JCM OSCE
QMH A&E
Feb 2014
Case 1
•
•
•
•
•
F/32
LBP for one week
No fever, no neurological deficits
PE unremarkable
Xray LS spine
Case 1
Question 1
• What is the Xray finding?
• What could be the DDx?
Question 2
• What could be causative organism?
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
Questions
• What are the findings?
• How do you manage him?
• What are the indications for surgical
treatment?
Case 3
• F/21
• PMH: Schizophrenia
• Sudden onset of colicky generalised
abdominal pain again since after lunch
• Small amount BO
• PE: abd distension
AXR
Questions
• What are the findings?
• Name a few differential diagnoses
• What is the diagnosis?
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
CT face
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?
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
CT brain + neck
CT reconstruction
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