Hypertensive disorders: angiotensin II sensitivity: 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: angiotensin II sensitivity

Sample item

Normal pregnant women resist the pressor effect of infused angiotensin II. What happens in women who go on to develop pre-eclampsia?

AThis refractoriness is lost weeks before hypertension appearsBPlasma renin activity rises above normal pregnancy valuesCThe pressor response equals that of a non-pregnant woman from the startDRefractoriness becomes greater than normal

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

The answer and the reasoning

A. This refractoriness is lost weeks before hypertension appears

In normal pregnancy, vascular sensitivity to angiotensin II is reduced. In women destined to develop pre-eclampsia, this resistance disappears before clinical hypertension, which was the basis of the angiotensin sensitivity test. Renin and angiotensin II levels are actually lower than in normal pregnancy.

Option by option

A. This refractoriness is lost weeks before hypertension appears (correct)
Correct. Loss of refractoriness to angiotensin II precedes the rise in blood pressure.
B. Plasma renin activity rises above normal pregnancy values
Renin activity is suppressed in pre-eclampsia compared with normal pregnancy.
C. The pressor response equals that of a non-pregnant woman from the start
Normal pregnancy already shows reduced sensitivity, which is lost only later in the pre-eclamptic woman.
D. Refractoriness becomes greater than normal
Increased refractoriness would protect from hypertension rather than predict it.

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 A, This refractoriness is lost weeks before hypertension appears. In normal pregnancy, vascular sensitivity to angiotensin II is reduced.

Why is "Plasma renin activity rises above normal pregnancy values" not the answer?

Renin activity is suppressed in pre-eclampsia compared with normal pregnancy.

Why is "The pressor response equals that of a non-pregnant woman from the sta…" not the answer?

Normal pregnancy already shows reduced sensitivity, which is lost only later in the pre-eclamptic woman.

Why is "Refractoriness becomes greater than normal" not the answer?

Increased refractoriness would protect from hypertension rather than predict it.

What concept does this question test?

It tests Hypertensive disorders: angiotensin II sensitivity in OBG. In women destined to develop pre-eclampsia, this resistance disappears before clinical hypertension, which was the basis of the angiotensin sensitivity test. Renin and angiotensin II levels are actually lower than in normal pregnancy.

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: angiotensin II sensitivity?

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.