JCM OSCE YCH 3/7/2013. Question 1 F/57, slip and fell land sustained left wrist injury 1.What are...
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Transcript of JCM OSCE YCH 3/7/2013. Question 1 F/57, slip and fell land sustained left wrist injury 1.What are...
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JCM OSCE
YCH 3/7/2013
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Question 1
• F/57, slip and fell land sustained left wrist injury
1. What are the x-ray findings & diagnosis?
2. What is the treatment?
3. What complication is expected if she was put on short arm dynacast?
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Question 1
• F/57, slip and fell land sustained left wrist injury
1. What are the x-ray findings & diagnosis?• Intra-articular fracture of radius (volar side), volar displacement of
carpus, Barton’s fracture
2. What is the treatment? • Open reduction and internal fixation
3. What complication is expected if she was put on short arm dynacast?• Malunion / displacement of the fracture
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Question 2
• M/80
• History of recurrent AROU
• Presented with right hip pain
1. What is the x-ray finding?
2. What is the diagnosis?
3. What other malignant tumor would present with similar x-ray finding?
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Question 2
• M/80• History of recurrent AROU• Presented with right hip pain.• 1. What is the x-ray finding?
• Osteosclerotic lesion over pelvis and Right hip
• 2. What is the most likely diagnosis?• CA prostate with bone secondaries
• 3. What other malignant tumor would present with similar x-ray finding?
• CA breast with bone secondaries
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Question 3
• A boy presented with slip and fell landed on outstretched hand
1. What are the x-ray findings?
2. What is the diagnosis?
3. What is the most common associated injury?
4. What is the treatment?
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Question 3
• A boy presented with slip and fell landed on outstretched hand
• 1. What are the x-ray findings?• Anterior Fat pad sign, crack over radial neck
• 2. What is the diagnosis? • Type II epiphyseal injury over radial neck
• 3. What is the most common associated injury?• Posterior interosseous nerve
• 4. What is the treatment?• Immobilization for 2-3 weeks
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Question 4
• 20-year-old man presented with recurrent episodes of palpitation.
1. Describe the ECG.
2. What is the diagnosis?
3. What are the 2 common arrhythmias associated with this condition?
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Question 4
• 20-year-old man presented with recurrent episodes of palpitation.
• 1. Describe the ECG. • Sinus rhythm, Short PR interval, widen QRS, delta
wave
• 2. What is the diagnosis?• Wolff-Parkinson-White syndrome
• 3. What are the 2 common arrhythmias associated with this condition?
• AVRT, pre-excited AF
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Question 5
• 70 year-old-man presented with left upper abdominal discomfort for months.
• Recent weight loss x 5kg/several months
• P/E:
• Splenomegaly, tip 8cm below left costal margin
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COMPLETE BLOOD COUNT WBC 57.5 H 3.7 - 9.2 x10^9/L RBC 3.70 L 4.30 - 5.90x10^12/L HGB 10.8 L 13.4 - 17.1 g/dL HCT 0.322 L 0.400-0.510 L/L MCV 87.0 82.0 - 97.0 fL MCH 29.2 27.0 - 33.0 pg MCHC 33.5 32.0 - 35.0 g/dL RDW 15.3 H 11.0 - 14.0 % PLT 78 L 145 - 370 x10^9/L WBC DIFFERENTIAL Neutrophil 47.8 H 1.7 - 5.8 x10^9/L NEU % 83.0 H 43.0 - 71.0 % Lymphocyte 2.3 1.0 - 3.1 x10^9/L LYM % 4.0 L 19.0 - 46.0 % Monocyte 1.2 H 0.1 - 0.8 x10^9/L MON % 2.0 L 3.0 - 12.0 % Eosinophil 0.6 H 0.0 - 0.5 x10^9/L EOS % 1.0 0 - 7.0 %
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Question 5
1. Name 4 differential diagnosis?• Chronic myeloid leukemia, Myelofibrosis, Chronic malaria, Kala-azar
(Visceral leishmaniasis)
2. What is the most likely diagnosis?• CML
3. Name 2 further investigations?• Peripheral blood smear, Bone marrow biopsy
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End
Thank you