Question

A 40-year-old woman presents to the emergency department with a blood pressure of 220/120 mmHg, severe headache, blurred vision and dyspnoea. Fundoscopy shows bilateral papilloedema. There is no focal neurological deficit. Serum creatinine is 220 µmol/L (baseline 80 µmol/L). What is the most appropriate management strategy?

Accepted Answer

Admit to a monitored setting and start intravenous antihypertensive therapy to reduce mean arterial pressure by no more than 25% in the first hour.

Answer

Commence oral amlodipine and discharge with close outpatient follow-up.

Answer

Administer sublingual nifedipine repeatedly until blood pressure normalises.

Answer

Delay antihypertensive therapy until a CT head excludes intracranial haemorrhage.

Answer

Start high-dose diuretic therapy alone to normalise blood pressure as quickly as possible.

Practice question