Hypertensive Cases

12 Questions | By Cardtrick | Last updated: Mar 21, 2022 | Total Attempts: 2560

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This beginning quiz is merely to set the stage for hypertensive cases and not all-inclusive.

Questions and Answers

1.

TA is a 58 year old male. He reports to the emergency room after being seen at the his primary care physician's clinic. His blood pressure upon entering the emergency room is 200/130 mm Hg and he has shortness of breath (SOB) with a headache. He has a past medical history of hypertension x 5 years. He denies smoking and illicit drug use. He rarely drinks alcohol. His medications are the following: Lisinopril 20 mg QD, HCTZ 25 mg QD. His labs are all within normal limits. How would you characterize his hypertension and what is the goal blood pressure?
- A.
  
  Hypertensive Urgency; < 160/100 mmHg in 24-48 hours
- B.
  
  Hypertensive Urgency; < 120/80 mmHg in 30-60 minutes
- C.
  
  Hypertensive Emergency; Reduce mean arterial pressure to 120 mmHg in 2 hours
- D.
  
  Hypertensive Emergency; < 160/100 mmHg over 2-6 hours
2.

TA is a 58 year old male. He reports to the emergency room after being seen at the his primary care physician's clinic. His blood pressure upon entering the emergency room is 200/130 mm Hg and he has shortness of breath (SOB) with a headache. He has a past medical history of hypertension x 5 years. He denies smoking and illicit drug use. He rarely drinks alcohol. His medications are the following: Lisinopril 20 mg QD, HCTZ 25 mg QD. His labs are all within normal limits. Which of the following is an appropriate treatment option?
- A.
  
  Sodium nitroprusside 0.75 mcg/kg/min IV
- B.
  
  Metoprolol tartrate 25 mg PO
- C.
  
  Hydralazine 15 mg IV bolus
- D.
  
  Labetalol 20 mg IV push then 15 mg every 10 minutes
3.

TA is a 58 year old male. He reports to the emergency room after being seen at the his primary care physician's clinic. His blood pressure upon entering the emergency room is 200/130 mm Hg and he has shortness of breath (SOB) with a headache. He has a past medical history of hypertension x 5 years. He denies smoking and illicit drug use. He rarely drinks alcohol. His medications are the following: Lisinopril 20 mg QD, HCTZ 25 mg QD. His labs are all within normal limits. Which of the following are appropriate for TA?
- A.
  
  Check medication adherence
- B.
  
  Emphasize restriction of sodium in diet
- C.
  
  Potentially increase current dose of HCTZ to 50 mg QD
- D.
  
  Re-evaluate in a week
- E.
  
  All of the above
4.

TD is a 60 year old female who said she hadn't urinated in a few days while battling a headache. She took her blood pressure at home and became worried so she traveled to the emergency department. Her blood pressure was taken again and it was 200/130. Her past medical history is significant for hypertension and osteoporosis. She takes HCTZ 25 mg QD and alendronate 70 mg weekly. Her pertinent labs are as follows: BUN 36 mg/dL; SCr 2.2 mg/dL. How would you characterize her hypertension and what is her goal pressure?
- A.
  
  Hypertensive urgency; < 180/100 mmHg in 1 hour
- B.
  
  Hypertensive urgency; < 160/100 mmHg in 36 hours
- C.
  
  Hypertensive emergency; reduce mean arterial pressure to 120 mmHg in 2 hours
- D.
  
  Hypertensive emergency; < 120/80 mmHg in 30 minutes
5.

TD is a 60 year old female who said she hadn't urinated in a few days while battling a headache. She took her blood pressure at home and became worried so she traveled to the emergency department. Her blood pressure was taken again and it was 200/130. Her past medical history is significant for hypertension and osteoporosis. She takes HCTZ 25 mg QD and alendronate 70 mg weekly. Her pertinent labs are as follows: BUN 36 mg/dL; SCr 2.2 mg/dL. Which of the following is an appropriate treatment option for her?
- A.
  
  Metoprolol 25 mg PO
- B.
  
  Lisinopril 20 mg PO
- C.
  
  Furosemide 80 mg PO
- D.
  
  Labetalol 20 mg IV then 15 mg IV every 10 minutes thereafter
6.

JS is a 5 feet 8 inches, 100 kg, 57 year old male who comes into the emergency room complaining of chest pain that "won't go away". His blood pressure was taken and was recorded as 220/140. A fundoscopic exam showed slight retinal tears. His past medical history is significant for hyperglycemia, hypertension, and gout. His medications are the following: losartan 50 mg QD, HCTZ 25 mg QD, metformin 500 mg TID with meals, sildenafil 10 mg PRN and allopurinol 100 mg QD. He has no medication allergies. His pertinent labs are: Glucose 110 mg/dL. How would you characterize his hypertension and which of the following correctly describes his goal blood pressure?
- A.
  
  Hypertensive urgency; < 120/80 mmHg in 30 minutes
- B.
  
  Hypertensive emergency; mean arterial pressure of 130 mmHg in 3 hours
- C.
  
  Hypertensive emergency; diastolic blood pressure of 120 mmHg between 30-60 minutes
- D.
  
  Hypertensive emergency; mean arterial pressure of 140 mmHg in 2 hours
7.

JS is a 5 feet 8 inches, 100 kg, 57 year old male who comes into the emergency room complaining of chest pain that "won't go away". His blood pressure was taken and was recorded as 220/140. A fundoscopic exam showed slight retinal tears. His past medical history is significant for hyperglycemia, hypertension, and gout. His medications are the following: losartan 50 mg QD, HCTZ 25 mg QD, metformin 500 mg TID with meals, sildenafil 10 mg PRN, and allopurinol 100 mg QD. He has no medication allergies. His pertinent labs are: Glucose 110 mg/dL. Which of the following is an appropriate treatment option for JS?
- A.
  
  Lisinopril 40 mg PO
- B.
  
  Nitroglycerin 50 mcg/min IV infusion
- C.
  
  Amlodipine 10 mg PO
- D.
  
  Enalaprilat 5 mg IV bolus
8.

PL is a 64 year old female who is rushed to the emergency room, repeating over and over how "her head hurts". Her blood pressure was taken and was reported as 190/110. A fundoscopic exam revealed no damage to the retina. Her past medical history is significant for hypertension and depression. Her medications are lisinopril 10 mg QD and sertraline 50 mg QD. She is allergic to penicillins and develops hives. Her pertinent labs are: BUN 30 and SCr 3.1 mg/dL. How would you characterize her hypertension and what is her goal blood pressure?
- A.
  
  Hypertensive urgency; < 160/100 mmHg over 4 hours
- B.
  
  Hypertensive Emergency; mean arterial pressure of 105 mmHg in 2 hours
- C.
  
  Hypertensive Emergency; diastolic blood pressure of 95 mmHg in 30 minutes
- D.
  
  Hypertensive Emergency; < 120/80 mmHg in 4 hours
- E.
  
  B or C
9.

PL is a 64 year old female who is rushed to the emergency room, repeating over and over how "her head hurts". Her blood pressure was taken and was reported as 190/110. A fundoscopic exam revealed no damage to the retina. Her past medical history is significant for hypertension and depression. Her medications are lisinopril 10 mg QD and sertraline 50 mg QD. She is allergic to penicillins and develops hives. Her pertinent labs are: BUN 30 and SCr 3.1 mg/dL. Which of the following is an appropriate treatment option for PL?
- A.
  
  Sodium nitroprusside 5 mcg/kg/min IV followed by appropriate titration
- B.
  
  Diltiazem 120 mg PO
- C.
  
  Hydralazine 10 mg PO
- D.
  
  Labetalol 20 mg IV push then 15 mg every 10 minutes thereafter
10.

TS is a 31 year old pregnant female. She is admitted to the emergency room for complaints of chest pain and nausea. Her blood pressure reading is 200/110. Her past medical history is significant for hypertension. Her current medications are HCTZ 50 mg PO QD and folic acid 1 mg PO QD. A fundoscopic exam shows slight tears in the retina. She has no medication allergies. All lab values are within normal. Which of the following is an appropriate treatment option for TS?
- A.
  
  Carvedilol 6.25 mg PO
- B.
  
  Lisinopril 10 mg PO
- C.
  
  Labetalol 20 mg IV then 15 mg q10 minutes thereafter
- D.
  
  Enalaprilat 5 mg IV bolus
11.

BN is a 25 year old male who comes into the emergency room after an apparent acute overdose of cocaine. His blood pressure is recorded as 190/120. His past medical history is not significant for any conditions and he currently takes no medications. His pertinent labs values are as follows: BUN 26 and SCr 2.8 mg/dL. Which of the following is the most appropriate treatment option for BN?
- A.
  
  Metoprolol 25 mg PO
- B.
  
  Nicardipine 5 mg/hr IV initial infusion
- C.
  
  Amlodipine 10 mg PO
- D.
  
  Enalaprilat 5 mg IV bolus
12.

JT is a 45 year old male who presents to the emergency room with chest pain and SOB. His blood pressure is immediately taken and it is recorded as 190/120. His past medical history is relevant for hypertension, GERD, and back pain. His medications are lisinopril 10 mg QD, omeprazole DR 20 mg QD, and hydrocodone-acetaminophen 5-325 mg q6h PRN pain. He has no drug allergies. Pertinent lab values are BUN 30 and SCr 2.7 mg/dL.Which of the following is the most appropriate treatment for JT?
- A.
  
  Esmolol 1 mg/kg IV loading dose over 1 minute then appropriate titration
- B.
  
  Losartan 50 mg PO
- C.
  
  Hydralazine 25 mg PO
- D.
  
  Hydralazine 15 mg IV bolus with possible re-bolus q20 minutes