Hypertensive Emergencies MCQ Quiz | Emergencies

1. What is the primary feature that distinguishes a hypertensive emergency from a hypertensive urgency?

2. In most hypertensive emergencies, what is the recommended goal for mean arterial pressure (MAP) reduction in the first hour?

3. A 65-year-old male presents with tearing chest pain radiating to his back and a blood pressure of 210/120 mmHg. Which condition requires the MOST rapid and aggressive blood pressure reduction?

4. Which of the following is the drug of choice for managing hypertension in a patient with acute pulmonary edema?

5. Hypertensive encephalopathy is characterized by a clinical triad of severe hypertension, altered mental status, and what other sign?

6. A 32-year-old pregnant woman at 36 weeks gestation presents with a BP of 180/115 mmHg, proteinuria, and a severe headache. What is the most appropriate first-line IV antihypertensive agent?

7. Prolonged use of sodium nitroprusside, especially in patients with renal insufficiency, can lead to toxicity from which metabolite?

8. A patient with known cocaine abuse presents with severe hypertension, tachycardia, and chest pain. Which class of antihypertensive drugs should be avoided?

9. What is the mechanism of action of fenoldopam?

10. The finding of “flame-shaped hemorrhages, cotton-wool spots, and papilledema” on fundoscopy is indicative of:

11. In treating hypertensive emergency associated with acute ischemic stroke in a patient eligible for thrombolysis, the blood pressure should be lowered to:

12. What is the characteristic pathological finding in small arteries and arterioles during a hypertensive emergency?

13. Which antihypertensive agent is contraindicated in patients with severe bradycardia or second/third-degree heart block?

14. A patient with pheochromocytoma crisis presents with a BP of 230/130 mmHg. What is the initial pharmacological management?

15. A patient on an IV infusion for a hypertensive emergency develops confusion, psychosis, and metabolic acidosis. Which drug is most likely responsible?

16. Which agent is a short-acting, cardioselective beta-1 blocker administered as a continuous IV infusion, making it ideal for titrating heart rate and blood pressure?

17. Microangiopathic hemolytic anemia with schistocytes on the peripheral blood smear can be a sign of which type of target-organ damage in a hypertensive emergency?

18. In the management of aortic dissection, the primary goal, in addition to lowering SBP to <120 mmHg, is to reduce what other hemodynamic parameter?

19. Which of the following is an IV ACE inhibitor that can be used in hypertensive emergencies, but is contraindicated in pregnancy?

20. What is the main concern with using hydralazine for hypertensive emergencies due to its unpredictable dose-response?

21. Clevidipine is an ultrashort-acting dihydropyridine calcium channel blocker. What is a key contraindication related to its formulation?

22. What is the primary mechanism by which severe hypertension leads to hypertensive encephalopathy?

23. In a patient with hypertensive emergency and acute kidney injury (AKI), which of the following drugs is often preferred as it may improve renal blood flow?

24. A hypertensive emergency patient is treated with an IV agent. They subsequently develop reflex tachycardia. This is a common side effect of which class of drugs?

25. What is the primary reason for avoiding rapid, excessive reduction of blood pressure in a hypertensive emergency (except in specific conditions like aortic dissection)?