10-29-2011, 05:34 PM
15. A 43-year-old man comes to the physician because of headache, blurred vision, and confusion for 2 days. He has not had weakness or numbness, difficulty walking, chest pain or discomfort, diplopia, or vertigo. He has hypertension treated with propranolol but says that he does not take his medication regularly. His temperature is 36.4°C (97.5°F), pulse is 74/min, respirations are 14/min, and blood pressure is 190/120 mm Hg. The neck is supple. Funduscopic examination shows enlargement of the optic discs with indistinct borders. Blood vessels near the discs are indistinct. The lungs are clear to auscultation. There is an S4 with no murmur. Neurologic examination shows no abnormalities. Which of the following is the most likely diagnosis?
A) Cerebral infarction
B) Malignant hypertension
C) Retinal detachment
D) Subarachnoid hemorrhage
E) Transient ischemic attack
A) Cerebral infarction
B) Malignant hypertension
C) Retinal detachment
D) Subarachnoid hemorrhage
E) Transient ischemic attack
