1. OPSE 3 April 2013-Question
Prepared by: Dr. HK Ngan PMH AED

2. Case 1
M/65
PH:DM, HT
Attended AED because of abdominal distension and constipation for two days

3. Case 1

4. Case 1 1) Describe the x-ray findings? 2) What is the diagnosis?
3) What are the main complications of this condition?
4) Name three predisposing factors for this condition?
5) What is the treatment?

5. Case 2 Nigerian tourist F/42
Brought in by police from airport for abdominal pain

6. Case 2

7. Case 2 1) Describe the x-ray findings? 2) What is the diagnosis?
3) What will be the complication of this condition?
4) What is your management?

8. Case 3
PH: Good
M/50
Presented to AED for chest pain on and off for 3 weeks. Now symptoms free.
Serial Troponin I<0.03 (not rasied)

9. Case 3

10. Case 3 1) What is the ECG findings 2) What is the diagnosis?
3) What is the significance of this condition and what will be the complication?
4) What is the best treatment for this condition and why?

11. Case 4
F/40
Brought in by mother with abnormal behavior and delusional idea for one month. No history of head injury.

12. Case 4

13. Case 4 A B C D

14. Case 4 1) What is the CT findings?
2) Give 3 differential diagnosis from the CT finding?
3) Give the cistern/fissure name of A,B, C, D
4) What bedside clinical examination you would emphasis with this CT image?
5) What other investigation you would like to do to confirm your suspicion?

15. Case 5 63/M Construction site worker
Right eye being splashed by liquid concrete(cement)
Used tap water to rinse it briefly
C/O pain, tearing, blurring of vision
PEEM level

16. Case 5

17. Case 5 Describe the clinical findings from the photo.
What is the likely culprit chemical causing such injury?
Name one essential bedside test.
Which will have more serious injury, acid or alkali? Give your explanation
How would you grade the severity of this injury?