ERES Bonaerense Medicina Practice Questions - Buenos Aires Province Health Residencies Examination (Examen De Residencias Del Sistema De Salud Bonaerense - ERES Medicina) Exam

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A 52-year-old man presents to the emergency room with a blood pressure reading of 210/120 mmHg. He reports a mild generalized tension headache but denies chest pain, shortness of breath, visual changes, or focal neurological deficits. Fundoscopic examination is normal without papilledema or flame hemorrhages. Serum creatinine, electrolytes, and urinalysis are within normal limits. An ECG shows voltage criteria for left ventricular hypertrophy without acute ischemic changes. What is the most appropriate management for this patient?

Diagnose hypertensive emergency and administer intravenous sodium nitroprusside to lower mean arterial pressure by 50% in the first hour Administer sublingual nifedipine capsules immediately to rapidly normalize blood pressure to < 120/80 mmHg Diagnose hypertensive urgency and initiate or adjust oral antihypertensive medication with planned outpatient follow-up within 24 to 72 hours Admit the patient to the intensive care unit for continuous intravenous labetalol infusion and arterial line placement

Correct Answer:

Diagnose hypertensive urgency and initiate or adjust oral antihypertensive medication with planned outpatient follow-up within 24 to 72 hours

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