mymrcgp

Physical Examination

Hypertension (Newly Diagnosed)

 

 

Common Examination Components:

(You are likely to be expected to examine the common components in each case)


 

Blood Pressure Check both arms*


Peripheral Pulse (rate and rhythm)


Urinalysis (for albumin/protein)


Fundoscopy (for evidence of end organ damage)


Palpation Cardiac apex, thrills and bruits


Auscultation Murmurs, bruits.


Note it is unlikely you will be expected to measure a Role Players blood pressure in the CSA.
 
*(Guidance for blood pressure monitoring states that BP should be checked in both arms. If a difference of >20 mmHg is present repeat the readings. If the difference remains use the arm with the higher reading. Take two measurements and a third if the second is substantially lower than the first.
An inter-arm difference of > 15mmHg is an independent risk factor of vascular disease and mortality **
 **Reference: Christopher E Clark, Rod S Taylor, John L Campbell. The difference in blood pressure readings between arms and survival: primary care cohort study. BMJ, 2012; 344 DOI: 10.1136/bmj.e1327
 

_______________________________


 What CSA Examiners and Trainers Expect - A Typical Scenario

(Study by N.Boeckx: Data from 300 GP Trainers and 16 CSA examiners)


Case Details: An asymptomatic 49 year old female presents with high blood pressure readings from her gym. She has no past history of note. This is a case of newly diagnosed hypertension (BP 162/94). There are no alarming features in the history or on examination. Choose the examinations you would expect from a safe GP in a 10 minute consultation.

Case Discussion: There are lot of common components examiners in a new hypertensive patient. To avoid running out of time in the clinical management section you need to know them off by heart so you can move through the examination swiftly. You are looking to complete your examination in under 3 minutes.

Chest Menu

Main Exam Menu

Main Exam Menu

Chest Menu

Main Exam Menu

Main Exam Menu