Hypertension (OSCE)
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Assessment of Hypertension
Goals[edit | edit source]
- identify end organ damage
- identify signs of secondary hypertension
Differential[edit | edit source]
- Medications
- Renal: vascular, parenchymal
- Endocrine: Cushing’s, pheochromocytoma, primary aldosteronism, hyperparathyroidism, thyroid
- Aortic dissection
Vitals[edit | edit source]
- standard vitals
- weight and height (BMI)
Inspection[edit | edit source]
- Neck:
- thyroid
- JVP
- Skin
- Cushing’s (striae, acne, hirsutism)
- pheochromocytoma (clammy, diaphoretic)
- arterial insufficiency (skin, hair changes)
Palpation[edit | edit source]
- Point of maximum impulse (PMI)- diffuse
- peripheral pulses (symmetric)
- radiofemoral delay
Auscultation[edit | edit source]
- carotid bruit
- pulmonary edema
- S4 gallop, murmurs
- bruits (abdominal, renal, femoral)
Fundoscopic exam[edit | edit source]
- Grade 1 - spasm of retinal vessels
- Grade 2 - constriction retinal arterioles, AV nicking
- Grade 3 - vascular changes, hemorrhage, exudates
- Grade 4 - papilledema
External link[edit | edit source]
- Auscultation of Carotid Bruit - bruit audio, case studies and quiz