Hypertensive disorders: change of partner and risk: 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: change of partner and risk

Sample item

A multiparous woman who had a normal first pregnancy develops pre-eclampsia in a first pregnancy with a new partner. Which concept explains her increased risk?

ALimited prior exposure to the new partner's paternal antigensBPersistence of the trophoblast from the first pregnancyCPrevious successful pregnancy having induced tolerance to the new partnerDIncreased maternal age alone

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

The answer and the reasoning

A. Limited prior exposure to the new partner's paternal antigens

An immune maladaptation theory suggests that prior exposure to a partner's antigens, as through earlier pregnancy or long cohabitation, protects against pre-eclampsia. A new partner means a new antigen exposure, so the risk resembles that of a primigravida.

Option by option

A. Limited prior exposure to the new partner's paternal antigens (correct)
Correct. Limited exposure to the new partner's antigens raises the risk, as in a first pregnancy.
B. Persistence of the trophoblast from the first pregnancy
There is no persistence of trophoblast from the earlier pregnancy that explains the risk.
C. Previous successful pregnancy having induced tolerance to the new partner
Tolerance developed to the first partner does not extend to the new partner.
D. Increased maternal age alone
Maternal age alone does not explain the effect of a changed partner.

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 A, Limited prior exposure to the new partner's paternal antigens. An immune maladaptation theory suggests that prior exposure to a partner's antigens, as through earlier pregnancy or long cohabitation, protects against pre-eclampsia.

Why is "Persistence of the trophoblast from the first pregnancy" not the answer?

There is no persistence of trophoblast from the earlier pregnancy that explains the risk.

Why is "Previous successful pregnancy having induced tolerance to the new par…" not the answer?

Tolerance developed to the first partner does not extend to the new partner.

Why is "Increased maternal age alone" not the answer?

Maternal age alone does not explain the effect of a changed partner.

What concept does this question test?

It tests Hypertensive disorders: change of partner and risk in OBG. A new partner means a new antigen exposure, so the risk resembles that of a primigravida.

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: change of partner and risk?

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.