Hypertensive emergency with encephalopathy: which finding would you expect on examination?

• A. Normal exam
• B. Xanthelasma
• C. Varicose veins
• D. Papilledema

Answer: (D)

Hypertensive emergency with encephalopathy injures the brain and can raise intracranial pressure. A classic sign of that raised pressure is papilledema, which is optic disc swelling seen on fundoscopic exam. This finding reflects end-organ involvement from severe hypertension and aligns with brain dysfunction like encephalopathy. The other options don’t fit this scenario: a normal exam would miss the brain injury; xanthelasma is a marker of chronic lipid disease; varicose veins are unrelated to acute hypertensive damage. So papilledema is the expected examination finding.