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Preeclampsia with severe features — USMLE Step 2 CK MCQ

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HardObstetrics & GynecologyPreeclampsia with severe featuresUSMLE Step 2 CK

A 38-year-old Asian American woman comes to the hospital because of pelvic symptoms or pregnancy-related concerns. History and focused examination are notable for headache, right upper quadrant pain, hypertension, thrombocytopenia, and proteinuria at 34 weeks. Temperature is 101.5°F (38.6°C), blood pressure is 82/48 mmHg, pulse is 132/min, respirations are 28/min, and oxygen saturation is 90% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Obstetric evaluation shows fetal status, urine protein testing, and complete blood count findings relevant to the presentation. Which of the following is the most likely diagnosis?

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Correct answer: B — Preeclampsia with severe features

The vignette describes Preeclampsia with severe features, supported by headache, right upper quadrant pain, hypertension, thrombocytopenia, and proteinuria at 34 weeks. Preeclampsia with severe features is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.acog.org/clinical/clinical-guidance#stage-9-order-31