🏥 USMLE Exam Prep

A 32-year-old primigravid woman at 36 weeks gestation presents to the emergency department with a severe headache, blurry vision, and epigastric pain. Her blood pressure is 170/110 mmHg. Urine dipstick shows 3+ proteinuria. Deep tendon reflexes are 4+ with clonus. Which of the following is the most appropriate initial management step?

A Administer oral nifedipine
B Initiate continuous fetal heart rate monitoring and administer magnesium sulfate
C Perform immediate induction of labor
D Order a 24-hour urine collection for protein

✓ Correct Answer: Option B

This patient has severe preeclampsia with features of impending eclampsia (hyperreflexia with clonus). Magnesium sulfate is crucial for seizure prophylaxis. Fetal monitoring is also essential for assessing fetal well-being.

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