Hypertensive disorders: hydralazine adverse effects: 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: hydralazine adverse effects

Sample item

A woman with pre-eclampsia given intravenous hydralazine for severe hypertension develops palpitations, headache and flushing. What explains these effects?

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

The answer and the reasoning

B. Direct arteriolar vasodilatation with reflex sympathetic activation

Hydralazine relaxes arteriolar smooth muscle directly, and the fall in pressure triggers a baroreflex-mediated sympathetic response, giving tachycardia, headache and flushing. These effects can be mistaken for worsening pre-eclampsia, and it is avoided as the first choice.

Option by option

  • A. Cyanide released from drug metabolism

    Cyanide toxicity is a problem with sodium nitroprusside.

  • B. Direct arteriolar vasodilatation with reflex sympathetic activation (correct)

    Correct. Arteriolar dilatation produces reflex tachycardia, headache and flushing.

  • C. Inhibition of angiotensin II formation

    Inhibiting angiotensin formation is the effect of ACE inhibitors.

  • D. Beta-adrenergic blockade with unopposed alpha activity

    Hydralazine does not block beta receptors.

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 B, Direct arteriolar vasodilatation with reflex sympathetic activation. Hydralazine relaxes arteriolar smooth muscle directly, and the fall in pressure triggers a baroreflex-mediated sympathetic response, giving tachycardia, headache and flushing.

Why is "Cyanide released from drug metabolism" not the answer?

Cyanide toxicity is a problem with sodium nitroprusside.

Why is "Inhibition of angiotensin II formation" not the answer?

Inhibiting angiotensin formation is the effect of ACE inhibitors.

Why is "Beta-adrenergic blockade with unopposed alpha activity" not the answer?

Hydralazine does not block beta receptors.

What concept does this question test?

It tests Hypertensive disorders: hydralazine adverse effects in OBG. These effects can be mistaken for worsening pre-eclampsia, and it is avoided as the first choice.

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: hydralazine adverse effects?

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.