Rosh Internal Medicine Boost Practice Exam

In a patient with blurred vision and hypertension, what is a critical aspect of their history to review?

1. Medication adherence

2. Family history of diabetes

3. Recent infections

4. History of migraines

The correct answer is: Medication adherence

In a patient presenting with blurred vision and hypertension, reviewing medication adherence is crucial. Poor adherence to prescribed antihypertensive medications can lead to uncontrolled blood pressure, which may contribute to ocular complications, such as hypertensive retinopathy. This can manifest as blurred vision and other visual disturbances. Ensuring that the patient is taking their medications as directed can help identify if inadequate treatment is a factor in their symptoms. While other aspects of the patient's history, such as family history of diabetes, recent infections, and history of migraines, can be clinically relevant, they do not directly address the immediate concern of the patient's high blood pressure which is likely contributing to the blurred vision. Diabetes could suggest a risk for conditions like diabetic retinopathy, but without high blood pressure management, the risk of hypertensive complications rises significantly. Thus, understanding medication adherence serves to directly target the potential root of the problem in this scenario.