KOORDINATOR PENDIDIKAN

DEPARTEMEN OBSTETRI DAN GINEKOLOGI

FAKULTAS KEDOKTERAN UNIVERSITAS INDONESIA

BANK SOAL

Kategori Basic science / Riset / Obstetri / Ginekologi *)

Tahap Basic / T1A / T1B / T2A / T2B / T3A / T3B / T4A / T4B
Topik Preeclampsia with HELLP Syndrome
(Mohon dituliskan)

Jenis soal MCQ / EMQ / SAQ *)

Kasus Question (1-4)
(Tuliskan kasus
pemicu) A 24-year-old G1P0 woman presents for a prenatal visit at
34 weeks’ gestation. She complains of some mild nausea
and vomiting over the past 3 days. She has no headache
and no visual changes. Her BP is 160/83 mm Hg. On
examination, she has 21 lower extremity pitting edema,
and 31 reflexes bilaterally with four beats of clonus. A
urinalysis dip has +2 protein.
Pertanyaan 1. Which of the following questions would be helpful?
(Tuliskan a. Do you have double vision?
pertanyaannya) b. Do you have pain radiating down your legs?
c. Are you constipated?
d. Do you have pain in your right upper abdomen?
e. Do you have ringing in your ears?

2. Which of the following laboratory tests would NOT be

helpful at this point?
a. Platelets
b. WBC
c. LFTs
d. LDH
e. Obstetric ultrasound

3. The laboratory test results come back with elevated

 LFTs, low platelets, a normal hematocrit (Hct), and an
elevated LDH. What is her diagnosis?
a. Preeclampsia
b. Eclampsia
c. Chronic hypertension
d. HELLP syndrome
e. GH

4. The next step in her management is:

a. betamethasone
b. expectant management until severe preeclampsia
c. IV hydralazine
d. induction of labor
e. immediate cesarean delivery

5. Which of the following is the best management of a 18-

year-old G1 P0 woman at 28 weeks gestation with a blood
pressure of 160/110 mmHg, elevated liver function tests,
and a platelet count of 60.000/uL ?
a. Oral antihypertensive therapy
b. Platelet transfusion
c. Magnesium sulfate therapy and induction of labor
d. Intravenous immunoglobulin therapy
e. Blood transfusion
Jawaban 1. D
(Tuliskan jawabannya) 2. B
3. D
4. D
5. C
Tanggal pembuatan 6 Februari 2016
Pembuat Dimas Radityo
Sumber Pustaka Williams Obstetric 24th edition
Pereview
Tanggal Review
Kategori Basic science / Riset / Obstetri / Ginekologi *)
Tahap Basic / T1A / T1B / T2A / T2B / T3A / T3B / T4A / T4B
Topik Preeclampsia with HELLP Syndrome
(Mohon dituliskan)

Jenis soal MCQ / EMQ / SAQ *)

Kasus Question (6)
(Tuliskan kasus
pemicu) A 25-year-old G1P0 at 31 weeks’ gestation presents with
blood pressures in the 160 to 170/110 to 120 ranges and a
severe headache that does not decrease with
acetaminophen treatment. On laboratory testing, her
platelets are 72,000; AST is 226; and Creatinine is 1.4
Pertanyaan 6. What is your plan for this patient :
(Tuliskan a. Betamethasone and expectant management
pertanyaannya) b. Hydralazine and expectant management
c. Magnesium sulfate and expectant management
d. Immediate delivery
e. Magnesium sulfate, hydralazine, betamethasone, and
immediate delivery

7. With regards to haemolysis, elevated liver enzymes and

low platelets (HELLP) syndrome:
a. The incidence of HELLP is 2% of those with
preeclampsia/eclampsia
b. The rate of recurrent HELLP syndrome in
subsequent pregnancies is 4%
c. HELLP syndrome is associated with 10 % maternal
mortality
d. Women who had HELLP syndrome in a previous
pregnancy have a 80% risk of developing
preeclampsia in subsequent pregnancies
e. Burr cells and polychromasia in peripheral smear
are indicative of haemolysis

8. Below are not complications of HELLP syndrome:

a. Chronic renal failure
 b. Hepatic rupture
c. Massive hepatic necrosis
d. Subcapsular liver hematoma
e. Placental abruption

9. In HELLP syndrome:
a. most patients are in the immediate postpartum
state
b. Platelet count falls below 100 x 109/L
c. The recurrence rate is 40-60% per cent if the index
pregnancy diagnosis was after 32 weeks
d. The LDH concentration falls
e. Profound vasodilatation occurs

10. Which of the following is not a part of HELLP

syndrome?
a. Haemolysis
b. Lowered platelet count
c. Elevated liver enzymes
d. Elevated platelet count
e. High blood pressure
Jawaban 6. E
(Tuliskan jawabannya) 7. E
8. A
9. B
10.D
Tanggal pembuatan 6 Februari 2016
Pembuat Dimas Radityo
Sumber pustaka Williams Obstetric 24th edition
Tanggal review
Pereview
Kategori Basic science / Riset / Obstetri / Ginekologi *)
Tahap Basic / T1A / T1B / T2A / T2B / T3A / T3B / T4A / T4B
Topik Preeclampsia with HELLP Syndrome
(Mohon dituliskan)

Jenis soal MCQ / EMQ / SAQ *)

Kasus Question (11)
(Tuliskan kasus
pemicu) A 22 year old woman attends her postnatal review six
weeks after the delivery of her first child. She has had an
emergency caesarean section at 33 weeks of gestation for
severe pre eclampsia complicated with HELLP syndrome.
Pertanyaan 11. What is her risk of developing pre-eclampsia in her next
(Tuliskan pregnancy?
pertanyaannya) a. 1 in 2
b. 1 in 4
c. 1 in 6
d. 1 in 8
e. 1 in 10

12. Which of the following is true of thrombocytopenia

secondary to preeclampsia?
a. It is an indication for cesarean route of delivery.
b. It is an indication for delivery if levels drop below
140,000/jxL.
c. It is frequently accompanied by fetal thrombocytopenia.
d. It may not reach a nadir until 48-72 hours after
delivery.

13. Clinical evidence of hemolysis includes which of the

following?
a. Decrease in hematocrit
b. Presence ofspherocytes in peripheral blood
c. Elevation of serum lactate dehydrogenase level
d. All of the above

14. Which of the following laboratory studies may aid in

the differentiation between severe preeclampsia and acute
fatty liver?
a. Glucose
b. Creatinine
c. Platelet count
d. Transaminases

15. Regarding eclampsia and HELLP syndrome:

a. Eclampsia is always preceded by symptoms of pre
eclampsia
b. Eclampsia describes any seizures occurring during
pregnancy
c. HELLP syndrome is a combination of haemolysis,
elevated liver enzymes and low platelets
d. HELLP syndrome always occur with proteinuria or
hypertension
e. HELLP syndrome is a mild variant of pre-eclampsia

16. In relation to pregnancy and critical care the following

is not true:
a. HELLP syndrome can occur without proteinuria and
hypertension
b. HELLP syndrome is a combination of haemolysis,
elevated liver enzymes and low platelets
c. Major obstetric hemorrhage is the leading cause of
maternal mortality worldwide and is the most
frequent indication for pregnancy related critical
care admission
d. Anemia seen in HELLP syndrome is non hemolytic
in nature
e. The majority of survivors of amniotic fluid embolus
syndrome suffer chronic neurological deficits.

17. All of the following are characteristic of preeclampsia

EXCEPT:
A. Less than 50% of the hypertension seen in
pregnancy is due to preeclampsia
 B. Preeclampsia can be seen before the twentieth
week of gestation if the patient has a hydatidiform
mole
C. In patients with the HELLP syndrome, hypertension
and oedema need not be present to make the
diagnosis of preeclampsia
D. Women at risk include primigravidas and those
under age 20
E. Smoking might prevent from pre-eclampsia

18. The HELLP syndrome:

a. Occurs in approximately 3% of pregnant women
b. Shows increase risk of development in smokers
c. Present preterm in 80% of sufferers
d. Shows reduced perinatal mortality with maternal
administration of dezamethasone
e. Requires arterial hypertension as a prerequisite for
diagnosis

19. Which of the following statements is not true about

Magnesium Sulphate in relation to Pre-eclampsia &
Eclampsia?
a. Increased tendon reflexes are an early sign of
Magnesium Sulphate overdose
b. Decreased tendon reflexes are an early sign of
Magnesium Sulphate overdose
c. Magnesium Sulphate halves the risk of Eclampsia
d. Magnesium Sulphate acts a membrane stabilizer,
reducing the excitability of neurons.
e. Magnesium Suphate is indicated if there is significant
risk of a mother developing Eclampsia.

20. Below are drugs used to reduce the high blood pressure
associated with Pre-eclampsia, EXCEPT :
a. Nifedipine
b. Labetol
c. Lisonopril
d. Methyldopa
 e. Hydrazaline

Jawaban 11. B
(Tuliskan jawabannya) 12. D
13. D
14. A
15. C
16. D
17. A
18. C
19. A
20. C
Tanggal pembuatan 6 Februari 2016
Pembuat Dimas Radityo
Sumber pustaka Williams Obstetric 24th edition
Tanggal review
Pereview