Hypertensive disorders: pulmonary oedema management: 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: pulmonary oedema management

Sample item

A woman with severe pre-eclampsia becomes breathless after intravenous fluids, with bibasal crepitations and SpO2 of 88 per cent. What are the first measures?

AA rapid crystalloid bolus for presumed hypovolaemiaBDouble the magnesium sulphate maintenance doseCA terbutaline infusionDOxygen, sit her upright, give intravenous furosemide and restrict fluids

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

The answer and the reasoning

D. Oxygen, sit her upright, give intravenous furosemide and restrict fluids

Pulmonary oedema in pre-eclampsia results from capillary leak and fluid load. Oxygen, an upright position, a loop diuretic and fluid restriction are the first steps, together with blood pressure control, and delivery is planned once she is stable.

Option by option

A. A rapid crystalloid bolus for presumed hypovolaemia
More fluid would worsen the pulmonary oedema.
B. Double the magnesium sulphate maintenance dose
More magnesium risks toxicity and does not help the oedema.
C. A terbutaline infusion
Terbutaline is a tocolytic that can precipitate pulmonary oedema and is harmful here.
D. Oxygen, sit her upright, give intravenous furosemide and restrict fluids (correct)
Correct. These measures treat pulmonary oedema directly.

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, Oxygen, sit her upright, give intravenous furosemide and restrict fluids. Pulmonary oedema in pre-eclampsia results from capillary leak and fluid load.

Why is "A rapid crystalloid bolus for presumed hypovolaemia" not the answer?

More fluid would worsen the pulmonary oedema.

Why is "Double the magnesium sulphate maintenance dose" not the answer?

More magnesium risks toxicity and does not help the oedema.

Why is "A terbutaline infusion" not the answer?

Terbutaline is a tocolytic that can precipitate pulmonary oedema and is harmful here.

What concept does this question test?

It tests Hypertensive disorders: pulmonary oedema management in OBG. Oxygen, an upright position, a loop diuretic and fluid restriction are the first steps, together with blood pressure control, and delivery is planned once she is stable.

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: pulmonary oedema management?

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.