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OSCE Raika Jamali M.D. Gastroenterologist and hepatologist

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Presentation on theme: "OSCE Raika Jamali M.D. Gastroenterologist and hepatologist"— Presentation transcript:

1 OSCE Raika Jamali M.D. Gastroenterologist and hepatologist
Sina hospital Tehran University of Medical Sciences

2 Case 1 An old man with sudden chest pain and dyspnea. You see his CT scans and barium swallow.

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5 What is the best treatment?
What is the diagnosis? Dissection of aortic aneurysm Perforation of esophagus Cardiac rupture Perforation of thoracic duct What is the best treatment? Antibiotic therapy NPO Surgical intervention endoscopy

6 Case 2 A middle age woman with dysphagia.

7 What is your diagnosis? Corrosive esophagitis Reflux esophagitis
Esophageal web Esophageal ring Esophageal tumor

8 Case 3 An old man with severe sudden chest pain and history of hypertension. Gradually he experienced dyspnea. BP: 190/ RR: T: 37.3 You see the ECG of patient:

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10 What is the best initial treatment strategy?
What is your diagnosis? Acute inferior wall MI Aortic aneurysm dissection Pnumothorax Acute Pericarditis What is the best initial treatment strategy? Fibrinilytic therapy PCI ASA 325 mg Antiplatlet therapy

11 Case 4 An old man presented with acute sudden chest pain. He became dyspenic soon after admission. The CXR at admission (right) and after 1 hour is shown.(left)

12 What is the best management?
What is your diagnosis? Acute pnumothorax Acute pnumonia Dissection of aneurysm of aorta Acute pericarditis What is the best management? Chest tube insertion Antibiotic therapy Surgical consult NSAID

13 Case 5 A diabetic woman with dyspnea, and vertigo. BP: 70/46 RR: 22

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15 What is the best initial management?
What is your diagnosis? True posterior wall MI Intracerebral hemorrhage Acute pnumothorax Aortic aneurysm dissection What is the best initial management? Hydration PCI Antifibrinolytic therapy Nitroglycerin infusion

16 Case 6 Young girl presented with chest pain.

17 What is the best treatment?
What is the diagnosis? Dissection of aortic aneurysm Pulseless syndrome Coarctation of aorta What is the best treatment? Surgical consult Steroid Stent placement

18 Case 7 Patient with flank pain and hematuria.
You see the CT angiography of the patient.

19 What is the best management?
What is your diagnosis? Renal artery stenosis Renal artery occlusion Renal vein trombosis What is the best management? Anticoagulation Stent placement Surgical consult

20 CASE 8 Patient presented with confusion, fever, and ichterus.

21 What is the differential diagnosis?
What do you see in PBS ? Sickle cell anemia Spherocytosis Schistocyte Basophilic stippling What is the differential diagnosis? Hemolytic uremic syndrome Disseminated intravascular coagulation Thrombotic thrombocytopenic purpura All of the above

22 Case 9 Young boy with fever and chills. Diffuse rales in both lung fields.

23 What do you see in PBS? Hemolytic anemia Basophilic stippling
Heinz body Tear drop cell Toxic granulation

24 CASE 10 A young girl with anemia and abdominal pain.

25 What is the next treatment?
What do you see in PBS? Target cell Spherocyte Heinz body Sickle cell What is the next treatment? Hydration Blood exchange Control of infection and hypoxia All of the above What is the best treatment?

26 Case 11 This patient presented with chronic cough.

27 What is the differential diagnosis?
What do you see? Aneurysm of aorta Pericardial cyst Duplication cyst Superior mediastinal mass What is the differential diagnosis? Ectopic thyroid Thymus Teratoma All of the above

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