Women's health · History + examination

Headache and swelling at 34 weeks of pregnancy - GP

HardYear 5 · Curtin style · 15 min + 2 min reading · 5 tasks

2 min reading · 15 min station · reminders at 2 min

Station - Instructions for candidate

You are a junior doctor working in a general practice in Perth that provides antenatal shared care.

Ayen Mading, a 29-year-old chef, is 34 weeks into her first pregnancy under shared care with King Edward Memorial Hospital. She has come in between shifts because of two days of headache and swelling of her face and hands. The practice nurse has recorded her blood pressure and weight. A sphygmomanometer, urine dipsticks, a tendon hammer, a tape measure and a handheld Doppler are available.

Practice nurse
Weight 84 kg (80 kg at the 31-week visit). Antenatal record: BP 118/74 at 28 weeks; gestation by dating scan 34 weeks 2 days today; 20-week morphology scan normal; blood group A positive.

Your tasks are to:

  1. Take a focused history.
  2. Perform a focused examination.
  3. Request any relevant investigations and interpret the results provided.
  4. Summarise your findings to the examiner with your most likely diagnosis and differential diagnoses.
  5. Outline your immediate management plan to the examiner.
  • Please verbalise your examination to the examiner; findings will be provided on request.

This is a 15-minute station, with 2 minutes of reading time.

Ask the examiner

Say what you would examine or request, the way you would in the station. Nothing is named until you ask for it.

Whatever the examiner recognises is revealed below. Or pick a numbered item to reveal it blind.

Investigations

Ask for a category the way you would in the station: “Can I have the obs and a set of bloods?”

Examination

Say what you would examine and how; the examiner reports what you would find.