Hypertensive disorders: haemodynamic profile: 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: haemodynamic profile

Sample item

How does the plasma volume in established pre-eclampsia compare with that of a normal pregnancy?

AIt is the same, with a normal haematocritBIt is expanded, with a low vascular resistanceCIt is more expanded, with a low haematocritDIt is contracted, with haemoconcentration and raised haematocrit

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

The answer and the reasoning

D. It is contracted, with haemoconcentration and raised haematocrit

Instead of the physiological expansion of plasma volume, women with pre-eclampsia have a contracted intravascular volume from vasoconstriction and capillary leak. Haematocrit tends to rise, and vascular resistance is high. This is why diuretics and fluid overload are both harmful.

Option by option

A. It is the same, with a normal haematocrit
Plasma volume is not normal, since the expected expansion fails to occur.
B. It is expanded, with a low vascular resistance
Vascular resistance is high in pre-eclampsia, not low.
C. It is more expanded, with a low haematocrit
A more expanded volume with low haematocrit is the opposite of the real picture.
D. It is contracted, with haemoconcentration and raised haematocrit (correct)
Correct. Plasma volume is contracted and haematocrit rises.

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 D, It is contracted, with haemoconcentration and raised haematocrit. Instead of the physiological expansion of plasma volume, women with pre-eclampsia have a contracted intravascular volume from vasoconstriction and capillary leak.

Why is "It is the same, with a normal haematocrit" not the answer?

Plasma volume is not normal, since the expected expansion fails to occur.

Why is "It is expanded, with a low vascular resistance" not the answer?

Vascular resistance is high in pre-eclampsia, not low.

Why is "It is more expanded, with a low haematocrit" not the answer?

A more expanded volume with low haematocrit is the opposite of the real picture.

What concept does this question test?

It tests Hypertensive disorders: haemodynamic profile in OBG. Haematocrit tends to rise, and vascular resistance is high. This is why diuretics and fluid overload are both harmful.

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: haemodynamic profile?

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.