🏥 USMLE Exam Prep

A 48-year-old man presents to the emergency department with a severe headache, blurred vision, and altered mental status. His blood pressure is 220/130 mmHg. Funduscopic examination reveals papilledema and hemorrhages. An ECG shows left ventricular hypertrophy. Which of the following is the most appropriate immediate management?

A Initiate oral nifedipine for rapid blood pressure reduction
B Administer intravenous labetalol to gradually lower blood pressure by 10-20% in the first hour
C Order a CT scan of the head immediately before initiating any treatment
D Administer a loop diuretic such as furosemide

✓ Correct Answer: Option B

This is a hypertensive emergency with end-organ damage (papilledema, altered mental status). Blood pressure should be lowered by no more than 10-20% in the first hour using IV agents (e.g., labetalol, nicardipine) to prevent hypoperfusion and further organ damage.

Related USMLE Exam Prep Questions