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NBME 21 Answers

nbme21/Block 1/Question#11 (reveal difficulty score)
A 27-year-old primigravid woman at 34 weeks' ...
Schistocytes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—hayayah(1212)
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HELLP syndrome: Hemolysis Elevated Liver enzymes Low Platelets.

A manifestation of severe preeclampsia. Blood smear shows schistocytes. Can lead to DIC and hepatic subcapsular hematomas ยŽ rupture ยŽ severe hypotension.

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mambaforstep  FA 2019 pg 629 +5
qball  One thing I find odd with this question is HELLP is a manifestation of severe preeclampsia but she has had an otherwise unremarkable pregnancy. Shouldn't she have hypertension/edema in regards to her pregnancy beforehand? +1
demihesmisome  Pre-eclampsia, if not severe, can be entirely asymptomatic. +2
misterdoctor69  Her blood pressure is 164/102, which qualifies her as having preeclampsia. +1



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