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OSCE Question 02/2015
TMH AED
1
Question 1
• M/69• Known history of HT, IHD, PVD• Sudden onset of constant low back pain• BP 162/85mmHg• P 78/min
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Question 1
• Suggest 5 differential diagnosis of acute low back pain
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Question 1
• Bedside abdominal USG was performed
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Question 1
• What’s the sonographic diagnosis?
• How to measure the size of the lesion?
• How to classify the type of the lesion using ultrasound?
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Question 1
• State the microbe that is most commonly associated with this condition?
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Question 2
• F/40• Good past health• Sudden onset of right sided weakness 1 hour
before• BP 180/93 mmHg• P 104/min• GCS 15/15
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Question 2
• Urgent CT brain was performed
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Question 2
• Described the CT finding
• Suggest 3 more hyperacute stroke CT signs
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Question 2
• Outline subsequent management plan for this patient
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Question 2
• State 3 etiologies for young onset stroke
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Question 2
• Cerebral angiogram was performed after stabilization
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Question 2
• Describe the finding
• What is the diagnosis?
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Question 3
• F/56• Good past health• Vehicle-pedestrian collision with left knee
injury• BP 153/79mmHg• P 95/min
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Question 3
• Left knee X-ray was taken
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Question 3
• Describe the X-ray finding
• What is the classification of the aboved condition?
• Which type this patient belonged to?
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Question 3
• What is the mechanism of the injury?
• Name 4 potential complications
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Question 4
• M/72• History of DM, HT, SSS on pacemaker• Sudden onset of severe chest pain for 3 hours,
only partially relieved by TNG• BP 164/88 mmHg• P 62/min
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Question 4
• ECG was performed
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Question 4
• Describe the ECG findings
• State an ECG criteria for assistance of diagnosis
• What is the diagnosis?
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Question 4
• Outline the management in AED
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Question 5
• M/62• Repeated vomiting for 1 day, with mild epigastric pain
after an alcohol binge• First vomited out undigested food and then mild blood
streak• BP 123/59 mmHg• P 84/min• Abdominal examination was unremarkable. Per rectal
examination noted brownish stool.• CXR was normal
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Question 5
• Name 3 clinical prediction rules/scores in upper gastrointestinal bleeding to risk stratification
• He asked if his condition could be managed without hospital admission
• State which score is the most relevant in this scenario? What cut-off and associated clinical implication for the score?
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Question 5
• More history was taken and he had known alcoholic with alcoholic liver cirrhosis
• Blood tests result:– Hb 13.4 g/dL– Urea 7.8 mmol/L
• How would you management this patient?
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Question 5
• He developed gross haematemesis during his stay in AED
• BP 96/49 mmHg• P 106/min
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Question 5
• How would you manage this patient in addition to the management you ordered before?
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Question 6
• M/69• History of HT, DM, old CVA• Decrease general condition for 1 month
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Question 6
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Question 6
• Describe the CT finding
• What further investigations would you proceed?
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Question 6
• If the opening pressure of the lumbar puncture is 12 cm H2O
• What is the condition called?
• What is the classic triad of this condition?
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Question 6
• What is the definitive treatment?
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