Hypertensive Nephrosclerosis and Renovascular Disease — DCE Clinical Case

Approach — what the examiner is testing

This station is not "take a blood pressure". It tests whether you can measure pressure properly, stage the damage hypertension has done, and hunt for a secondary cause — in that order [1].

Measure first. Seat her rested, back supported, arm at heart level, correct cuff size; measure both arms at least once (an inter-arm difference suggests subclavian disease), and consider standing pressure if symptoms or age suggest postural drop. Say what you are doing — examiners award the measurement rigour explicitly because out-of-office and standardised readings define true resistance [1] [2].