🏥 USMLE Exam Prep

A 55-year-old male presents to the ED with a severe headache, blurred vision, and chest pain. His blood pressure is 220/130 mmHg. Funduscopic exam reveals papilledema, and ECG shows signs of acute myocardial ischemia. What is the most appropriate immediate management goal for his blood pressure?

A Reduce mean arterial pressure by no more than 10-20% in the first hour.
B Rapidly reduce systolic blood pressure to below 120 mmHg within 30 minutes.
C Reduce diastolic blood pressure to below 90 mmHg within 24 hours.
D Administer oral antihypertensives to gradually lower BP over several days.

✓ Correct Answer: Option A

This patient has a hypertensive emergency with target organ damage. The goal is to reduce MAP by no more than 10-20% in the first hour to prevent hypoperfusion of vital organs, then gradually over 24-48 hours.

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