MSRA High-Yield MCQs: Pre-eclampsia, Eclampsia & HELLP Syndrome
- examiner mla
- Jun 29
- 2 min read
Updated: Jul 4
Which of the following would most warrant urgent delivery in a woman with pre-eclampsia?
Choose one of the options
BP 140/90 mmHg
1+ protein on dipstick
Severe headache and visual disturbance
BMI >35
Answer: C. Severe headache and visual disturbance
Suggests severe disease → urgent stabilisation and likely delivery.
A 31-year-old woman at 37+2 weeks gestation presents with BP 150/100 mmHg and 2+ proteinuria. She has no symptoms and normal bloods. What is the most appropriate next step?
Choose one of the options
Continue monitoring
Start oral labetalol
Administer IV magnesium sulfate
Plan delivery
Answer: D. Plan delivery
Pre-eclampsia at ≥37 weeks without severe features → offer delivery.
Which of the following is not a known complication of pre-eclampsia?
Choose one of the options
Placental abruption
Pulmonary embolism
Acute kidney injury
Fetal growth restriction
Answer: B. Pulmonary embolism
PE is not a direct complication of pre-eclampsia; the others are.
A patient on magnesium sulfate develops absent deep tendon reflexes and bradypnea. What is the most appropriate next step?
Choose one of the options
Increase magnesium infusion
Administer calcium gluconate
Start IV hydralazine
Perform emergency C-section
Answer: B. Administer calcium gluconate
Classic magnesium toxicity → treat with 10 mL 10% calcium gluconate IV.
Pre-eclampsia occurring before 20 weeks is most suggestive of:
Choose one of the options
Multiple pregnancy
Uncontrolled Type 1 diabetes
Triploidy
Gestational hypertension
Answer: C. Triploidy
Atypical early-onset pre-eclampsia <20 wks → think molar pregnancy or triploidy.
A woman with chronic hypertension presents at 32 weeks with worsening proteinuria and RUQ pain. Diagnosis?
Choose one of the options
Gestational hypertension
Normal progression of chronic HTN
HELLP syndrome
Superimposed pre-eclampsia
Answer: D. Superimposed pre-eclampsia
Chronic HTN + new proteinuria/symptoms = superimposed PE.
Which medication is contraindicated for hypertension in pregnancy?
Choose one of the options
Methyldopa
Labetalol
Nifedipine
Enalapril
Answer: D. Enalapril
ACE inhibitors are teratogenic → contraindicated in pregnancy.
According to NICE, what is the target BP for pregnant women with pre-eclampsia but no end-organ damage?
Choose one of the options
<160/110
<140/90
<130/80
<150/100
Answer: D. <150/100
NICE: target <150/100 unless organ damage → then <140/90.
Which of the following is a classic clue for HELLP syndrome?
Choose one of the options
Seizures
Hypoglycaemia
Thrombocytosis
RUQ pain with ↑AST, ↓platelets, schistocytes
Answer: D. RUQ pain with ↑AST, ↓platelets, schistocytes
Triad = haemolysis, ↑LFTs, ↓platelets.
At what gestation should delivery be offered in women with pre-eclampsia without severe features?
Choose one of the options
32 weeks
34 weeks
36 weeks
37 weeks
Answer: D. 37 weeks
≥37 weeks = plan delivery even if asymptomatic.
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