Which symptoms may be present with HELLP syndrome?

• A. Headache and dizziness
• B. RUQ pain, nausea, and malaise
• C. Chest pain
• D. Visual changes

Answer: (B)

The main idea here is recognizing how HELLP syndrome manifests, especially the liver-related symptoms. HELLP stands for hemolysis, elevated liver enzymes, and low platelets, so liver involvement is a key feature. When the liver is affected, patients often develop right upper quadrant tenderness from hepatic swelling and possible subcapsular involvement, along with nonspecific systemic symptoms from the ongoing hemolysis and hepatic injury. Nausea and malaise are common, making RUQ pain with these nonspecific symptoms a classic presentation of HELLP.

Chest pain is not typical for HELLP and points more toward cardiac or pulmonary issues. Visual changes can occur with severe preeclampsia due to retinal or cerebral involvement, but the combination of RUQ pain with nausea and malaise specifically reflects hepatic dysfunction in HELLP.