Hypertensive disorders: anaesthesia for caesarean: 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: anaesthesia for caesarean

Sample item

A woman with severe pre-eclampsia needs a caesarean section. Platelet count is 150,000 per microlitre and coagulation is normal. Which technique is preferred?

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

The answer and the reasoning

C. Spinal or epidural anaesthesia

With normal platelets and coagulation, neuraxial anaesthesia is preferred as it avoids the airway difficulty from oedema and the severe pressor response to laryngoscopy, which can cause intracranial haemorrhage. General anaesthesia is used for coagulopathy, very low platelets or emergencies, with measures to blunt the pressor response.

Option by option

  • A. Ketamine induction general anaesthesia

    Ketamine raises blood pressure and is avoided in severe pre-eclampsia.

  • B. General anaesthesia with rapid intubation and no pressor attenuation

    Unmodified rapid intubation can cause a dangerous surge in blood pressure.

  • C. Spinal or epidural anaesthesia (correct)

    Correct. Neuraxial block avoids laryngoscopy and its pressor surge.

  • D. Local infiltration alone

    Local infiltration alone gives inadequate anaesthesia for caesarean section.

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 C, Spinal or epidural anaesthesia. With normal platelets and coagulation, neuraxial anaesthesia is preferred as it avoids the airway difficulty from oedema and the severe pressor response to laryngoscopy, which can cause intracranial haemorrhage.

Why is "Ketamine induction general anaesthesia" not the answer?

Ketamine raises blood pressure and is avoided in severe pre-eclampsia.

Why is "General anaesthesia with rapid intubation and no pressor attenuation" not the answer?

Unmodified rapid intubation can cause a dangerous surge in blood pressure.

Why is "Local infiltration alone" not the answer?

Local infiltration alone gives inadequate anaesthesia for caesarean section.

What concept does this question test?

It tests Hypertensive disorders: anaesthesia for caesarean in OBG. General anaesthesia is used for coagulopathy, very low platelets or emergencies, with measures to blunt the pressor response.

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 Hypertensive disorders: anaesthesia for caesarean?

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.