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Rh alloimmunization prevention — USMLE Step 2 CK MCQ

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HardObstetrics & GynecologyRh alloimmunization preventionUSMLE Step 2 CK

A 35-year-old Middle Eastern woman comes to the clinic because of pelvic symptoms or pregnancy-related concerns. History and focused examination are notable for Rh-negative pregnant patient with first-trimester bleeding and unsensitized antibody screen. 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. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most likely diagnosis?

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Correct answer: C — Rh alloimmunization prevention

The vignette describes Rh alloimmunization prevention, supported by Rh-negative pregnant patient with first-trimester bleeding and unsensitized antibody screen. Rh alloimmunization prevention 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: ACOG Practice Bulletin on Prevention of Rh D Alloimmunization