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 • • • • 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 • • • • 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?