancel the fasting result.

Why is "Gestational diabetes only if all three values are raised" not the answer?

All three values do not have to be abnormal for the diagnosis.

What concept does this question test?

It tests Complications of pregnancy: interpreting the 75 g OGTT in OBG. Here the fasting value of 95 mg/dL exceeds 92. Diet advice and glucose monitoring follow.

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 Complications of pregnancy: interpreting the 75 g OGTT?

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.