Rosh Emergency Medicine Practice Test

In case of a patient with a suspected hypertensive emergency, which blood pressure reading is notably concerning?

1. 120/80 mm Hg

2. 140/90 mm Hg

3. 160/100 mm Hg

4. 204/112 mm Hg

The correct answer is: 204/112 mm Hg

In the context of a suspected hypertensive emergency, a blood pressure reading of 204/112 mm Hg is particularly concerning. A hypertensive emergency is characterized by severely elevated blood pressure that is typically accompanied by evidence of end-organ dysfunction or damage. This extreme reading indicates that the systolic and diastolic pressures are significantly above the normal threshold, which can lead to acute complications such as hypertensive encephalopathy, myocardial infarction, or acute kidney injury. The target threshold often used to define a hypertensive emergency is a systolic blood pressure greater than 180 mm Hg or a diastolic blood pressure greater than 120 mm Hg. In this case, the reading of 204/112 mm Hg exceeds these critical thresholds, highlighting the urgent need for immediate clinical intervention to reduce blood pressure and prevent serious cardiovascular or neurological consequences. In contrast, the other readings (120/80 mm Hg, 140/90 mm Hg, and 160/100 mm Hg) are concerning to varying degrees but do not represent the level of urgency and potential for acute complications seen with a reading of 204/112 mm Hg. A normal reading of 120/80 mm Hg indicates optimal blood pressure control, whereas 140/90 mm Hg can