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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 on theme: "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."— Presentation transcript:

1 osce KWH Aug 2013

2 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

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

5 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

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

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

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

15 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%

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

17 Plain films

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20 Contrast film

21 Contrast films

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25 Delay contrast films

26 Delay contrast

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29 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 ?

30 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.

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

36 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.

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

39 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.

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

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