MCQs on Hypertension

Written by Dr. Daniel Fraser (MBBS, FRACP) – Physician

Question 1

A 52-year-old man attends a routine check-up. His blood pressure is 148/94 mmHg, confirmed on two separate occasions over 2 weeks. He is asymptomatic and has no past medical history. According to current guidelines, how should his blood pressure be classified?

A) Normal blood pressure
B) Elevated blood pressure
C) Stage 1 hypertension
D) Stage 2 hypertension
E) Hypertensive emergency

Correct Answer: C) Stage 1 hypertension

Explanation:

This patient has a blood pressure reading consistently ≥140/90 mmHg but <160/100 mmHg, which meets the criteria for Stage 1 hypertension.

Stage 1 hypertension: systolic 140–159 mmHg or diastolic 90–99 mmHg
Stage 2 hypertension: systolic ≥160 mmHg or diastolic ≥100 mmHg
Hypertensive emergency is defined by markedly elevated BP (usually ≥180/120 mmHg) with acute target-organ damage.

Why other options are incorrect:

A) Normal BP is <120/80 mmHg.
B) “Elevated” BP refers to systolic 120–129 mmHg and diastolic <80 mmHg.
D) This patient’s BP is not high enough for stage 2.
E) No signs of end-organ damage or critically high BP.

Question 2

A 45-year-old man is found to have high blood pressure during a company health check. His blood pressure is 150/96 mmHg on two separate occasions. He has no symptoms. He smokes, consumes alcohol daily, and has a family history of hypertension. What is the most likely cause of his elevated blood pressure?

A) Renal artery stenosis
B) Phaeochromocytoma
C) Coarctation of the aorta
D) Primary hypertension
E) Cushing’s syndrome

Correct Answer: D) Primary hypertension

Explanation:

This patient has typical features of primary (essential) hypertension, which accounts for ~90–95% of all cases. It develops gradually and is associated with modifiable and non-modifiable risk factors such as:

Family history
Smoking
Alcohol use
Age over 40
Obesity and sedentary lifestyle

Why other options are incorrect:

A) Renal artery stenosis often presents with refractory or sudden-onset hypertension and may have bruits or renal dysfunction.
B) Phaeochromocytoma is rare and causes episodic hypertension with palpitations, headache, and sweating.
C) Coarctation typically presents earlier and with radiofemoral delay or BP discrepancy between limbs.
E) Cushing’s would have additional signs like central obesity, moon face, and striae.

Question 3

Sarah, a 33-year-old woman, presents with persistent high blood pressure readings around 170/105 mmHg. She reports headaches, palpitations, and sweating episodes. Physical examination reveals no abnormalities. Routine blood tests are normal. Her past medical history is unremarkable, and there is no family history of hypertension. Which one of the following is the most likely underlying cause of her hypertension?

A) Primary hypertension
B) Coarctation of the aorta
C) Phaeochromocytoma
D) Cushing’s syndrome
E) Chronic kidney disease

Correct Answer: C) Phaeochromocytoma

Explanation:

This patient is young with severe hypertension and paroxysmal symptoms such as palpitations, sweating, and headache, which are classic features of phaeochromocytoma, a catecholamine-secreting tumour.

Why other options are incorrect:

A) Primary hypertension is less likely at this age with these symptoms and no risk factors.
B) Coarctation of the aorta would typically present with BP discrepancies between upper and lower limbs or radiofemoral delay.
D) Cushing’s syndrome would present with weight gain, striae, facial rounding, and glucose intolerance.
E) Chronic kidney disease is unlikely in a young woman with normal renal function tests and no other risk factors.

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2. Cardiology Module

2.1 ECG

2.2 Acute Coronary Syndrome

2.3 Heart Failure

2.4 Hypertension

2.5 Valvular Heart Diseases

2.6 Other CVS Disorders

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