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Placental abruption — USMLE Step 2 CK MCQ

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ModerateObstetrics & GynecologyPlacental abruptionUSMLE Step 2 CK

A 24-year-old Middle Eastern woman comes to the urgent care clinic because of pelvic symptoms or pregnancy-related concerns. History and focused examination are notable for painful third-trimester bleeding, uterine tenderness, contractions, and fetal distress. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% 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?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Placental abruption

The vignette describes Placental abruption, supported by painful third-trimester bleeding, uterine tenderness, contractions, and fetal distress. Placental abruption 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-44