17/5

Question 1

HTN

• Now diagnosed with AMBP - what are the cut-offs for different stages
• How is it investigated?
• How is it managed? What are the targets?
• Who is referred for same-day specialist review?

Answer 1

Stage 1 >135/85
Stage 2 >150/95
Malignant >180/>120

Bedside
- AMBP or home monitoring
- Urine dip (check for urine:creatine ration and microscopic heamaturia)
- ECG - check for LVH
- fundoscopy (retinal haemorrhage or papilloedema)

Bloods
- U+Es - renal function
- HbA1c and glucose - diabetes
- lipid profile

Management
Conservative
- stop smoking
- increase exercise + healthy diet
- reduce salt, caffiene, alcohol
- advice leaflets

Medical
<55 or African American
1. C

> 55 or T2DM
1. A

2. dual therapy (A+C+D)
3. A+C+D

If still persistent seek expert advice or if K+ <4.5 = spironlcatone >4.5 - beta blocker or increased thiazide dose

Add a statin 20mg ON if a CV risk

Same day referral = those with malignant HTN or signs of organ damage

Question 2

How is DVT managed?

Answer 2

The same way as PE

Question 3

What kind of CV drug can increase the risk of gout?

Answer 3

Thiazide diuretics