Hypertensive disorders: placental bed histology: 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: placental bed histology

Sample item

Examination of the placental bed in severe pre-eclampsia would typically show which vascular finding?

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

The answer and the reasoning

D. Acute atherosis of decidual spiral arteries with foam cells

Failure of physiological conversion of the spiral arteries leaves narrow muscular vessels. Acute atherosis, with fibrinoid necrosis and lipid-laden macrophages, may develop, with placental infarcts. These changes impair uteroplacental flow and predispose to growth restriction.

Option by option

  • A. Hydropic swelling of villi with trophoblastic hyperplasia

    Hydropic villi with trophoblastic hyperplasia indicate a hydatidiform mole.

  • B. Neutrophil infiltration of the membranes

    Neutrophils in the membranes indicate chorioamnionitis.

  • C. Calcified villi with Hofbauer cell hyperplasia

    Calcified villi with Hofbauer cell hyperplasia are unrelated to pre-eclampsia.

  • D. Acute atherosis of decidual spiral arteries with foam cells (correct)

    Correct. Acute atherosis is the typical decidual vessel lesion.

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, Acute atherosis of decidual spiral arteries with foam cells. Failure of physiological conversion of the spiral arteries leaves narrow muscular vessels.

Why is "Hydropic swelling of villi with trophoblastic hyperplasia" not the answer?

Hydropic villi with trophoblastic hyperplasia indicate a hydatidiform mole.

Why is "Neutrophil infiltration of the membranes" not the answer?

Neutrophils in the membranes indicate chorioamnionitis.

Why is "Calcified villi with Hofbauer cell hyperplasia" not the answer?

Calcified villi with Hofbauer cell hyperplasia are unrelated to pre-eclampsia.

What concept does this question test?

It tests Hypertensive disorders: placental bed histology in OBG. Acute atherosis, with fibrinoid necrosis and lipid-laden macrophages, may develop, with placental infarcts. These changes impair uteroplacental flow and predispose to growth restriction.

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: placental bed histology?

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.