Osce KWH Aug 2013. Case 1 M/38 Right shoulder contusion after S/F PE: tenderness and swelling over his right upper chest. No skin impingement and no external.

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Presentation transcript:

osce KWH Aug 2013

Case 1 M/38 Right shoulder contusion after S/F PE: tenderness and swelling over his right upper chest. No skin impingement and no external wound found. No distal neurological deficit elicited

Questions 1) what is the diagnosis? 2) what is the classification of the fracture? 2) what is the management?

Case 2 F/6 Left elbow contusion after S/F in 2 months ago c/o: persistent pain after the injury PE: tenderness and swelling over her left elbow. ROM: 0-90 degree. No distal neurological deficit elicited. X rays left elbow was taken

Questions 1) what is the diagnosis? 2) what is the associated injury to look for? 3) what is the management?

Case 3 M/70 Left shoulder contusion after S/F PE: left shoulder in abducted position X rays of left shoulder was taken

Questions 1) what is the diagnosis? 2) what is the method of reduction?

Case 4 M/24 He complained of epigastric and LUQ abdominal pain after having been assaulted by someone on two days ago. PE: tenderness over his LUQ abdomen. No external wound was found. BP 148/74 mmHg P93/min SaO2 99%

His BP drop to 60/30 mmHg after admission and return to 130/70 mmHg after 1000 ml gelofusin infusion. Urgent CT was performed

Plain films

Contrast film

Contrast films

Delay contrast films

Delay contrast

Questions 1) describe the CT findings 2) what is the diagnosis? 3) what is the management? 4) What is the abnormal CT findings that indicate surgical intervention ?

Case 5 F/25 She attempted suicide by burning charcoal at home PE: GCS 14/15, BP 98/73 mmHg, Pulse 83/min, SaO2 99% on 100%O2 Systems review were unremarkable. No focal neurological sign elicited.

Question 1) describe the CT findings 2) what is the diagnosis? 3) what is the management?

Case 6 F/25, Phx depression Attempted suicide by drug overdose PE: unconscious, GCS 4/15, BP 100/60 mmHg Pulse 70/min She was intubated in AED.

Questions 1) describe the ECG finding 2) what is the diagnosis? 3) what is the mangement?

Case 7 M/37 Family history of premature death of unknown cause Complained of palpitation and atypical chest discomfort for few episodes. PE: BP 140/80 mmHg P 95/min Systems review were unremarkable.

Questions 1) describe the ECG findings 2) what is the diagnosis? 3) what is the management?