Welcome back toMasterUSMLE, where we break down key concepts forStep 2 CK. Today, we’re coveringhypertension and the essential screening tests that go with it.

A44-year-old restaurant owner comes in for a life insurance medical exam. Hisblood pressure is 150/94, confirmed on repeat measurement. He hasno known medical history, but hisBMI is 31, and his father had a heart attack at 52. He mentions feeling more fatigued lately and has gained weight over the past few years.

What’s the most important test to order?
Diabetes screening (fasting glucose or HbA1c).

• Hypertension and diabetes frequently coexist, accelerating cardiovascular disease.
• Obesity and family history raise the risk of insulin resistance.
• Early screening prevents complications like nephropathy, retinopathy, and stroke.

• Renal function & electrolytes to check kidney health
• Lipid panel to assess cardiovascular risk
• TSH to rule out hypothyroidism as a cause
• ECG to detect left ventricular hypertrophy or silent ischemia

Hypertension is often the first clue tounderlying metabolic disease.Diabetes screening is crucial, especially in patients with obesity or family history.

That’s it for today.Keep studying, stay sharp, and master the USMLE.

Case ScenarioWhy is this essential?Additional Tests for Newly Diagnosed HypertensionKey Takeaway