OSCE BANK

MRCGP-INT OSCE EXAM MARCH 2011

DAY ONE 1-occupational BA -TEXTILE INDUSTRY 2-acne 3- IBS 4-OCD 5-GOUT 6-DM (UNCONTROLLED ) 7-ALOPECIA 8-HIV-(NON REACTIVE ) 9-HTN 170/102 10-NECK PAIN RADIATE TO ARM FOR 6 MOS 11-DAUGHTER CONCERNED HER FATHER HAS FEEDING PROBLEM AFTER CA OESOPHAGUS 12-MOTHER OF 14 YRS GIRL C/O AGGRESSION 13 NEW PREG-SMOKER - HER FRIEND HAS A DOWN BABY 14-60 YRS WOMAN WITH URINE HESITENCY ON FUROSAMIDE OTHER DAYS -COLORECTAL CA MULTIFOCI IN LUNGS C/O SOB Day 3 MRCGP-INT exam (By Samah) shoulder pain mother concerns about her 14 years daughter(adolescence behavioral changes aggressive ,uncontrolled HTN 180/110(off treatment 5 years),,, pulmonary embolism ,dyspepsia(BMI 30) shingles vertigo(not BPPV) ,dementia myopathy, depression renal stone ,testicular lump(pt has history of TB) child tummy pain(recent transfer to new school mother concerns about her child( +ve family history of coeliac disease ),

MRCGP-INT SOUTH ASIA 26th sep-2nd oct 2010

1. T.B 2. BACKPAIN 3. CARPAL TUNNEL 4. DM-TYPE ONE CHILD REFUSE ING(MOTHER CONCERN) 5. DM (HA1c 8) 6. HTN-new empolyment first reading 165/90 lipid high/ECG normal 7. 55 YEARS,KNOWN HTN STOP ATENOLOL FOR 6 MONTHS BP190/100/ECG NORMAL/ HIGH LIPID. 8. MENORRAGIA. 9. MULTIPLE SCLEROSIS-numbness+previous loss of vision 10. IBD-RECTAL BLEEDING+watery eye+tinia bedis

11. IBD-rectal bleeding+leg erythema nodosum 12. A.F/SVT 13. SORE THROAT 14. PRIMARY AMENORRHOEA 15. HYPOTHYRIODISM 16. HYPERTHYRIODISM 17. VAGINAL DISCHARGE 18. COMPLETE ABORTION 19. COUGH EXERCISE ASTHMA 20. COUGH--SARCOIDISIS/PANCOST SYNDROME? 21. URINE INCONTENENCE-STRESS 22. MOTHER HER CHILD HAS CHICKEN BOX the mother is pregnant consern about herself &other children. 23. MOTHER CONCERN SHORT STATURE CHILD(GROWTH CHART NORMAL) 24. CHRONIC FATIGUE SYNDROM 25. ANXIETY-PANIC ATTACK 26. CONTACT DERMATITIS(nurse use formaldehayied frequently) 27. STROKE/TIA (PATIENT HAS WEAKNESS FOR 3 HOURS) 28. STRESS MANAGEMENT CASE(HAS STRESS AT WORK) 29. POST-MI 30. TRAVELLER DIAHROEA/?GARDIASIS 31. TRAVEL ADVICE (PATIENT GOING TO KENYA) 32. RENAL STONE (2 CASES) 33. CHRONIC CONSTIPATION in adult 34. RABES(LADY BITTEN BY CAT) 35. PNEUMONIA 36. ANKYLOSING SPONDIOLYSIS 37. Peri-menopause(cystitis,sex difficulty) 38. Reactive artharitis 39. Coeliac disease./chronic diarrhoea 2 months 40. Colon cancer (+ve FH familial polyposis) 41. Abdomine T.B(wt loss+diarrhoea+his father has chronic cough but do not know if has T.B) 42. Degenerative cervical disease of neck(pain refer to shoulder) O.A 43. BPH 44. Diverticulosis (left side repound tenderness) 45. Uncontrol adult asthma. 46. 60 years male diabetic (HbA1c 8 on metformin 500 mg od)HTN B.P170/95 on lisinopril 10/ 20?,DLP LDL slightly high,worried of lower limb oedema hisLFT/RENAL are normal. 47. Macular degeneration (see eye doctor) worried of vision loss/ driving. 48. nasal drip+headiness+frontal sinus pain+omit exam as he has pale mucosa and tender sinus. 49. Chest pain (ECG normal)?muscle/anxiety 50. Child costipation. 51. Teenage with menorragia ,relactant to talk(teenage issues) 52. Post-herptic neuralgia 53. HEADACHE (subarachnoid heamorrage) 54. Pulmonary embolism. 55. Brucellosis(mid age drink row milk-night swet,fever,diarrhoea ,wt loss) 56. Breast engorgment (baby died during delivery). 57. HEADACHE 3 MONTHS ,WT LOSS,WEAKNESS /YOUNG AGE 58. TENNIS ELBOW

59. NASAL POLYP 60. DEPRESSION 61. BBN-CHILD NEWLY DIAGNOSED 62. CA PANCREASE(abdominal pain radiating to the back for 2 months+wt loss 2weeks+bulky stool) 63. Stable angiana 64. Emergency contraception 65. Cystitis during pregnancy. 66. AMEOBISIS.asymtomatic shief with cysts in the stool result .concerning about his job and not to tell his manager,his child has diarrhea and. Note Alots of lab reports ,unless you ask he will not show you. Many stations with ECG print Many cases counselling need early ICE exploration to kow where to go. Many cases of chronic diseases(DM/HTN/DLP/IBD),Infectious(T.B/AMEBIOSIS). This Year exam of hot topics.(published in 2010). Less psychatric/BBN

Asthma: in all scenarios: Acute ER setting management, Worsening follow up, After attack follow up, Consult. Wheezes. Pneumonia, typical and atypical. Chest pain. Cough. Coughing up blood (Haemoptysis). COPD: in all scenarios: Acute ER setting management, Worsening follow up, After attack follow up, Consult. Shortness of breath. Chronic shortness of breath. Pulmonary embolism in ER setting. Anticoagulant counseling for pulmonary embolism. Bronchiectasis. Pleural effusion. Interstitial lung disease, occupational cough/SOB. Solitary pulmonary nodule on X-ray. Pneumothorax in ER setting. Rhinorrhea / Sore throat. Sinusitis. Chest X-ray interpretation. Pulmonary Function Tests interpretation.

Arterial blood gases interpretation. Smoking consult. Respiratory system examination.

onald Davidson is a 43 year old man who comes to your office complaining of shortness of breath. In the next 5/10/15 minutes take focused history. (SOB ).

Jeffrey Hanson is a 52 year old man who has come to your office because of frequent episodes of shortness of breath. In the next 5/10/15 minutes take focused history. (SOB ).

James Fairman is a 57 year man who comes to your office because during an employment routine check up he was found to have a nodule in his lung. In the next 5/10/15 minutes take focused history. (Lung nodule ).

Julian Cameron is a known case of chronic bronchitis who has come to your office for a regular check up. In the next 5/10/15 minutes perform focused physical exam. (Ex am ).

Albert Henderson is a 62 year old man who comes to your office with cough for three months. In the next 5/10/15 minutes take focused history. In the last minute the examiner will stop you to ask questions, (Cough ).

John Hunter is 54 year old man who comes to the emergency because of cough and recurrent lung infections. In the next 5/10/15 minutes take focused history. (COPD ).

George Camay is a 32 year old man and an asthmatic patient of your colleague Dr. Eric Goodson. He comes to your office for a follow up visit as your covering Dr Goodson while he is away. In the next 5/10/15 minutes talk to him (Asthm a ).

Nikkei Johnson is a 29 year old woman who has been diagnosed with asthma recently. In the next 5/10/15 minutes talk to her. (Asthm a ).

Steven Copper is 19 year old man who came to emergency with sudden right sided pain. In the next 5/10/15 minutes take focused history and focused physical examination. (chest pain/ Spontaneous Pneum othorax ).

Norman Pearson is a 77 year old man who came to your office complaining

of hoarseness for three months. In the next 5/10/15 minutes take focused history.(Cough ).

James Timothy is a 66 year old man who comes to your office complaining of coughing up blood. In the next 5/10/15 minutes take focused history. (Hem optasis ).

Nick Camberley is 65 year old man known case of COPD who comes to the emergency complaining of shortness of breath for two days. In the next 5/10/15 minutes, mange him. (COPD ex acerbation ).

Julie Osler is 67 year old woman who came to your office because of a bothersome dry cough for two months. In the next 5/10/15 minutes take focused history and answer her concerns. (Cough/ Atypical pneum onia ).

Sandy Homer is 22 year old asthmatic woman who comes to the emergency because of worsening shortness of breathing. In the next 5/10/15 minutes manage her. (Asthm a ex acerbation ).

Sandy Homer is 22 year old asthmatic woman who comes to the emergency because of worsening shortness of breathing. You managed her and she is stable now. In the next 5/10/15 minutes talk to her before discharge. (Asthm a Chest pain.

Myocardial ischemia/infarction: ER management. Cardiac arrest. Palpitation. Atrial fibrillation. Syncope. Hypertension. Hypotensive shock: ER management. Digoxin toxicity, ER management, and counseling setting. Pericarditis. Infective endocarditis. Heart failure/ generalized edema/ ankle swelling. Intermittent claudication. Acute/ chronic leg pain. Deep venous thrombosis. Complete cardiovascular examination. ECG interpretation. Cardiopulmonary Resuscitation (CPR).

1.

William Hartman is a 46 year old man who comes to your office with chest pain. In the next 5/10/15 minutes take focused history and address his concerns. (Chest pain ).

2.

Michael McCarthy is 52 year old man, who is a known case of hypertension. He came to your office for his annual check up. In the next 5/10/15 minutes perform a complete physical examination. On the last minute the examiner will stop you and ask you questions. (Hypertension ).

3.

Melissa Pilgrim is a 27 year old woman who has come to your office because oh heart racing. In the next 5/10/15 minutes take focused history and talk to her about a possible management plan. (Palpitation ).

4.

Dan Greenspan is a 68 year old man who had brought to the emergency because he passed out earlier today at home. In the next 5/10/15 minutes perform a complete physical examination. (Syncope ).

5.

Jenny Davidson is a 23 year old girl who suddenly lost her consciousness today and fainted. In the next 5/10/15 minutes take focused history and address her concerns. (Syncope ).

6.

Lenny Sullivan is a 56 year old man who got a sudden bad chest pain when he was having lunch with his family. He was brought to emergency few minutes ago. In the next 5/10/15 minutes manage him. (M I ).

7.

Alfred Sabitto is a 53 year old man who comes to your office because ho got swelling of his legs. In the next ten minutes take focused history and address his concerns. (Heart failure ).

8.

David Perry is a 54 year old diabetic man who came to your office because of leg pain after walking. In the next 5/10/15 minutes take focused history and perform a focused physical examination. (Claudication ).

9.

Eric O'Malley is a 51 year old man who came to emergency because of chest pain and palpitation. In the next 5/10/15 minutes take focused history and address his concerns. (Chest pain/ Atrial Fibrillation ).

10.

Sandra Anderson is 81 year old woman who was brought to emergency by ambulance semiconscious, hypotensive and bradycardia. In the next 5/10/15 minutes manage him. (Digox in intox ication ).

11.

Andrew McDonald is 60 year old man who has a cardiac arrest while the ambulance is rolling into the emergency. He is quickly brought into the resuscitation room. In the next 5/10/15 minutes run code blue and manage him. (Cardiac arrest ).

12.

Tina White is a 22 year old woman who was referred to you by a community nurse because of high blood pressure. In the next 5/10/15 minutes take focused history and talk to her about a possible management plan. (Hypertension/

Pheochrom ocytom a ).
13.

Tim Brown is a 39 year old male who came to emergency because of sharp chest pain. He feels unwell and trouble breathing. In the next 5/10/15 minutes take focused history and perform a focused physical examination. (Pericarditis ).

14. Difficulty swallowing (Dysphagia). 15. Nausea / vomiting. 16. Heartburn/ Gastroesophageal Reflex Disease. 17. Peptic ulcer disease. 18. Upper GI bleeding. 19. Lower GI bleeding. 20. Diarrhea, acute & chronic. 21. Constipation. 22. Steatorrhea. 23. Irritable bowel syndrome. 24. Inflammatory bowel disease, Crohn's & ulcerative colitis. 25. Diverticulosis/ Diverticulitis. 26. Abdominal pain, acute & chronic. 27. Jaundice. 28. Biliary colic. 29. Hepatomegally/ hepatitis.. 30. Splenomegally. 31. Abdominal distension. 32. Abdominal mass. 33. Complete abdominal examination.

34. Liver function tests interpretation. 35.

Anthony Smith is a 73 year old man presents to your office complaining of trouble swallowing. In the next 5/10/15 minutes take focused history. (Dysphagia ).

36.

Natasha Husinoff is a 36 year old woman presents to your office complaining from diarrhea for six months. In the next 5/10/15 minutes take focused history. (Diarrhea ).

37.

Mark Joe is a 52 year old man who was brought to emergency with abdominal pain and vomiting. His vitals are: BP 80/40 mmHg, HR 120 bpm, RR 18 bpm, Temp 37.5 C. In the next 5/10/15 minutes mange him. (Upper GI bleeding ).

38.

Catherine Roberson is 81 year old who was brought to emergency by her daughter because of blood with bowel motion. Her vitals are: BP 140/90 mmHg, HR 70 bpm, RR 17 bpm, Temp 37.5 C. In the next 10/15 minutes take focused history and perform focused physical examination. (Low er GI bleeding ).

39.

Michael Johnson is a 62 year old man who came to emergency complaining of LLQ pain and fever. In the next 5/10/15 minutes take focused history and perform focused physical examination. (Diverticulitis ).

40.

Michael Johnson is a 62 year old man who came to emergency complaining of LLQ pain. In the next 10/15 minutes take focused history and perform focused physical examination. (I schem ic colitis ).

41.

Leo Alfonso is 19 year old male who was brought to emergency because of abdominal pain. His vitals are BP 90/50 mmHg, HR 120 bpm. In the next 5/10/15 minutes mange him. (Appendicitis ).

42.

Lorry Samuel is 25 year old female who came to emergency complaining of recurrent RLQ pain. In the next 10/15 minutes take focused history and perform focused physical examination. (Crohn ).

43.

Kim Ho is 27 year old man who came to emergency because he turned yellow. In the next 10/15 minutes take focused history and perform focused physical examination. (Jaundice ).

44.

Lora Timber is 40 year old woman who came to emergency complaining of recurrent RUQ pain. In the next 5/10/15 minutes take focused history and perform focused physical examination. (Cholecystitis ).

45.

Jessica Smith is 22 year old woman who came to your office complaining of greasy foul smelling stool and weight loss. In the next 5/10/15 minutes take focused history. (Steatorrhea ).

46.

George Wilson is 64 year old man who comes to your office requesting a laxative because he is always 'blocked up'. In the next 5/10/15 minutes take focused history. (Constipation ).

47.

Steve Gomella was brought to the emergency by his friends after vomiting blood. In the next 5/10/15 minutes take focused history and talk to him about your possible plan of management. (Hem atam esis ).

48. Anemia. 49. Eosinophilia. 50. Neutropenia. 51. Thrombocytopenia. 52. Easy bruising/ Bleeding tendency. 53. Patechae/ Purpura. 54. Elevated hemoglobin/ Polycethemia. 55. Splenomegaly. 56. Hypercoagulable state. 57. Urticaria/ Angioedema/ Anaphylaxis. 58. Allergic reactions/ Atopy/ food allergies. 59. Lymphadenopathy; Generalized/ localized. 60. Blood transfusion reactions. 61. Neck mass. 62. Mediastinal mass. 63. Complete hematological examination. 64. Abnormal Complete Blood Profile, WBC. 65.

Kim Quang is a 17 year old woman who presents to your office with recurrent episodes of bleeding from her nose. Please take focused history in the next 5/10/ 15 minutes. (I TP ).

66.

Jackie Levis is 22 year old woman who has been booked by the surgeon to

undergo laparoscopic cholecystectomy in two days. She comes to your office with questions about the risk of blood transfusions as her friend warned her about the possibility of HIV and Hepatitis infection. Please talk to her in the next 5/10/15 minutes. (Blood transfusion ).
67.

Rajeev Khan is a fifty year old man who is supposed to have his forth blood transfusion today. He has a hematological disease that he needs blood transfusion every few weeks. Last time he had a bad reaction that made him feverish and ill. He refused to go on until he talks to you because he is afraid it might happen again. Please talk to him in the next 5/10/15 minutes. (Blood

transfusion ).
68.

Scott Fuller is a 47 year old man who comes with fatigue and a hemoglobin of 95. Please talk to him in the next 5/10/15 minutes and address his concerns. (Anem ia ).

69.

Lucy Armstrong is 23 year old woman who came to your office after she felt a lump in her right side of her upper neck. In the next 5/10/15 minutes take a focused history and perform a focused physical exam. (Note: She keeps her bra and thighs exposed with gestures of seduction. The case is infectious mononucleosis and she is sexually active. Take sexual history and safe sex counseling too.) (Lym phadenopathy/ Seduction/ Safe sex ).

70.

Andres Fallen is a 45 years old man who is a known case of Hodgkin disease under the care of your colleague Dr, James Brown who is away and you are covering for him. He came to your office for a follow up. In the next 5/10/ 15 minutes take a focused history and perform a focused physical exam. (Lym phadenopathy ).

71.

Mark Anthony is a 42 year old man comes to your office because he felt few lumps in his groins. In the next 5/10/15 minutes take a focused history and perform a focused physical exam. (Lym phadenopathy ).

72.

Mary Copper is a 31 year old woman who had delivered a healthy boy last week came to your office because of bluish dots and areas over her body. In the next

5/10/15 minutes take a focused history. (Patechae/ Purpura ).

Sandra Hunter is 27 year old business woman who had just returned from Asia in a business trip came to your office because of right calf pain. In the next 5/10/15
Head injury: ER management.

73. 1.

Cervical spine trauma. Bacterial meningitis. Unsteadiness/ Dizziness/ Ataxia. Loss of consciousness/ Comatose management. Tremor/ Parkinsonism. Stroke/ TIA. Subarachnoid hemorrhage. Headache: all types and settings. Temporal arteritis. Seizure: attack at ER setting/ Follow up consult. Memory impairment. B 12 neuropathy. Chronic back pain. Carpal tunnel syndrome. Sciatica/ leg pain. Gait disturbances. Weakness. Numbness. Pituitary adenoma. Complete neurological examination. Limb neurological examination. Cranial nerves examination. Coordination examination. Glasgow coma scale.

minutes take a focused history and perform a focused physical exam. (DVT). Larry Warren is a 32 year old man who presents to the you in the walk-in clinic complaining of headache. Please take focused history and address his concerns in the next 5/10/15 minutes. (Headache).

2.

Jerry La point is a 53 year old gentleman who comes to the emergency complaining of sudden severe headache. Please take focused history and perform a focused physical examination in the next 10/15 minutes. (Headache).

3.

Michael Jones is a 55 year old bus driver who was brought to the emergency by family members because he had a 'spell'. Please take a focused history in the next 5/10/15

minutes. (Seizure).
4.

Albert Russel is 55 year old man who comes to your office for the first time to have a check up examination. Please perform a complete cranial nerves examination in the 5/10/ 15 ten minutes. (Cranial nerves examination).

5.

Steve Barreto is 67 year old man who came to your office because he has been having frequent falls which made him very concerned. Please talk to him and address his concerns in the next 5/10/15 minutes. (Fall / Unsteadiness/ Dizziness/ Ataxia.).

6.

Frank Sullivan is a 57 year old man who came to the emergency by an ambulance because of weakness of his right arm and leg. Please take a focused history and perform a focused neurological exam in the next 10/15 minutes. (Stroke).

7.

Javid Ehsani is 58 years old man who had some transient attacks of left eye blindness and was rushed to the emergency by his family. Please take focused history and address his concerns in the next 5/10/15 minutes. (Temporal arteritis).

8.

David Harrison is a 66 year old businessman who comes to your office because of unsteady walking pattern. Please take focused history and perform a focused neurological exam in the next 5/10/15 minutes. (Unsteadiness/ Dizziness/ Ataxia.).

9.

A middle aged man was brought by the police to the emergency after being found unconscious. Please manage the case in the next 5/10/15 minutes. (Loss of consciousness/ Comatose management.).

10.

John Smith is 80 years old man presents to the emergency having sudden onset of speaking difficulty earlier today. It has now resolved. Please take focused history and perform a focused neurological exam in the next 5/10/15 minutes. (TIA).

11.

Tony Longfield is 16 years old male who is a know case of epilepsy on medication came to your office referred from the driver licence authority. Please talk to him in the next ten minutes. (Epilepsy).

12.

Maria Lanzonzo is 60 year old woman came to your office complaining of tremor. Please take a focused history and perform a focused neurological exam in the next 5/10/15 minutes. (Tremor/ Parkinsonism).

13.

George Haung is 26 year old man who was brought to the emergency by his partner. She said that he had the 'flu' for the last two days and has complained of headache and fever. Please take a focused history and perform a focused neurological exam in the next 5/10/

15 minutes. (Meningitis).
14.

Leanne Price is 32 year old who came to your office because of right hand tingling and numbness. Please take a focused history and perform a focused neurological exam in the next 5/10/15 minutes. (Carpel Tunnel).

15.

Anthony Smitherman is 44 year old man who came to your office because of fatigue and problems with walking with staggering. Please take a focused history and perform a focused neurological exam in the next 5/10/15 minutes. (B12 Neuropathy).

16.

Eric Brown, a 28 year old male, was brought to the emergency unconscious after falling from a platform at work this morning. Please perform a complete neurological exam in the next 5/10/15 minutes. (Head injury/ Cervical spine: ER management.).

17.

Bob Jackson, a 46 year old construction man, came to your office because of sudden back pain for two days. Please take a focused history and perform a focused neurological exam in the next 10/15 minutes. (Back pain).

18.

Leo alfanso is 47 year old man who had leg pain for years getting worse recently. Please take a focused history and perform a focused neurological exam in the next 5/10/15 minutes. (Sciatica).

19.

John Riddle is 26 year old male who had a minor car accident a week ago. He came to your office because he noticed that he don't see on the sides. Please take a focused history and perform a focused neurological exam in the next 10/15 minutes. (Pituitary).

20.

Sue Haung is 30 year old woman who had a car accident three days ago. She came to your office because of neck pain. Please take a focused history and perform a focused neurological exam in the next 10/15 minutes. (Whip splash C-spine injury).

Urinary tract infection/ Dysuria/ Frequency. Urethral/ penile discharge in males. Hematuria/ red urine/ blood in urine. Renal failure, acute and chronic. Protienurea. Hyperkalemia/ Hypokalemia Hypernatremia/ Hyponatremia. Impotence/ Erectile dysfunction. Incontinence. Benign prostatic hypertrophy. Prostatic cancer.

Scrotal pain. Scrotal swelling/ mass. Hernias. Abnormal serum hydrogen ion concentration.

Jasmine Corel is a 22 year old woman who comes to the emergency complaining of burning sensation with urination. In the next 10/15 minutes take a focused history and perform a focused physical examination. (UTI ).

Jack William is a 70 year old man who comes to the emergency complaining of difficulty making his urine. In the next 10/15 minutes take a focused history and perform a focused physical examination. (UTI / Prostate ).

Mick Humper is a 48 year old man who comes to the emergency complaining of the worst pain he has ever had and at the hospital he noticed is urine is red.. In the next 10/15 minutes take a focused history and perform a focused physical examination. (Renal colic/ stone ).

Sam Longwill is a 69 year old man who comes to your office because he saw blood in his urine. In the next ten minutes take a focused history and perform a focused physical examination. (Hem aturia ).

Marie Brono is a 56 year old woman who comes to your office complaining of urine leaking. In the next 5/10/15 minutes talk to her. (I ncontinence ).

Andre Heatherford is a 19 year old male who comes to the walk-in clinic complaining of penile discharge. In the next 5/10/15 minutes talk to him. (Urethral/ penile discharge ).

Anthony martin is a 43 year old man who presents to your office having a problem getting and maintaining erection. In the next 5/10/15 minutes talk to him. (Erectile dysfunction ).

Eric Smith is a 82 year old man he comes to emergency complaining of problems with emptying his bladder. In the next 5/10/15 minutes talk to him. (Prostate ).

Amy Davidson is a 61 year old woman who is a patient of your colleague Dr. Wong. She comes to your office complaining of being unwell. Dr Wong sent for some investigations and she is here for the results. Her hemoglobin is 100,

creatinine 1000, and BUN 22.4. In the next 5/10/15 minutes talk to her. (Renal

failure ).

David Robert is a 64 year old man who is a patient of your colleague Dr. Wong. He comes to your office complaining of being unwell. Dr Wong sent for some investigations and he is here for the results. His blood pressure is165/ 100, and creatinine 700. In the next 5/10/15 minutes talk to her. (HTN/ Renal failure ).