Investigations Flashcards
1
Q
How do you diagnose hypertension?
A
- Measure BP in relaxed, temperate setting with person quiet and seated and arm supported
- Measure both arms
- If difference between both arms >15mmHg, repeat, if occurs subsequently measure more in higher BP arm
- Palpate pulse before to check for irregular pulse and if so check BP manually
- If BP in clinic >140/90mmHg take 2nd and if still high take 3rd and record the lower 2
- If between 140/90 and 180/120mmHg offer ambulatory BP monitoring to confirm hypertension (or home BPM)
2
Q
What is the criteria for HBPM?
A
- 2 consecutive measurements, 1 min apart
- Recorded twice daily
- Continue for 4-7 days
- Average value of all measurements to make diagnosis
3
Q
What are the stages of hypertension?
A
Stage 1: 135/85 - 149/94
Stage 2: 150/95 - 179/119
Stage 3 (severe): >180/120 - this can cause hypertensive emergency (malignant hypertension)
4
Q
How do you investigate Addison’s disease?
A
Short ACTH stimulation test (Synacthen test)
- Tetracosactide (synacthen) 250ug iv/im after checking blood cortisol at 0 mins
- Check blood cortisol at time 0 and 30 mins
- Cortisol at 30min should be >600nmol/l (Addison’s excluded if >550)
5
Q
What is the result of the aldosterone:renin ratio in primary and secondary hyperaldosteronism?
A
Primary: high aldosterone, low renin
Secondary: high aldosterone, high renin
