OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran...
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Transcript of OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran...
![Page 1: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/1.jpg)
OSCEanswers
(Part two)Raika Jamali M.D.
Gastroenterologist and hepatologistSina hospital
Tehran University of Medical Sciences
![Page 2: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/2.jpg)
Case 12
• Attention to the monosodium urate crystal on polarized light microscopy and the tophus. The correct diagnosis is gouty arthritis
• Intraarticular steroid is already considered the best treatment in gouty knee monoarthritis.
![Page 3: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/3.jpg)
Case 13
• Attention to the Subungueal splinter hemorrhage and Janeway lesions (non-tender, small erythematous or haemorrhagic macular or nodular lesions on the palms or soles only a few millimeters in diameter) . The correct diagnosis is infective endocarditis.
• Intravenous antibiotic is the best treatment .
![Page 4: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/4.jpg)
Case 14
• Attention to the Spherocytes. The correct diagnosis is Spherocytosis .
• Folate supplement is recommended in this case with mild anemia.
![Page 5: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/5.jpg)
Case 15
• Attention to the hairy cell. The correct diagnosis is Hairy cell leukemia.
• Bone marrow transplant is the best treatment option.
![Page 6: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/6.jpg)
Case 16
• Attention to the hypersegmented neutrophil . The correct diagnosis is megaloblastic anemia.
• B12 supplement is the best treatment option.
• Shilling test might help in defining the etiology.
![Page 7: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/7.jpg)
Case 17
• The diagnosis is fecal impaction.
![Page 8: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/8.jpg)
Case 18
• Attention to the food material in stomach and empty duodenum. The correct diagnosis is gastric outlet obstruction.
![Page 9: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/9.jpg)
Case 19
• Acute viral hepatitis does not match with the patient diagnosis.
• In acute viral hepatitis the ichterus appears when the fever is decreased.
![Page 10: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/10.jpg)
Case 20
• Diagnostic paracentesis should be considered for the diagnosis of ascitis etiology.
• Shock liver do not match the patient diagnosis according to history.
![Page 11: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/11.jpg)
Case 21
The patient is a case of severe preeclampsia. Termination of pregnancy is the best treatment strategy.
![Page 12: OSCE answers (Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences.](https://reader035.fdocuments.in/reader035/viewer/2022081809/56649f045503460f94c18645/html5/thumbnails/12.jpg)
Case 22
Considering the increased gamma globulin level, autoimmune hepatitis is the best diagnosis.
Steroid is the best treatment in this patient.