Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Renovascular Hypertension


Related Terms

  • Chronic Renal Artery Stenosis
  • Renal High Blood Pressure
  • Renal Vascular Hypertension

Differential Diagnosis

Specialists

  • Cardiovascular Internist
  • Nephrologist

Comorbid Conditions

Factors Influencing Duration

Factors include the individual's age, lifestyle modifications, the extent of renovascular damage and systemic vascular disease, presence of bilateral disease, the specific treatments instituted (medical or surgical), the individual's response to treatment, and the development of complications.

Medical Codes

ICD-9-CM:
405 - Hypertension, Secondary
405.0 - Hypertension, Secondary, Malignant
405.01 - Renovascular Hypertension, Secondary, Malignant
405.09 - Hypertension, Secondary, Malignant, Other
405.1 - Hypertension, Secondary, Benign
405.11 - Renovascular Hypertension, Secondary, Benign
405.19 - Hypertension, Secondary, Benign, Other
405.9 - Hypertension, Secondary, Unspecified
405.91 - Hypertension, Renovascular, Secondary, Unspecified
405.99 - Hypertension, Secondary, Unspecified, Other

Diagnosis

History: Individuals may complain of headache, anxiety, the sensation of the heart pounding (palpitations), a rapid heartbeat (tachycardia), light-headedness, and mental sluggishness. If the onset is acute, the individual may have abdominal or flank pain, nausea, vomiting, or fever or severe headache. Alternately, the individual may report few or no symptoms.

Physical exam: High blood pressure (hypertension) may be the only indication of renovascular hypertension. Changes in the retina (hypertensive retinopathy) may be seen. An abnormal sound may be heard when listening to the abdomen with a stethoscope (abdominal bruit). There may be evidence of heart failure such as swollen legs (peripheral edema), crackles or wheezing on listening to the lungs (rales) and an enlarged liver.

Tests: Several diagnostic procedures are used to test for renovascular hypertension. The diagnostic challenge is to find evidence of both renal stenosis and renal ischemia. Blood tests can demonstrate impaired renal function. These tests include BUN, creatinine, potassium, and plasma renin activity. Urinalysis may show blood or protein in the urine.

The captopril test involves the injection of captopril, followed by measurement of renin in the blood. Individuals with renovascular hypertension will show a rise in renin, while those with hypertension unrelated to renovascular disease (essential hypertension) will not. This test has a high percentage of false-positive results, particularly among blacks.

Radioisotope renography involves the injection of a radioisotope followed by an imaging procedure to monitor the movement of the radioisotope through the kidney. This procedure can provide information regarding the size of the kidneys, the glomerular filtration rate (GFR), and blood flow. A variation of this procedure is called captopril renography. The procedure is done before and again after injection of captopril. In renovascular hypertension, the test demonstrates a reduction in renal function. As in the captopril test, this test is less accurate in blacks.

Renal vein renin determination measures blood levels of renin in the right and left renal veins. These levels are then compared with that of the inferior vena cava. Increased renin levels indicate that the cause of the hypertension is kidney-related.

Duplex Doppler scanning utilizes ultrasound to measure the speed of blood flow through the kidney. Other procedures that allow imaging of the kidney include magnetic resonance angiography (MRA) following injection of a dye into the renal arteries, and spiral computed tomography (CT) following injection of a contrast agent.

Conventional renal arteriography and using digital imaging which allows subtraction of bone and soft tissue and the use of less dye (intra-arterial digital subtraction angiography) are reserved for individuals who are high-risk for renovascular hypertension. This is because the procedure is invasive. The procedure takes place in the hospital on an outpatient basis. A catheter is inserted into the renal artery. A dye is then injected through the catheter into the artery. X-ray pictures are taken as the dye circulates throughout the kidney.

Source: Medical Disability Advisor






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