Download JCM OSCE

JCM
OSCE
AED UCH
5/9/2012
Case 1
• 11/M
• Fought with classmate
• Right arm pain with tenderness
• What is the X-ray finding?
• Name three differential diagnoses from the Xray finding.
• What will be your management?
Case 2
• 13 months/M
• Cough for 3 days
• Noisy breathing for a day
• Name 2 CXR findings. Are they pathological?
• Name 3 neck X-ray findings.
• What is the diagnosis?
• Name 2 medications for the disease.
Case 3
• 90/M
• Known COAD
• Chest pain for a day
• Besides the emphysematous and fibrotic
changes of the lung, what are the X-ray
findings?
• What are the two differential diagnoses?
• What further imaging is helpful?
• If the patient deteriorates with SOB, what will
be your management?
Case 4
• A 59 years old lady was recently prescribed
transdermal patch for treatment of her
Alzheimer’s disease because of poor oral drug
compliance.
• The patient was found to have vomiting,
diarrhoea, dizziness and generalized limb
weakness the day after starting the patch.
• The patient was fully conscious, with blood
pressure 137/73 mmHg and pulse rate of 58
bpm.
• Her pupil size were 2 mm, chest clear on
auscultation and bowel sounds were normal.
•
What is the most likely ingredient in the patches?
•
Which drug class does the drug belong to?
•
Which enzyme is inhibited by the drug?
•
What is the most important step in the management
of this patient?
•
Name the antidote(s) for overdose of this drug.
Case 5
• 47/F
• Hx of Antithrombin III deficiency
• Presented with
• Headache for a few days
• Right side weakness for a day
• BP 130/80, p 90/min
• Afebrile
• GCS 13/15; E3V4M6
• PERL
• Right hemi-paresis with power grade 4/5
• What is the CT finding?
• What is the diagnosis?
• Any laboratory test can help to make the
diagnosis?
• Any further imaging can help to confirm the
diagnosis?
• What is the mainstay of treatment?