Archive Of Standardized Exam Questions: Preeclampsia


This page is dedicated to organizing various examples of standardized exam questions whose answer is preeclampsia. While this may seem a odd practice, it is useful to see multiple examples of how preeclampsia will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.


Question # 1

A 40 year old woman, G1P0, is at 36 weeks gestation when she comes in for evaluation on the labor and delivery floor. When she woke up this morning she noticed that her feet were very swollen, to the point that she has difficulty walking around her apartment. her blood pressure was measured at home (by her partner who is a nurse) and was 146/95 mm Hg. She explains that she has good fetal movements, no contractions, no vaginal bleeding, and no vaginal leakage of fluid. The patient explains that she is very tired and also feels short of breath. Her blood pressure now (5 hours after the at-home measurement) is 140/90 mm Hg, and upon taking her weight, it is noted that she has gained 6 lbs in the past week. Physical exam reveals pitting edema on the lower extremities. Laboratory analysis reveals the following findings:

  • Hemoglobin: 11.0 g/dL
  • Platelets:  170,000/mm³
  • Creatinine: 0.7 mg/dL
  • Aspartate aminotransferase:  10 U/L

A urine dipstick is performed that shows both 2+ protein and 1+ glucose. A urine-creatine ratio is ordered but is pending. What is the patient’s likely diagnosis?

Explanation: hypertension (2 measurements) + proteinuria (urine dipstick will be confirmed with additional study) = preeclampsia (have already met diagnostic criteria).

Question # 2

A 37 year old woman, G1P0 (who is at 37 weeks gestation) is brought to the emergency room after the sudden onset of vaginal bleeding and severe lower abdominal pain. The patient’s prenatal course course is notable for diet-controlled gestational diabetes. At 20 weeks, a ultrasound showed normal fetal anatomy/a normal fundal placenta. The patient has a known 10 pack year smoking history, and has been trying to quit this habit. her temperature is 98.4 °F, her blood pressure is 160/90 mm Hg, and her heart rate is 115/min. A physical examination shows uterine tenderness, and the physician notes the presence of moderate vaginal bleeding. A digital cervical exam shows a 4-cm dilated cervix, the fetus in the breech presentation, and the fetus at 0 station. A fetal heart tracing shows a fetal heart rate of 130/min, present accelerations, and moderate variability. There are contractions every 2 minutes, and they last 20 seconds. A urinalysis shows 3+ protein. What obstetric complication might this patient have?

Explanation: hypertension  + proteinuria (urine dipstick) = preeclampsia (have already met diagnostic criteria).

Question # 3

A 36 year old primigravida woman at 35 weeks gestation come stoeckled the labor and delivery floor with a blood pressure of 155/95 mm Hg. The patient has a spontaneous dichorionic diamniotic twin gestation, however her pregnancy course has been uneventful so far. She has no remarkable past medical history. The patient admits to feeling good fetal movements. She denies contractions, vaginal bleeding, and the leakage of fluid. She denies any vision changes or headaches. Her current blood pressure is 150/100 mm Hg. Her deep tendon reflexes are 3+. Non-stress testing is reactive for both of her fetuses. Lab results are listed below:

  • Hemoglobin: 12.5 g/dL
  • Hematocrit: 39%
  • Platelets: 115,000/mm³
  • Aspartate aminotransferase: 810 U/L*
  • Alanine aminotransferase: 420 U/L*
  • Creatinine: 1.7 mg/dL*
  • Urine protein/creatinine ratio: 0.80*

What diagnosis can be made from the above information?

Explanation: hypertension (2 measurements) + elevated liver enzymes + elevated creatinine + elevated urine protein/creatinine ratio = preeclampsia (have more then met criteria for SEVERE preeclampsia at this point)

Question # 4

A 18 year old girl, G1P0 is at 37 weeks gestation. She comes to the emergency department with headache, blurry vision, and also complains of fatigue. She has missed a few of her prenatal visits due to taking her final exams at school. Her blood pressure si 190/100 mm Hg, and pulse is 110/min. A urine dipstick shows 4+ protein. Physical examination shows increased ankle clonus, but there are no other remarkable neurological findings. Her laboratory results are as follows:

  • Hemoglobin: 8.0 g/dL
  • Platelets: 60,000/mm³
  • Aspartate aminotransferase: 12 U/L
  • Lactate dehydrogenase, serum: 1648 U/L

What is the diagnosis in this patient?

Explanation: hypertension + proteinuria = preeclampsia (there are many other symptoms that support the diagnosis)

Question # 5

A 34 year old woman (G1P1) is at 34 weeks gestation when she is admitted to the hospital for labor. She explains that she has blurred vision, and her chart reveals a 5 lb weight gain over the past week. She had a routine prenatal care visit 1 month ago with no abnormalities noted. Her temperature is 98.4°F, pulse is 75/min, respirations are 15/min, blood pressure is 155/110 mm Hg. Physical exam shows pedal edema. Lab results are as follows:

  • Hemoglobin: 12.7 g/dL
  • Leukocyte count: 7500/mm³
  • Platelet count: 210,000³
  • Serum creatinine: 1.2 mg/dL
  • Urine protein: 2+*

What is this patient’s likely diagnosis?

Explanation: hypertension + proteinuria = preeclampsia (there are many other symptoms that support the diagnosis)

Question # 6

A 39 year old woman is at 35 weeks gestation and comes to the clinic for a routine prenatal visit. She has been receiving routine prenatal care since the start of her pregnancy. Her pregnancy has been complicated with hypertension that has been controlled with labetolol. She has a history of type 1 diabetes mellitus. Her HgA1c measurement last month was 5.7%. Her blood pressure is 140/90 mm Hg. Physical examination shows a soft uterus with a fundal height of 33 cm. The fetal heart rate is 130/min. A 24-hour urine collection shows a protein concentration of 700 mg. What is the diagnosis in this patient?

Explanation: hypertension + proteinuria = preeclampsia (there are many other symptoms that support the diagnosis)


Page Updated: 10.08.2016