Hypertension (OSCE)

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Assessment of Hypertension

Goals[edit]

  • identify end organ damage
  • identify signs of secondary hypertension

Differential[edit]

Vitals[edit]

  • standard vitals
  • weight and height (BMI)

Inspection[edit]

  • Neck:
    • thyroid
    • JVP
  • Skin
    • Cushing’s (striae, acne, hirsutism)
    • pheochromocytoma (clammy, diaphoretic)
    • arterial insufficiency (skin, hair changes)

Palpation[edit]

  • Point of maximum impulse (PMI)- diffuse
  • peripheral pulses (symmetric)
  • radiofemoral delay

Auscultation[edit]

  • carotid bruit
  • pulmonary edema
  • S4 gallop, murmurs
  • bruits (abdominal, renal, femoral)


Fundoscopic exam[edit]

  • 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]

Other OSCE modules[edit]