I Human review
o Harvey Hoya
Essential HTN
o You will initially get an overview of the patient but you need to start asking
questions
o HPI
... [Show More] How can I help you today? Is a good opening question
Do you have any other symptoms or concerns?
Current or past medical problems that you have?
Tell me about the health of your grandparents?
Tell me about your diet and what you normally eat?
Do you have any problems with fatigue, difficulty sleeping?
Any nausea, vomiting, constipation, diarrhea?
Ask about urination
Ask about allergies
Ask about prescription medication
Ask how severe their symptoms or problem is
Ask about heat/cold intolerance
Ask about dizziness, weakness, numbness
Ask about alcohol intake
Ask about tobacco use
Ask about drug use
Ask about thyroid problems
Any chest pain
Any breathing issues
Ask about musculoskeletal issues
Ask when symptoms started
o Exam
Look at skin
Look in eyes
With ophthalmoscope
o Look for retinopathy
Look at mouth
Palpate the neck
Measure the JVP
Look at chest wall anterior and posterior
Palpate PMI and listen to heart
Palpate the chest and lungs then auscultate
Auscultate the abd and femoral arteries
Measure abd girth
Palpate and percuss the abd
Check mental status
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Auscultate the carotid arteries
o Key findings and problem statement
Key findings are blood pressure measured times 2
Note other important findings during the exam
The most key thing would be the blood pressure
Choose differentials
Hypertension, primary and secondary
White coat HTN
Obstructive sleep apnea
o Tests
Sleep study
CMP
CXR- PA and lateral
Thyroid function test-TFT
Echocardiogram-transthoracic
EKG
CBC
UA
o Management plan
Have diagnosis
Write a goal
Talk about medications
Follow-up management
o Write up a H&P
The Art of Diagnosis and Treatment
o Make sure you are doing the right thing because the diagnosis you make will stay
on the patient’s medical record
o Always take the patient serious, no matter what they say
o If a patient misses appointments, it could be due to other issues such as vehicle
issues, not something negative. Make your own opinions on patients rather than
taking other peoples advice on a patient
o OLD CARTS
Onset, Location/radiation, duration, character, aggravating factors,
reliving factors, timing and severity
o Save UCSD’s Practial Guide to Clinical Medicine
Good site to look at
o History of Present Illness
Chief complaint
Ask questions
Get the patients story
o Past medical history
Ask patients to bring in all medications
Important to ask about allergies every visit [Show Less]