jcm osce qmh a&e feb 2014. case 1 f/32 lbp for one week no fever, no neurological deficits pe...
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JCM OSCE
QMH A&EFeb 2014
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Case 1
• F/32• LBP for one week• No fever, no neurological deficits• PE unremarkable• Xray LS spine
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Case 1
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Question 1
• What is the Xray finding?• What could be the DDx?
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Question 2
• What could be causative organism?
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Case 2
• M/20• Complained of R sided chest pain for one day• No SOB• No history of trauma• PE showed decreased breath sound over R
lung
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Questions
• What are the findings?• How do you manage him?• What are the indications for surgical
treatment?
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Case 3
• F/21• PMH: Schizophrenia• Sudden onset of colicky generalised
abdominal pain again since after lunch• Small amount BO• PE: abd distension
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AXR
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Questions
• What are the findings?• Name a few differential diagnoses• What is the diagnosis?
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Case 4
• F/50• Found collapsed in hospital canteen• On arrival GCS 14/15• BP 160/70, P 60• Tenderness and swelling over right face
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CT face
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Questions
• Please describe the CT scan finding• What do you need to look for in physical
examination?• If CT scan is not available, what Xray view will
you order? Any pitfall in this view?
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Case 5
• M/77• Trip and fell with head and neck injury• Brief LOC• PE: GCS 15/15• Tenderness over R neck• RUL power 4/5, LUL 5/5
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CT brain + neck
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CT reconstruction
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Questions
• What are the CT findings?• What do you need to look for in physical
examination• What is the classification of this injury?• What are the possible long term
complications in this injury?• Name 2 clinical prediction rules for predicting
cervical injury requiring Xray