Hypertension MCQs – NEET PG Medicine

Explanation:
Beta blockers like labetalol reduce shear stress and heart rate critical in aortic dissection.

Clinical relevance:
Management-based high-yield MCQ.

Key takeaway:
Dissection → control HR first.

Explanation:
The morning surge in blood pressure is mainly due to increased sympathetic nervous system activity upon awakening.

Clinical relevance:
Morning BP surge is linked to higher risk of stroke and myocardial infarction.

Key takeway:
Sympathetic overactivity explains circadian BP variation.

Explanation:
Grade III hypertensive retinopathy includes flame-shaped hemorrhages cotton wool spots and hard exudates.

Clinical relevance:
Fundoscopy-based MCQs are frequently image-driven in NEET-PG.

Key takeaway:
Hemorrhages + cotton wool spots = Grade III.

Explanation:
Urgency involves severe BP elevation without acute target organ damage.

Clinical relevance:
Management differs from emergency.

Key takeaway:
Urgency ≠ emergency.

Explanation:
Aortic unfolding and cardiomegaly indicate long-standing systemic hypertension.

Clinical relevance:
Radiology correlation MCQs are common in INI-CET.

Key takeaway:
Aortic unfolding = chronic HTN.

Explanation:
Abdominal bruit suggests renovascular hypertension.

Clinical relevance:
Classic bedside clue.

Key takeaway:
Listen to the abdomen.

Explanation:
Hypertensive emergency requires acute target organ damage.

Clinical relevance:
Management questions depend on this definition.

Key takeaway:
Emergency = damage; urgency = no damage.

Explanation:
Unilateral small kidney with reduced flow suggests renovascular hypertension.

Clinical relevance:
Image-based renal HTN MCQs are high-yield.

Explanation:
NSAIDs cause sodium retention and reduce antihypertensive efficacy.

Clinical relevance:
Important drug-history question.

Key takeaway:
NSAIDs worsen BP.

Explanation:
ACE inhibitors reduce proteinuria and slow CKD progression.

Clinical relevance:
Management-based integrated question.

Key takeaway:
Proteinuria → ACEi/ARB.

Explanation:
Papilledema defines Grade IV hypertensive retinopathy and malignant hypertension.

Clinical relevance:
Medical emergency with poor prognosis if untreated.

Key takeaway:
Papilledema = malignant HTN.

According to standard definitions, hypertension is diagnosed when systolic blood pressure is persistently ≥140 mmHg on repeated measurements. Values below this do not meet diagnostic criteria.

Explanation:
Papilledema defines Grade IV hypertensive retinopathy.

Clinical relevance:
Classic classification question.

Key takeaway:
Papilledema = malignant hypertension.

Explanation:
ACE inhibitors cause fetal renal dysgenesis and are contraindicated in pregnancy.

Clinical relevance:
Repeatedly tested safety question.

Key takeaway:
ACEi/ARB strictly avoided in pregnancy.

Explanation:
Portal hypertension is unrelated to systemic arterial hypertension.

Clinical relevance:
Classic ‘EXCEPT’ question pattern.

Key takeaway:
Remember cardiac, renal, retinal, CNS effects.

Explanation:
Orthostatic hypotension is defined as ≥20 mmHg systolic drop on standing.

Clinical relevance:
Frequently tested definition.

Key takeaway:
20/10 rule.

Explanation:
Primary aldosteronism presents with hypertension hypokalemia low renin and high aldosterone.

Clinical relevance:
Very high-yield endocrine hypertension question.

Key takeaway:
Low renin + hypokalemia = think aldosteronism.

Explanation:
Weight loss provides the greatest sustained BP reduction.

Clinical relevance:
Preventive medicine integration.

Key takeaway:
Weight matters most.

Explanation: ACE inhibitors reduce intraglomerular pressure and proteinuria.

Clinical relevance: Very common NEET-PG clinical MCQ.

Key takeaway: ACEi/ARB preferred in diabetic nephropathy.

Explanation:
The aldosterone-renin ratio is the preferred initial screening test.

Clinical relevance:
Commonly tested investigation-based MCQ.

Key takeaway:
ARR first imaging later.

Explanation:
Masked hypertension has normal clinic BP but elevated ambulatory or home BP.

Clinical relevance:
Associated with increased cardiovascular risk.

Key takeaway:
Masked HTN is dangerous.

Explanation:
Home BP monitoring or ambulatory BP monitoring confirms white coat hypertension.

Clinical relevance:
Increasingly tested modern concept.

Key takeaway:
Out-of-office BP is key.

Explanation:
Voltage criteria such as S in V1 + R in V5/V6 >35 mm suggest LVH.

Clinical relevance:
ECG-based hypertensive organ damage is a favorite exam topic.

Key takeaway:
LVH = chronic pressure overload.

Explanation:
Non-selective and older beta blockers worsen insulin resistance.

Clinical relevance:
Metabolic syndrome integration.

Key takeaway:
Beta blockers affect glucose metabolism.

Chronic kidney disease is a common cause of secondary hypertension.

Clinical relevance: Frequently tested as a direct factual question.

Key takeaway: Always consider CKD in secondary HTN.