1. OSCE
JCM
Mar 2017

2. Case 1 F/81, attended A&E for suicidal attempt with Dettol poisoning.
She drank about 100 ml of dettol 30 minutes before arrival at A&E.
GCS15/15, BP 124/69 mmHg, pulse 88/min, SaO2 98% RA.

3. Dettol

4. Name 3 ingredients in Dettol.
What are the clinical features of Dettol poisoning? ( Please name 2)
Is gastric lavage indicated? Why?

5. Case 2
F/64 fell with left leg pain, X ray of left femur showed fracture shaft of left femur.
X ray of right femur was also taken for her.

6. Left femur

7. Right femur

8. Please name 2 atypical features that you can spot on the X ray.
What medication is associated with this type of fracture ?

9. Case 3
F/20 with good past health presented with seizure to A&E department
Seizure controlled with IV valium
Plain CT brain was done.

11. Name TWO abnormalities you could spot on the CT brain.
Name ONE likely diagnosis.

12. Further history from parents revealed that she had pneumonia 2 weeks ago, treated in outpatient setting with oral augmentin.
She had fever and difficulty to control her left hands for 2 days before onset of seizure.

13. Name 3 principles of management for this patient.

14. Case 4
M/48 presented to A&E with collapse, decrease in general condition. GCS 3/15 on arrival. BP 95/50 mmHg. Noticed left sided weakness. Left side power 0/5. Right sided power 3/5. CT brain was done and revealed infarct over right side of brain.

16. Inequality of BP was noticed for this patient
Inequality of BP was noticed for this patient. A CT angiogram was done for investigation and was shown.

18. What is the radiological feature you could spot on the CT angiogram?
What is the diagnosis based on the CT angiogram?

19. Name ONE classification system of the condition based on CT angiogram.
What is the type of condition based on the classification system named?

20. Which branch of aorta is involved to give rise to this clinical picture of stroke?

21. Case 5
M/21 presented with syncope. His vital sign is stable at A&E. ECG was done for him and was as shown.

23. What is the diagnosis?
What should be the definitive treatment?