JCM OSCE AED UCH 5/9/2012.

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Presentation transcript:

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 X- ray 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?