### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
have hypertension, bystolic, diabetic insulin pump, had tia in dec 09 on plavix, bp has been good since jan. feeling shaky last couple of days, checked at home and bp was 120/78 tues night, last night 117/76. today having really bad headache really shaky, not glucose, checked bp ( i work at a surgery center) 136/120, waited 10 min took again on same machine 137/94, went to different machine, 135/87 sitting, standing 143/98. should i be concerned about the 1st one?

### output:

Hello, You have a history of hypertension & diabetes. It looks like your blood pressure is fluctuating, BP should always remain stable. Fluctuating BP should be monitored & managed else it may cause symptoms like headache, trigger developing heart disease, nosebleed, dizziness, make you feel weak & fatigued. 1. Hypoglycemia, hyperthyroidism, alcohol intake, Chat Doctor.  2. Sometimes Neurological problems may cause tremor. 3. You are suggested to get physically examined & get proper treatment of hypertension at the earliest. In the meantime, get CBC, Blood sugar (R & PP) Urinalysis, lipid profile, X-Ray, ECG, Echocardiography, Stress tests done to rule out any developing coronary artery disease.4. Diabetes triggers the symptoms, maintain your blood sugar levels. 5. You can get Nerve Conduction tests done at the earliest to rule out any developing Peripheral Neuropathy.  In the meantime avoid stress, stay away from alcohol & 