Transcript ospe

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?
• 2) what is the classification of the fracture?
• 2) what is the management?
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
Questions
• 1) what is the diagnosis?
• 2) what is the associated injury to look for?
• 3) what is the management?
Case 3
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M/70
Left shoulder contusion after S/F
PE: left shoulder in abducted position
X rays of left shoulder was taken
Questions
• 1) what is the diagnosis?
• 2) what is the method of reduction?
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%
• His BP drop to 60/30 mmHg after
admission and return to 130/70 mmHg
after 1000 ml gelofusin infusion.
• Urgent CT was performed
Plain films
Plain films
Plain films
Contrast film
Contrast films
Contrast films
Contrast films
Contrast films
Delay contrast films
Delay contrast
Delay contrast
Delay contrast
Questions
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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
• 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
• 1) describe the CT findings
• 2) what is the diagnosis?
• 3) what is the management?
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.
Questions
• 1) describe the ECG finding
• 2) what is the diagnosis?
• 3) what is the mangement?
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.
Questions
• 1) describe the ECG findings
• 2) what is the diagnosis?
• 3) what is the management?