Clinical Case Scenario
An elderly woman presents to the emergency room with generalized weakness, headache, and confusion. Her blood pressure is 220/105 mmHg. Physical examination reveals skin thickening of the extremities, facial telangiectasias, and decreased oral aperture. Laboratory studies reveal creatinine levels of 3.5 mg/dL, hemoglobin at 7.0 g/dL, a platelet count of 75,000/mm³, and lactate dehydrogenase at 700 U/L.
What is the appropriate initial treatment?
