Hypertension and Altered Mental Status (AMS) - Differential Diagnosis Framework



Hypertension:

 • Hypertensive emergency

 • Hypertensive encephalopathy

 • PRES

 • Sympathetic stimulation



Cardiac:

 • CHF

 • Fluid overload



Endocrinopathies:

 • Cushing’s syndrome

 • Primary aldosteronism

 • Pheochromocytoma

 • Hyperthyroidism



CNS:

 • Stroke - with compensatory HTN

 • Seizures/NCSE

 • Delirium/agitation

 • CNS tumor

 • Intracranial mass



OB:

 • Eclampsia/Pre-Eclampsia



Renal:

 • Acute GN

 • Acute/Chronic renal failure

 • Renal artery stenosis



Autonomic Hyperactivity:

 • GBS



Autoimmune:

 • Vasculitis

 • Lupus

 • Polyarteritis nodosa

 • Scleroderma renal crises



Drug (+):

 • Cocaine

 • NMS

 • Serotonin syndrome

 • Sympathomimetic agents

 • Amphetamine intoxication

 • Monoamine oxidase inhibitors



Drug (-):

 • ETOH withdrawal

 • Opioid withdrawal

 • Clonidine cessation



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