Transcript OSCE
OSCE
Raika Jamali M.D.
Gastroenterologist and hepatologist
Sina hospital
Tehran University of Medical Sciences
Case 35
• A kidney transplant patient with chronic
diarrhea. You see the duodenal biopsy.
• What is the diagnosis?
– Giardiasis
– Sterongiloidosis
– Tuberculoma
– Sarcoidosis
• What is the treatment?
– Metronidazole
– Ivermectin
– Steroid
– Praziquantel
Case 36
• An old man with RUQ pain and elevated
liver enzyme.
• You see the splenoportography.
• What is the diagnosis?
– Hepatic vein trombosis
– Portal vein trombosis
– splenic vein trombosis
– IVC trombosis
• What is the treatment?
– Anticoagulation
– IVC basket
– Angioplasty
– Surgical repair
Case 37
• Young woman with OCP use presented
with acute severe abdominal pain and
tense ascitis.
• You see the hepatic angiography.
• What is the diagnosis?
– Hepatic vein trombosis
– Portal vein trombosis
– splenic vein trombosis
– IVC trombosis
• What is the treatment?
– Anticoagulation
– IVC basket
– Angioplasty
– Surgical repair
Case 38
• An old man with history of CCU admission
presented with severe abdominal pain.
• What is the diagnosis?
– Acute mesenteric ischemia
– Portal vein trombosis
– Non obstructive mesenteric ischemia
– IVC trombosis
• What is the best initial treatment?
– Anticoagulation
– IVC basket
– Angioplasty
– Surgical repair
Case 39
• A young woman with abdominal pain and
skin rash.
• What is the diagnosis?
– Vasculitis of mesenteric arteries
– Non obstructive mesenteric ischemia
– Thromboemboli in mesenteric arteries
• What is the best initial treatment?
– Anticoagulation
– Steroid plus anticoagulation
– Angioplasty
– Surgical repair
Case 40
• A young girl with severe abdominal pain.
• What is the diagnosis?
– Vasculitis of mesenteric arteries
– Non obstructive mesenteric ischemia
– Thrombosis in mesenteric arteries
• What is the best initial treatment?
– Anticoagulation
– Steroid plus anticoagulation
– Angioplasty
– Surgical repair
Case 41
• A YOUG BOY WITH SEVERE
ABDOMINAL PAIN, VOMITING AND
HYPERTENSION.
• What is the diagnosis?
– Vasculitis of mesenteric arteries
– Non obstructive mesenteric ischemia
– Thrombosis in mesenteric arteries
• What is the best initial treatment?
– Anticoagulation
– Steroid plus anticoagulation
– Angioplasty
– Surgical repair
Case 42
• An old woman with fatigue and fever from
4 weeks ago. A systolic murmur in LSB is
heard.
• What is the diagnosis?
– Left atrial myxoma
– Infective endocarditis
– Vasculitis of coronary arteries
• What is the best initial treatment?
– Anticoagulation
– Steroid plus anticoagulation
– Antibiotic therapy
– Surgical repair
Case 43
• A young kidney transplant with
odynophagia.
• What is not the diagnosis?
– CMV esophagitis
– Candidiasis
– Pill induced esophagitis
– Herpes esophagitis
Case 44
• A man with chronic abdominal pain,
diarrhea, rectal bleeding and severe anal
pain for last one year.
What is your diagnosis?
Anal fissure
Perianal abcess
Anal fistula
What is the best initial therapeutic
strategy?
Metronidazole and ciprofloxacin
Infliximab
Steroid and azathioprine
Case 45
A middle age man with intermitant episodes of dysphagia.
No weight loss.
What is your diagnosis?
GERD esophagitis
Pill induced esophagitis
Eosinophilic esophagitis
Case 46
An old man presented with dyspnea and RUQ
pain.
Physical examination revealed:
Distension of the jugular vein,
Spider nevi,
Bilateral leg edema
Tenderness in RUQ
Span of liver 16 cm.
What is your diagnosis?
Constrictive pericarditis
Pericardial tamponade
Hydatid cyst
What is the best initial therapeutic strategy?
Pericardiectomy
Antibiotic therapy
Steroid and azathioprine