Medical disorders in pregnancy: sickle cell crisis: 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 in pregnancy: sickle cell crisis

Sample item

A 26-year-old woman with sickle cell disease at 30 weeks presents with severe bone pain, tachycardia and oxygen saturation of 91 percent. Which initial management is most appropriate?

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

The answer and the reasoning

A. Oxygen, intravenous fluids, adequate opioid analgesia and thromboprophylaxis with specialist care

A sickle crisis in pregnancy is treated with oxygen, careful hydration, effective analgesia, search for and treatment of infection, and thromboprophylaxis because pregnancy and immobility raise thrombotic risk. Care is shared with a haematologist, and exchange transfusion is considered in severe disease. Fluids are given cautiously to avoid pulmonary oedema.

Option by option

  • A. Oxygen, intravenous fluids, adequate opioid analgesia and thromboprophylaxis with specialist care (correct)

    Correct. Oxygen, fluids, analgesia and thromboprophylaxis form the standard first response.

  • B. Oral iron and folic acid alone

    Iron is generally avoided without proven deficiency, and it does not treat an acute crisis.

  • C. Large-volume rapid fluid bolus without any analgesia

    Aggressive fluid loading risks pulmonary oedema and pain still needs treatment.

  • D. Prophylactic induction of labour at once and discharge on oral paracetamol

    Induction does not treat the crisis and simple oral analgesia is inadequate for severe pain.

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 A, Oxygen, intravenous fluids, adequate opioid analgesia and thromboprophylaxis with specialist care. A sickle crisis in pregnancy is treated with oxygen, careful hydration, effective analgesia, search for and treatment of infection, and thromboprophylaxis because pregnancy and immobility raise thrombotic risk.

Why is "Oral iron and folic acid alone" not the answer?

Iron is generally avoided without proven deficiency, and it does not treat an acute crisis.

Why is "Large-volume rapid fluid bolus without any analgesia" not the answer?

Aggressive fluid loading risks pulmonary oedema and pain still needs treatment.

Why is "Prophylactic induction of labour at once and discharge on oral parace…" not the answer?

Induction does not treat the crisis and simple oral analgesia is inadequate for severe pain.

What concept does this question test?

It tests Medical disorders in pregnancy: sickle cell crisis in OBG. Care is shared with a haematologist, and exchange transfusion is considered in severe disease. Fluids are given cautiously to avoid pulmonary oedema.

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 Medical disorders in pregnancy: sickle cell crisis?

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.