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HELLP Syndrome — RACP Adult Medicine MCQ

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EasyGastroenterologyHELLP SyndromeRACP Adult Medicine

A 32-year-old woman at 34 weeks gestation presents with severe headache, visual disturbance, and epigastric pain. BP is 175/110 mmHg. Urinalysis shows 3+ proteinuria. Platelets are 85 × 10⁹/L, ALT 350 U/L, LDH 650 U/L. What is the most likely diagnosis?

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Correct answer: E — Pre-eclampsia with severe features (HELLP syndrome)

Hypertension with proteinuria, headache, visual disturbance, and epigastric pain with thrombocytopenia, elevated LFTs, and elevated LDH is HELLP syndrome (Haemolysis, Elevated Liver enzymes, Low Platelets) — a severe variant of pre-eclampsia. Management: IV magnesium sulfate (seizure prophylaxis), antihypertensives (labetalol, hydralazine), and delivery. Definitive treatment is delivery.

Reference: SOMANZ – 2023 – Hypertension in Pregnancy Guidelines