JNC 7 recommends the following routine laboratory tests before initiation of therapy for hypertension:
12-Lead electrocardiogram (ECG)
Urinalysis, including urinary albumin excretion or albumin/creatinine ratio
Blood glucose
Blood hematocrit
Serum electrolytes, especially potassium
Serum calcium
Lipid profile: Total cholesterol, LDL, HDL, triglycerides
Creatinine or estimated GFR
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Generalized anxiety disorder
DSM-V Diagnostic Criteria for Generalized Anxiety Disorder
“
A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school
performance).
AND
B. The individual finds it difficult to control the worry.
AND
C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the
past 6 months);
Note: Only one item is required in children.
1. Restlessness or feeling keyed up or on edge.
2. Being easily fatigued.
3. Difficulty concentrating or mind going blank.
4. Irritability.
5. Muscle tension.
6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
AND
D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
AND
E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g.,hyperthyroidism).
AND
F. The disturbance is not better explained by another mental disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder social phobia, contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder,
The perimenopause symptoms are caused by an overall drop, as well as dramatic but erratic fluctuations, in the levels of estrogens, progestin, and testosterone. Some of these symptoms such as formication etc may be associated with the hormone withdrawal process.
C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
AND
D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.
”
Urine drug screen to rule out any other associated drug abuse
Routine blood work such as electrolytes and hemoglobin to rule out any associated disease explaining the symptoms
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Pheochromocytoma
The hallmark symptoms of a pheochromocytoma are those of sympathetic nervous system hyperactivity, symptoms usually subside in less than one hour and they may include:
Palpitations especially in epinephrine producing tumors.
