MCCQE Part 1 (100% Accurate)

SPIKES correct answers Setting up interview, assessing patient Perception, obtaining patient's Invitation to disclose information, giving Knowldege and information to patient, addressing patient's Emotions, Strategy and Summary Canada Health Act correct answers Accessibility, Comprehensiveness, Portability, Public administration, Universality HTN correct answers 135/85 on 3 separate occasions, =180/110 on dedicated office visit, or diabetes = 130/80 ACR for DM and CKD correct answers ACR 30 mg/mmol is abnormal When to start management of HTN correct answers BP160/100 or 140/90 when pt has other RF like diabetes and smoking Pharmacological for HTN correct answers HTN alone = thiazide, HTN + atherosclerosis = ACEI, HTN + postMI = beta blockers, HTN + DM = ACEI Preeclampsia-eclampsia correct answers HTN with proteinuria AFTER 20 weeks of gestation Sx of preeclapmpsia correct answers Visual disturbance, new onset h/a, epigastric or RUQ pain, rapidly progressing peripheral edema, rapid weight gain Px of preeclampsia correct answers Positive roll over test (=15 dBP increase), vasospasm/retinal edema, clonus (severe preeclampsia), RUQ tenderness Protein in urine preeclampsia correct answers =300 mg/d of protein Treatment of preeclampsia correct answers Delivery, betamethasone (34 weeks gestation), mg sulphate Malignant HTN correct answers HTN emergency: BP 180/120 with retinal hemorrhages, excudates or papilledema. May also have malignant nephrosclerosis Hypertensive encephalopathy correct answers HTN emergency: BP 180/120 with cerebral edema Mx of malignant HTN correct answers Reduce dBP to 100-105 over 2-6 hours (initial fall in BP should not exceed 25% of current BP) Hypovolemic shock Mx correct answers Crystalloids 1-2L IV bolius. Maintain MAP of 60 or maintain sBP90, urine output 0.5ml/kg/h. If hemorrhagic, transfuse in addition to crystalloid. Maintain Hct 30-35%