Hypertensive disorders: pathogenesis: 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: pathogenesis

Sample item

Which event is central to the pathogenesis of pre-eclampsia?

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

The answer and the reasoning

B. Inadequate trophoblastic invasion of spiral arteries

Failure of trophoblastic invasion and remodelling of spiral arteries leaves high-resistance vessels, causing placental ischaemia and release of anti-angiogenic factors (sFlt-1) that produce widespread endothelial dysfunction. This explains hypertension, proteinuria and organ involvement.

Option by option

  • A. Thrombosis of the portal vein

    Portal vein thrombosis is not part of the pathogenesis.

  • B. Inadequate trophoblastic invasion of spiral arteries (correct)

    Correct. Abnormal placentation is the starting event.

  • C. Autoimmune destruction of the placenta

    Autoimmune destruction is not the mechanism.

  • D. Excess progesterone production

    Progesterone excess is not implicated.

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 B, Inadequate trophoblastic invasion of spiral arteries. Failure of trophoblastic invasion and remodelling of spiral arteries leaves high-resistance vessels, causing placental ischaemia and release of anti-angiogenic factors (sFlt-1) that produce widespread endothelial dysfunction.

Why is "Thrombosis of the portal vein" not the answer?

Portal vein thrombosis is not part of the pathogenesis.

Why is "Autoimmune destruction of the placenta" not the answer?

Autoimmune destruction is not the mechanism.

Why is "Excess progesterone production" not the answer?

Progesterone excess is not implicated.

What concept does this question test?

It tests Hypertensive disorders: pathogenesis in OBG. This explains hypertension, proteinuria and organ involvement.

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: pathogenesis?

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.