Intensive Care Medicine (ICM) Practice Exam

Which of the following is not a finding associated with acute hypertensive crisis causing end-organ damage?

1. Hemiparesis

2. Cotton-wool exudates

3. Hematuria

4. Angina

The correct answer is: Angina

An acute hypertensive crisis can lead to significant end-organ damage and is characterized by a rapid increase in blood pressure, which can cause a variety of clinical findings depending on the organs affected. Hemiparesis, cotton-wool exudates, and hematuria are findings associated with damage to specific organs due to high blood pressure. Hemiparesis can occur in a hypertensive crisis due to cerebral ischemia or hemorrhage affecting motor pathways in the brain, leading to weakness on one side of the body. Cotton-wool exudates represent retinal damage associated with hypertension, often visible on a fundoscopic exam. They occur due to localized ischemia affecting the nerve fiber layers in the retina. Hematuria can result from acute damage to the kidneys caused by severely elevated blood pressure, often indicating nephrosclerosis or acute kidney injury. In contrast, angina is not a direct finding of end-organ damage related to a hypertensive crisis. While it can occur in the context of myocardial ischemia due to high blood pressure leading to increased myocardial oxygen demand, it is more related to coronary artery disease and ischemic heart disease than to the acute organ damage seen in a hypertensive crisis. Therefore, angina is not a specific