Hypertesive Emergency

2777 Views 9 Replies 6 Participants Last post by good_boy_1234, Jun 21, 2010

good_boy_1234

Discussion Starter · Jun 20, 2010

A 48-year-old man is brought to the emergency department by his wife after obtaining a blood pressure reading of 234/142 mm Hg on a home blood pressure monitor. In the emergency department, his blood pressure is 236/144 mm Hg. The patient states that he has always had poorly controlled blood pressure. He also states that he took medication for a migraine headache 2 hours earlier. Which of the following medications did he most likely take?
A. Diclofenac potassium
B. Ergotamine
C. Methysergide
D. Propranolol
E. Sumatriptan

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Casandra

· #2 · Jun 20, 2010

Hypertensive emergency

I would say: B - Ergotamine as it's commonly used in migrane therapy and causes vascular constriction (as a result of binding with alpha receptors)

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drsue

· #3 · Jun 20, 2010

i'll go with B, ergotamine an ergot drug which causes vasoconstriction.

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aalawi

· #4 · Jun 21, 2010

Hi
I just want to pay your attention for the fact that the case presented is not hypertensive emergency rather is hypertensive urgency which is defined as diastolic BP>120 mm Hg in absence of symptoms of end organ damage as confusion, blurred vision, papilledema, chest pain, pulmonary edema, anuria, rising BUN/creatinine or urinary sediment suggestive of kidney damage.
The very same diastolic BP level in the presence of one of these symptoms will be considered hypertensive emergency.
thanks.

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drmodi44

· #5 · Jun 21, 2010

E. Sumatriptan.....not sure....

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achistikbenny

· #6 · Jun 21, 2010

I am thinking the answer is E

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good_boy_1234

Discussion Starter · #7 · Jun 21, 2010

True Answer: E. Sumatriptan

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Casandra

· #8 · Jun 21, 2010

good_boy_1234 said:
True Answer: E. Sumatriptan

Could you please explain why the correct answer is E, while during Ergotamine therapy above symptoms can also occur?

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good_boy_1234

Discussion Starter · #9 · Jun 21, 2010

Casandra said:
Could you please explain why the correct answer is E, while during Ergotamine therapy above symptoms can also occur?

Both are used in migrane, but this enormous increase in BP means Sumatriptan

I hope if anybody could explain more

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good_boy_1234

Discussion Starter · #10 · Jun 21, 2010

aalawi said:
Hi
I just want to pay your attention for the fact that the case presented is not hypertensive emergency rather is hypertensive urgency which is defined as diastolic BP>120 mm Hg in absence of symptoms of end organ damage as confusion, blurred vision, papilledema, chest pain, pulmonary edema, anuria, rising BUN/creatinine or urinary sediment suggestive of kidney damage.
The very same diastolic BP level in the presence of one of these symptoms will be considered hypertensive emergency.
thanks.

Thank you but this is what was written in Q bank explanation!!

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