Hypertensive disorders: epigastric pain mechanism: 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: epigastric pain mechanism

Sample item

What is the mechanism of epigastric or right upper quadrant pain in severe pre-eclampsia?

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

The answer and the reasoning

D. Distension of the hepatic capsule from periportal haemorrhage and oedema

Hepatic involvement produces periportal haemorrhage, fibrin deposition and oedema that stretch Glisson's capsule. The pain is a warning of impending eclampsia or HELLP and calls for urgent liver enzymes, platelets and delivery planning.

Option by option

  • A. Biliary colic from gallstones

    Gallstone colic is a coincidental cause and does not explain the link with severe pre-eclampsia.

  • B. Gastric acid hypersecretion

    Acid hypersecretion is not part of pre-eclampsia pathology.

  • C. Ischaemia of the pancreas

    Pancreatic ischaemia is not the mechanism.

  • D. Distension of the hepatic capsule from periportal haemorrhage and oedema (correct)

    Correct. Capsular stretch from periportal haemorrhage and oedema causes the pain.

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, Distension of the hepatic capsule from periportal haemorrhage and oedema. Hepatic involvement produces periportal haemorrhage, fibrin deposition and oedema that stretch Glisson's capsule.

Why is "Biliary colic from gallstones" not the answer?

Gallstone colic is a coincidental cause and does not explain the link with severe pre-eclampsia.

Why is "Gastric acid hypersecretion" not the answer?

Acid hypersecretion is not part of pre-eclampsia pathology.

Why is "Ischaemia of the pancreas" not the answer?

Pancreatic ischaemia is not the mechanism.

What concept does this question test?

It tests Hypertensive disorders: epigastric pain mechanism in OBG. The pain is a warning of impending eclampsia or HELLP and calls for urgent liver enzymes, platelets and delivery planning.

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: epigastric pain mechanism?

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.