A 60-year-old patient of yours has a persistently high diastolic blood pressure above 90 mmHg.
Ambulatory blood pressure monitoring is not currently available so you decide to check his home blood pressures.
According to NICE what is the minimum number of blood pressure readings a patient should record at home?
A previously healthy 38-year-old woman is 20 weeks pregnant with her first child. She has been experiencing increasing shortness of breath in recent weeks and has started coughing up pink frothy sputum, particularly when lying down. She reports no chest pain. Blood tests reveal no anemia, but upon listening to her chest, you detect a mid-diastolic heart murmur at the apex. Her chest exam is otherwise normal, and her resting pulse is 90 bpm SR with O2 sats at 96%. What is the most probable diagnosis?
A healthy 60-year-old male has a clinic blood pressure of 120/75 mmHg.
When should you offer him another blood pressure test?
You see a 65-year-old gentleman who you have recently diagnosed with heart failure and an ejection fraction of 35%. You have titrated him up to the maximum dose of ACE-I and his renal function, sodium and potassium have all remained within normal limits for the past three months.
According to NICE, how often should he now have his treatment monitored?
A 42-year-old white male is diagnosed with hypertension.
He is usually fit and well with no significant past medical history. His ECG is normal, he has no microalbuminuria, and clinical examination is otherwise unremarkable.
Assuming there are no contraindications, place the following in the correct order in which they should be initiated to manage his high blood pressure:
A ACE-inhibitor
B Calcium channel blocker
C Thiazide-like diuretic
D Alpha blocker
You are reviewing a patient with hypertension who is 65 years old. As part of the review, you assess his 10 year cardiovascular disease risk and this is significant at 32%.
This prompts discussion about the role of lipid lowering treatment in the primary prevention of cardiovascular disease. Following discussion, you both agree to start him on atorvastatin 20 mg daily. You can see his recent blood tests (FBC, U&Es, LFTs, TFTs and fasting glucose) are all normal.
In terms of follow up blood testing, which of the following should be performed after starting the atorvastatin?
A 58-year-old man comes to his GP complaining of headaches and blurred vision that have been present for two days. He has been taking amlodipine 5 mg, which was prescribed at the same clinic two weeks ago. During the examination, his blood pressure is measured at 190/115 mmHg. Although his cardiovascular examination is unremarkable, retinal hemorrhages are observed during fundoscopy, but no papilledema is present. What is the best course of action for this patient?
A 55-year-old has just been diagnosed with hypertension and you have commenced treatment with an ACE inhibitor (ACE-I).
As per NICE guidelines, what are the monitoring obligations after initiating an ACE-I?
You are assessing a 70-year old man with a history of heart failure. He is still exhibiting signs of fluid overload, prompting you to raise his furosemide dosage from 20 mg to 40 mg. What additional monitoring should be recommended?
A 61-year-old woman is prescribed statin therapy (rosuvastatin 10 mg daily) for primary prevention of cardiovascular disease (CVD) due to a QRISK2 assessment indicating a 10-year risk of CVD greater than 10%. Her liver function profile, renal function, thyroid function, and HbA1c were all normal at the start of treatment. According to NICE guidelines, what is the most appropriate initial monitoring plan after starting statin therapy?