1. OSCE Question 02/2015
TMH AED

2. Question 1 M/69 Known history of HT, IHD, PVD
Sudden onset of constant low back pain
BP 162/85mmHg
P 78/min

3. Question 1
Suggest 5 differential diagnosis of acute low back pain

4. Question 1
Bedside abdominal USG was performed

5. Question 1 What’s the sonographic diagnosis?
How to measure the size of the lesion?
How to classify the type of the lesion using ultrasound?

6. Question 1
State the microbe that is most commonly associated with this condition?

7. Question 2 F/40 Good past health
Sudden onset of right sided weakness 1 hour before
BP 180/93 mmHg
P 104/min
GCS 15/15

8. Question 2
Urgent CT brain was performed

9. Question 2 Described the CT finding
Suggest 3 more hyperacute stroke CT signs

10. Question 2
Outline subsequent management plan for this patient

11. Question 2
State 3 etiologies for young onset stroke

12. Question 2
Cerebral angiogram was performed after stabilization

13. Question 2
Describe the finding
What is the diagnosis?

14. Question 3 F/56 Good past health
Vehicle-pedestrian collision with left knee injury
BP 153/79mmHg
P 95/min

15. Question 3
Left knee X-ray was taken

16. Question 3 Describe the X-ray finding
What is the classification of the aboved condition?
Which type this patient belonged to?

17. Question 3 What is the mechanism of the injury?
Name 4 potential complications

18. Question 4 M/72 History of DM, HT, SSS on pacemaker
Sudden onset of severe chest pain for 3 hours, only partially relieved by TNG
BP 164/88 mmHg
P 62/min

19. Question 4
ECG was performed

20. Question 4 Describe the ECG findings
State an ECG criteria for assistance of diagnosis
What is the diagnosis?

21. Question 4
Outline the management in AED

22. Question 5
M/62
Repeated vomiting for 1 day, with mild epigastric pain after an alcohol binge
First vomited out undigested food and then mild blood streak
BP 123/59 mmHg
P 84/min
Abdominal examination was unremarkable. Per rectal examination noted brownish stool.
CXR was normal

23. Question 5
Name 3 clinical prediction rules/scores in upper gastrointestinal bleeding to risk stratification
He asked if his condition could be managed without hospital admission
State which score is the most relevant in this scenario? What cut-off and associated clinical implication for the score?

24. Question 5
More history was taken and he had known alcoholic with alcoholic liver cirrhosis
Blood tests result:
Hb 13.4 g/dL
Urea 7.8 mmol/L
How would you management this patient?

25. Question 5 He developed gross haematemesis during his stay in AED
BP 96/49 mmHg
P 106/min

26. Question 5
How would you manage this patient in addition to the management you ordered before?

27. Question 6 M/69 History of HT, DM, old CVA
Decrease general condition for 1 month

28. Question 6

29. Question 6 Describe the CT finding
What further investigations would you proceed?

30. Question 6 If the opening pressure of the lumbar puncture is 12 cm H2O
What is the condition called?
What is the classic triad of this condition?

31. Question 6
What is the definitive treatment?