HKCEM JCM OSCE NDH AED 1. CASE 1 M/ 38 Fell from bicycle on 19/12/2012 Landed on right shoulder Deny other associated injury Vital signs stable on arrival.

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Presentation transcript:

HKCEM JCM OSCE NDH AED 1

CASE 1 M/ 38 Fell from bicycle on 19/12/2012 Landed on right shoulder Deny other associated injury Vital signs stable on arrival P/E: Tenderness over right shoulder, no gross abnormality 2

X-ray for case 1 3

What were the X-ray findings? - How would you manage this patient? - 4

You follow-up this patient 1 week and 3 weeks later, he still complained of right shoulder stiffness. 5

You manage to follow up this patient 1 week and 3 weeks later 6

Comment on the x-ray - What investigation that you would like to proceed in order to verify your diagnosis? 7

CT scan of right shoulder Shown in the CT films 8

Findings of the CT scan? - Your diagnosis and management? - Complications? - 9

Case 2 F/ 39, pregnant lady attend your department Non-entitled, unbooked case C/O regular abdominal pain, leaking ~ 30 min before arrival How would you manage this patient? 10

History? - Physical examination? - Investigation? - 11

On examination, -Term size uterus, FH ~140 beats/ min In speculum and vaginal examination, what would you look for in order to help you to determine the presenting part of the fetus?

PV and speculum showed pool of clear liquor, and you feel a round and smooth structure. And you can’t feel the suture or the fontonale. What is your diagnosis? - How would you manage? Describe the maneuver that you employ? - 13

Complications? - 14

Case 3 M/20 Left eye punched by his colleague C/O: pain+, immediate blurred vision In physical examination, what would you particularly look for? - 15

What is your diagnosis? - How would you proceed to confirm your diagnosis? 16

17

How would you manage next? - 18

Case 4 F/51 S/F with head injury. C/O headache and facial pain GCS 15/15. Vital signs stable. 19

In physical examination, you found… 20

What investigation you would consider, in order to confirm your diagnosis? - What specific view you would order? - 21

X-ray shows… 22

Diagnosis? - Favorable or unfavorable fracture? Why? - How would you manage? - 23

24 Name 2 other associated serious injuries that warrant additional attention? -