Certified Medical Assistant (CMA AAMA)Clinical Workflow and Patient IntakeHard
A patient stands up after sitting for several minutes. Their blood pressure drops from 128/78 mmHg while seated to 104/70 mmHg while standing, and they report dizziness. This finding is most consistent with:
- Ahypertensive urgency
- Borthostatic hypotension
- Cpulsus paradoxus
- Dnormal physiologic variation
Show answer & explanationAnswer & explanation
Correct answer: B. orthostatic hypotension
Orthostatic hypotension is diagnosed when systolic blood pressure drops by 20 mmHg or more (or diastolic drops by 10 mmHg or more) within a few minutes of standing, often accompanied by dizziness. Here, systolic dropped 24 mmHg (128−104), meeting the diagnostic threshold.
Why the other options are wrong
- A. Hypertensive urgency involves severely elevated, not dropping, blood pressure.
- C. Pulsus paradoxus is an exaggerated drop in blood pressure during inspiration, unrelated to positional change.
- D. A 24 mmHg systolic drop with dizziness exceeds normal variation and is clinically significant.
Orthostatic Hypotension
A significant drop in blood pressure that occurs when a patient moves from sitting or lying to standing, often causing dizziness.
- Diagnostic criteria: SBP drop ≥20 mmHg or DBP drop ≥10 mmHg
- Measured within 2–3 minutes of standing
- Common causes include dehydration and certain medications
Memory trick: 'Twenty systolic or ten diastolic signals a drop.'