A 30-year-old woman presents with persistently high blood pressure above 180/90 mm Hg; her blood pressure was checked on two separate occasions during the last week. She denies any history of a chronic medical issue such as high blood pressure or diabetes. She also denies any complaints of nausea, vomiting, visual changes, dysuria, urgency, chest pain, or shortness of breath. However, she reports a positive family history of diabetes and hypertension in her family.
During her visit with you, you note that her blood pressure is 190/96 mm Hg in the right forearm and 188/94 mm Hg in the left forearm. On physical examination, she has no jugular venous distension, swelling of the eyes, or lymphadenopathy. Cardiovascular and pulmonary examinations are normal.
Urinalysis shows:
Protein = 2+
Blood = 1+ with many RBC casts on microscopy
Ketones, red blood cells (RBCs) = Nil
White blood cells (WBCs) = 0.2/hpf
Creatinine = 0.9 mg/dL
blood urea nitrogen = 17 mg/dL
24-hour urinary proteins = 2.4 g
Complete blood count, electrolytes, liver function test, complements, and blood sugar levels are all found to be within normal limits.
Which of the following is the most appropriate step in the management of this patient's condition?
This question appears in Med-Challenger Family Medicine Exam Review with CME
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