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MMLU-Pro / 6246 / A 15-year-old girl is brought to the physician 3 months after she had a blood…

Problem

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question

A 15-year-old girl is brought to the physician 3 months after she had a blood pressure of 150/95 mm Hg at a routine examination prior to participation in school sports. She is asymptomatic and has no history of serious illness. Twelve months ago, she was diagnosed with a urinary tract infection and treated with oral trimethoprim-sulfamethoxazole. She currently takes no medications. Subsequent blood pressure measurements on three separate occasions since the last visit have been: 155/94 mm Hg, 145/90 mm Hg, and 150/92 mm Hg. She is at the 50th percentile for height and 95th percentile for weight. Her blood pressure today is 150/90 mm Hg confirmed by a second measurement, pulse is 80/min, and respirations are 12/min. Examination shows no other abnormalities. Her hematocrit is 40%. Urinalysis is within normal limits. Cardiac and renal ultrasonography shows no abnormalities. Which of the following is the most appropriate next step in management?

category

health

options

  1. Measurement of serum potassium levels
  2. Measurement of urine corticosteroid concentrations
  3. Exercise and weight reduction program
  4. Captopril therapy
  5. Initiate diuretic therapy
  6. Referral for psychiatric evaluation
  7. Initiate calcium channel blocker therapy
  8. Measurement of urine catecholamine concentrations
  9. Measurement of plasma renin activity
  10. Initiate beta-blocker therapy

src

ori_mmlu-professional_medicine

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