IMG Support Program, Bredin Institute Mock OSCE, July 20!

Group 1 STATION 7
Station Name/Type: High Blood Pressure, "istory#taking and p"ysical e$amination %0 min&
E$aminer' Dr. K. Dinyari (ate' July 20, 201
E$aminee)s *ame' +++++++++++++++++++++++++++++
!ro"lem an# In$tru%tion$ to &'aminee:
,ou are going to see Mic"ael -o$, a .. year#old /us dri0er1 2e 3ent to a "ealt" 4air and 4ound "is /lood
pressure at 506781 9ake a 4ocused "istory and per4orm a rele0ant p"ysical e$amination1 ,ou do not need
to c"eck /lood pressure at t"is station1
()e%*li$t:
INT+OD,(TION: -&S NO
Greet t"e patient /y last64irst name: introduce sel4 and role: s"ake "ands ; ;
Identi4y and con4irm pro/lem list ; ;
*egotiate an agenda: esta/lis" a plan 4or t"e 0isit ; ;
Key !oint$: .ISTO+-/TAKING
!re$ent Illne$$:
2eadac"e ; ;
(i<<iness ; ;
Palpitations ; ;
C"est pain ; ;
=ision c"anges ; ;
>rinary pro/lems ; ;
9ingling, num/ness ; ;
Medications *S?I(s, steroids ; ;
?llergies ; ;
!a$t 0e#i%al .i$tory:
C"olesterol ; ;
(ia/etes mellitus ; ;
@idney pro/lems6 surgeries ; ;
2ypertension ; ;
9"yroid
1amily .i$tory:
C?( ; ;
29* ; ;
stroke ; ;
(M ; ;
So%ial .i$tory:
Smoking ; ;
?lco"ol ; ;
Cocaine 6 "eroine a/use ; ;
(iet ; ;
Aork "istory ; ;
Aeig"t ; ;
Stresses ; ;

IMG Support Program, Bredin Institute Mock OSCE, July 20!

Key !oint$: !.-SI(A2 &3A0INATION
Aas" "ands ; ;
Solicit consent 4or e$amination ; ;
Ensure t"at t"e patient is properly draped ; ;
C"eck pulse ; ;
-ingers 4or clu//ing and nicotine ; ;
C"eck BP in . di44erent lim/s and 2 di44erent positions ; ;
C"eck 4or moon 4ace, malar 4lus", or/ital edema, arcus senilis, $ant"olasma, 4acial
plet"ora, and anemia
; ;
Mention op"t"almoscopy ; ;
9"yroid e$am' ocular mo0ements: /icepis tendon re4le$ 4or slo3 release ; ;
Supracla0icular 4at pad, /u44alo "ump ; ;
Bisten to "eart ; ;
Bisten to lungs ; ;
Palpate kidneys ; ;
Cenal Bruit ; ;
2 perip"eral pulses' 4emoral6 dorsalis pedis ; ;
Perip"eral edema ; ;
Gi0e attention to patient)s p"ysical com4ort ; ;
=er/ali<e t"e maneu0ers on t"e e$amination ; ;
Key !oint$: (O00,NI(ATION
S"o3 empat"y and ackno3ledge patient)s concerns, 4rustration, and ot"er 4eelings ; ;
>se easily#understood language, a0oid6 e$plain medical Dargon ; ;
-acilitate patient responses 0er/ally and non#0er/ally %encouragement, silence,
repetition&
; ;
Bisten attenti0ely %3it"out interrupting or directing patient)s responses& ; ;
O44er suggestions and c"oices rat"er t"an directi0es ; ;
Maintain appropriate eye contact, posture, and gestures ; ;
Close t"e inter0ie3 3it" a /rie4 summary and contract 3it" t"e patient re' t"e ne$t
step %incl1 4ollo3#up&
; ;
Key !oint$: ST+,(T,+&
Structure t"e encounter in a logical seEuence ; ;
>se sign#posting and transitional statements ; ;
?ttend to timing ; ;
O4erall Impre$$ion ' Pass -ail
&'aminee5$ Demon$trate# Stren6t)$: +++++++++++++++++++++++++++++++++++++++++++++++++++++++
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Su66e$tion$ 7or Impro4ement: +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
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IMG Support Program, Bredin Institute Mock OSCE, July 20!
In$tru%tion$ to !atient :
,ou are Mic"ael -o$, a ..#year#old /us dri0er1 ,ou "a0e recently gone to a "ealt" 4air at t"e >ni0ersity o4
?l/erta 2ospital and 4ound your /lood pressure at 506781 ,ou are 3ondering i4 t"is is not too "ig" and
concerned a/out 3"et"er you mig"t su44er a "eart attack /ecause o4 it1
*o symptoms, no past medical "istory, not on any medications1
-amily "istory o4 29* and "eart attack in 4at"er %3"o died at t"e age o4 .7&1
Mot"er "as "ypot"yroidism and dia/etes1
,ou like to eat Dunk 4atty 4ood %Macdonald)s 4or lunc", doug"nuts 4or /reak4ast&1 ,ou "a0e /een smoking
one pack o4 cigarettes a day 4or 20 years and drinking a/out 8 /eers per 3eek: you do not e$ercise1 *o
maDor stressors in your li4e1
,ou do not kno3 muc" a/out c"olesterol1 ,ou do not go 4or regular c"eck#ups1 ,our last 0isit to t"e doctor
3as 5 years ago1
,ou "a0e gained 8 l/s1 in t"e last t"ree years1
!)y$i%al &'am:
*ormal op"t"almoscopy
9"yroid not palpa/le
SFS2 no murmur
C"est clear
?/domen and kidneys not palpa/le, no /ruit
Perip"eral pulses positi0e, no edema
!