A 71-year-old man with a 15-year history of hypertension presents to the emergency department with a 2-day history of severe occipital headache, blurred vision, and nausea. His wife reports he has been non-compliant with his antihypertensive medications for the past 3 months. On examination, he is alert but visibly distressed. Vital signs: BP 218/128 mmHg, HR 104/min, RR 22/min, temperature 37.2°C. Ophthalmologic examination reveals papilledema and flame-shaped hemorrhages. Laboratory studies show: serum creatinine 3.1 mg/dL (baseline 1.0 mg/dL 3 months prior), BUN 78 mg/dL, urinalysis with 3+ proteinuria and RBC casts, hemoglobin 9.8 g/dL, platelets 245,000/μL, LDH 680 U/L, and peripheral blood smear showing occasional schistocytes. Coagulation studies are normal. Which of the following best explains this clinical presentation?

1. A)Thrombotic thrombocytopenic purpura (TTP) with secondary hypertension
2. B)Post-infectious acute glomerulonephritis with hypertensive encephalopathy
3. C)Hemolytic uremic syndrome triggered by medication non-compliance
4. D)Acute cortical necrosis from sepsis-induced acute kidney injury
5. E)Hypertensive emergency with acute kidney injury secondary to malignant hypertensionGABARITO