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Preeclampsia with severe features — USMLE Step 3 MCQ

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HardOB/GYNPreeclampsia with severe featuresUSMLE Step 3

A 34-year-old woman at 36 weeks' gestation has new headache, visual spots, and right upper quadrant pain. Blood pressure is 168/112 mm Hg on two readings. Platelets are 92,000/microL, AST is 110 U/L, and urine protein-to-creatinine ratio is elevated. Which of the following is the most appropriate at this time?

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Correct answer: C — Give magnesium sulfate and antihypertensive therapy with delivery planning

Severe-range hypertension with neurologic symptoms, thrombocytopenia, transaminitis, and proteinuria indicates preeclampsia with severe features. Management includes seizure prophylaxis, blood pressure control, and delivery planning based on gestational age.

Reference: ACOG practice guidance