🏥 USMLE Exam Prep

A 34-year-old primigravid woman at 36 weeks gestation presents with persistent headache, visual changes, and epigastric pain. Her blood pressure is 160/105 mmHg. Urinalysis shows 3+ proteinuria. Deep tendon reflexes are 3+ bilaterally with clonus. Fetal heart tracing is reassuring. Which of the following is the MOST appropriate next step in management?

A Administer a nifedipine extended-release tablet
B Initiate magnesium sulfate intravenously
C Schedule for elective induction of labor at 37 weeks
D Perform an immediate C-section

✓ Correct Answer: Option B

This patient has severe preeclampsia with features concerning for impending eclampsia (hyperreflexia, clonus). Magnesium sulfate is the definitive treatment for seizure prophylaxis in severe preeclampsia and eclampsia. While delivery is indicated, magnesium is administered first.

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