Hypertension (OSCE)
Assessment of Hypertension
Goals
- identify end organ damage
- identify signs of secondary hypertension
Differential
- Medications
- Renal: vascular, parenchymal
- Endocrine: Cushing’s, pheochromocytoma, primary aldosteronism, hyperparathyroidism, thyroid
- Aortic dissection
Vitals
- standard vitals
- weight and height (BMI)
Inspection
- Neck:
- thyroid
- JVP
- Skin
- Cushing’s (striae, acne, hirsutism)
- pheochromocytoma (clammy, diaphoretic)
- arterial insufficiency (skin, hair changes)
Palpation
- Point of maximum impulse (PMI)- diffuse
- peripheral pulses (symmetric)
- radiofemoral delay
Auscultation
- carotid bruit
- pulmonary edema
- S4 gallop, murmurs
- bruits (abdominal, renal, femoral)
Fundoscopic exam
- Grade 1 - spasm of retinal vessels
- Grade 2 - constriction retinal arterioles, AV nicking
- Grade 3 - vascular changes, hemorrhage, exudates
- Grade 4 - papilledema
External link
- Auscultation of Carotid Bruit - bruit audio, case studies and quiz
Other OSCE modules
Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence
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