21st June 2026

A 42-year-old lady presents to her GP for a routine health check.

A 42-year-old lady presents to her GP for a routine health check. She has a history of hypertension for which she takes ramipril 10mg OD. She states that she feels well but has noticed her blood pressure readings at home are on the higher side. Her blood pressure is checked and is noted to be raised at 195/100.

The GP asks her to relax and then repeats her blood pressure in the other arm, and it is still elevated at 195/100. He proceeds to do a urine dipstick.

Urine dip: 

Glu neg, Bili neg, Ketones neg, Specific gravity 1, Blood neg, Protein neg, Nitrites neg, WCC neg

The GP proceeds to do a fundoscopic examination. The GP proceeds to refer this patient to the medical registrar on call at the neighbouring hospital. He states that the patient has grade III hypertensive retinopathy. 

What features are found in grade III hypertensive retinopathy?

Select the SINGLE most appropriate option from the list below. Select ONE option only.