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Answers to OSCE PYNEH (5/6/2013)
1.
Patient with epigastric pain:
a)
Free gas under right hemidiaphragm, free gas under left hemidiaphragm, continuous diaphragm sign
b) Erect Chest X-ray
c)
Board-like rigidity, absent bowel signs, rebound tenderness, peritonism (any 3)
d) Perforated peptic ulcer, perforated diverticulitis
2.
Patient with toe swelling
a)
Left big toe soft tissue swelling with free gas at toe tip & bony erosion/necrosis at distal phalanx
b) Gas gangrene and acute suppurative osteomyelitis of left big toe
c)
Diabetes mellitus
d) Hemoglucostix
e)
3.
Staphylococcus aureus, augmentin/ampicillin
A child with abnormal ECG.
a)
Accelerated idioventricular rhythm
b) Acute myocardial infarction treated with thrombolysis, myocarditis, cardiomyopathy (dilated cardiomyopathy or
hypertrophic cardiomyopathy), arrhythmogenic right ventricular dysplasia (any 3)
c)
4.
No treatment
Patient with SOB
a)
Right main bronchial intubation with endotracheal tube
b) Right upper lobe collapse
c)
Cardiomegaly, right pleural effusion, blunting of both CP angles (any 3)
d) Aspiration
e)
5.
Withdraw the ET tube and repeat CXR to confirm its position
Patient with PV spotting
a)
A: Bladder
B: Uterus
C: Vagina
b) Cystic adnexal mass
c)
Ectopic pregnancy
d) Fluid in the Pouch of Douglas, fetal heart beat outside uterus
e)
Gynaecological ward admission