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Headache and swelling at 34 weeks of pregnancy - GP

CurtinYear 515 min + 2 min readingWomen's health & obstetricsChallengingPre-internship
  • Focused history
  • Focused examination (blood pressure, oedema, reflexes, fundal height; urinalysis)
  • Request investigations
  • Dx + differentials
  • Initial Mx

Ready

2 min reading, 15 min station, warning at 2 min

Focus the timer and press Space to start or pause.

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 nurseBP 158/102 mmHg (seated, right arm, correct cuff). HR 88 /min. 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, including blood pressure, oedema, reflexes, abdominal examination with fundal height and fetal heart, and a urine dipstick. Verbalise each step to the examiner and the findings will be provided.
  3. Request any investigations you would arrange. Results will be provided by the examiner if appropriately indicated.
  4. State your most likely diagnosis and the differential diagnoses to the examiner.
  5. Outline your immediate management plan to the examiner, and explain to the patient what needs to happen now.
  • You do NOT need to summarise your history and examination findings to the examiner.
  • State drug, dose and route where relevant.
  • The examiner may hand you results at any point after you request them.

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

Ask the examiner

Say what you want out loud, then open it below. Each result stays hidden until you reveal it.

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.

Generated by AI for practice; check doses and pathways against eTG / AMH before relying on them.