Substance use: cocaine in pregnancy: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Substance use: cocaine in pregnancy

Sample item

A 27-year-old woman at 32 weeks of gestation who snorted cocaine two hours earlier develops severe constant abdominal pain, a hard tender uterus and dark vaginal bleeding. Which complication of cocaine use is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Placental abruption

Cocaine causes intense vasoconstriction and hypertension, which can lead to placental abruption, preterm labour and growth restriction. A painful, tense uterus with dark blood points to abruption rather than painless bleeding.

Option by option

  • A. Uterine inversion

    Uterine inversion occurs in the third stage of labour.

  • B. Placental abruption (correct)

    Correct. Cocaine-induced vasoconstriction and hypertension predispose to abruption.

  • C. Vasa previa

    Vasa previa causes bleeding with fetal heart changes after membrane rupture and is not related to drug use.

  • D. Placenta previa

    Placenta previa causes painless bright-red bleeding and is not triggered by cocaine.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Placental abruption. Cocaine causes intense vasoconstriction and hypertension, which can lead to placental abruption, preterm labour and growth restriction.

Why is "Uterine inversion" not the answer?

Uterine inversion occurs in the third stage of labour.

Why is "Vasa previa" not the answer?

Vasa previa causes bleeding with fetal heart changes after membrane rupture and is not related to drug use.

Why is "Placenta previa" not the answer?

Placenta previa causes painless bright-red bleeding and is not triggered by cocaine.

What concept does this question test?

It tests Substance use: cocaine in pregnancy in Psychiatry. A painful, tense uterus with dark blood points to abruption rather than painless bleeding.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Substance use: cocaine in pregnancy?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.