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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 wound found. No distal neurological deficit elicited. Questions. 1) what is the diagnosis?

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Presentation Transcript
slide1

osce

KWH

Aug 2013

case 1
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
questions
Questions
  • 1) what is the diagnosis?
  • 2) what is the classification of the fracture?
  • 2) what is the management?
case 2
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
questions1
Questions
  • 1) what is the diagnosis?
  • 2) what is the associated injury to look for?
  • 3) what is the management?
case 3
Case 3
  • M/70
  • Left shoulder contusion after S/F
  • PE: left shoulder in abducted position
  • X rays of left shoulder was taken
questions2
Questions
  • 1) what is the diagnosis?
  • 2) what is the method of reduction?
case 4
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%
slide16
His BP drop to 60/30 mmHg after admission and return to 130/70 mmHg after 1000 ml gelofusin infusion.
  • Urgent CT was performed
questions3
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 ?
case 5
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.
question
Question
  • 1) describe the CT findings
  • 2) what is the diagnosis?
  • 3) what is the management?
case 6
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.
questions4
Questions
  • 1) describe the ECG finding
  • 2) what is the diagnosis?
  • 3) what is the mangement?
case 7
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.
questions5
Questions
  • 1) describe the ECG findings
  • 2) what is the diagnosis?
  • 3) what is the management?