Hypertensive disorders: HELLP blood film: 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: HELLP blood film

Sample item

A pregnant woman with right upper quadrant pain has anaemia, raised LDH and a low platelet count. Which peripheral smear finding supports HELLP syndrome?

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

The answer and the reasoning

B. Schistocytes and burr cells

HELLP involves microangiopathic haemolytic anaemia, in which red cells are fragmented as they pass through fibrin strands in damaged small vessels. The smear shows schistocytes and burr cells, with high LDH and low haptoglobin, and the Coombs test is negative.

Option by option

  • A. Spherocytes with a positive direct Coombs test

    Spherocytes with a positive Coombs test indicate autoimmune haemolysis.

  • B. Schistocytes and burr cells (correct)

    Correct. Fragmented red cells reflect microangiopathic haemolysis.

  • C. Macro-ovalocytes with hypersegmented neutrophils

    Macro-ovalocytes and hypersegmented neutrophils indicate megaloblastic anaemia.

  • D. Sickle cells

    Sickle cells indicate haemoglobinopathy and would not explain thrombocytopenia and liver enzyme rise.

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.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Schistocytes and burr cells. HELLP involves microangiopathic haemolytic anaemia, in which red cells are fragmented as they pass through fibrin strands in damaged small vessels.

Why is "Spherocytes with a positive direct Coombs test" not the answer?

Spherocytes with a positive Coombs test indicate autoimmune haemolysis.

Why is "Macro-ovalocytes with hypersegmented neutrophils" not the answer?

Macro-ovalocytes and hypersegmented neutrophils indicate megaloblastic anaemia.

Why is "Sickle cells" not the answer?

Sickle cells indicate haemoglobinopathy and would not explain thrombocytopenia and liver enzyme rise.

What concept does this question test?

It tests Hypertensive disorders: HELLP blood film in OBG. The smear shows schistocytes and burr cells, with high LDH and low haptoglobin, and the Coombs test is negative.

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: HELLP blood film?

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.