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White coat hypertension — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareWhite coat hypertensionUSMLE Step 3

A 45-year-old woman returns after 4 weeks of home blood pressure monitoring. Office readings were 146/86 and 150/88 mm Hg, but validated home readings average 122/76 mm Hg. She has no target-organ disease. Which of the following would you recommend at the follow-up visit?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Diagnose white coat hypertension and continue periodic monitoring

Normal home readings with elevated office readings suggest white coat hypertension; ongoing monitoring is appropriate.

Reference: USPSTF hypertension screening recommendation; ACC/AHA hypertension guideline