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Pathology · patient case question

For a patient with an asymptomatic blood pressure of 175/100 mmHg, the appropriate action is:

Patient case: Sjögren Syndrome and Blood Pressure Screening

demo: 56-year-old female

chief: “My mouth and eyes are constantly dry.”

history: Rheumatoid arthritis. Positive anti-SSA (Ro) and anti-SSB (La) antibodies.

meds: Hydroxychloroquine

findings: Blood pressure 145/92 mmHg on two readings. Dry, atrophic oral mucosa with a lobulated tongue, generalized gingival recession, marginal gingivitis, and rampant cervical caries. Bilateral parotid enlargement. Extensive interproximal staining.

  1. Refer to a physician for evaluation while deferring elective care
  2. Proceed with all planned treatment without comment
  3. Call emergency medical services immediately
  4. Administer a sublingual antihypertensive in the dental office
Show answer and explanation

Correct answer: A. Refer to a physician for evaluation while deferring elective care

  • A. Correct. An asymptomatic reading in this range warrants medical referral and deferral of elective treatment; urgent care may proceed with monitoring and stress reduction.
  • B. Ignoring a reading this high misses an opportunity to intervene in a modifiable cardiovascular risk.
  • C. EMS activation is reserved for hypertensive crisis with end-organ symptoms — chest pain, visual change, neurologic deficit, or severe headache.
  • D. Dentists do not initiate antihypertensive therapy; that is the physician's role.

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