JCM OSCE
YCH 3/7/2013
Question 1
•
F/57, slip and fell land sustained left wrist
injury
1. What are the x-ray findings & diagnosis?
2. What is the treatment?
3. What complication is expected if she was put
on short arm dynacast?
Question 1
•
F/57, slip and fell land sustained left wrist
injury
1. What are the x-ray findings & diagnosis?
•
Intra-articular fracture of radius (volar side), volar displacement of
carpus, Barton’s fracture
2. What is the treatment?
•
Open reduction and internal fixation
3. What complication is expected if she was put
on short arm dynacast?
•
Malunion / displacement of the fracture
Question 2
• M/80
• History of recurrent AROU
• Presented with right hip pain
1. What is the x-ray finding?
2. What is the diagnosis?
3. What other malignant tumor would
present with similar x-ray finding?
Question 2
•
•
•
•
M/80
History of recurrent AROU
Presented with right hip pain.
1. What is the x-ray finding?
• Osteosclerotic lesion over pelvis and Right hip
• 2. What is the most likely diagnosis?
• CA prostate with bone secondaries
• 3. What other malignant tumor would present with similar
x-ray finding?
• CA breast with bone secondaries
Question 3
• A boy presented with slip and fell landed
on outstretched hand
1. What are the x-ray findings?
2. What is the diagnosis?
3. What is the most common associated
injury?
4. What is the treatment?
Question 3
• A boy presented with slip and fell landed on
outstretched hand
• 1. What are the x-ray findings?
• Anterior Fat pad sign, crack over radial neck
• 2. What is the diagnosis?
• Type II epiphyseal injury over radial neck
• 3. What is the most common associated injury?
• Posterior interosseous nerve
• 4. What is the treatment?
• Immobilization for 2-3 weeks
Question 4
• 20-year-old man presented with recurrent
episodes of palpitation.
1. Describe the ECG.
2. What is the diagnosis?
3. What are the 2 common arrhythmias
associated with this condition?
Question 4
• 20-year-old man presented with recurrent
episodes of palpitation.
• 1. Describe the ECG.
• Sinus rhythm, Short PR interval, widen QRS, delta
wave
• 2. What is the diagnosis?
• Wolff-Parkinson-White syndrome
• 3. What are the 2 common arrhythmias
associated with this condition?
• AVRT, pre-excited AF
Question 5
• 70 year-old-man presented with left upper
abdominal discomfort for months.
• Recent weight loss x 5kg/several months
• P/E:
• Splenomegaly, tip 8cm below left costal
margin
COMPLETE BLOOD COUNT
WBC
57.5 H
RBC
3.70 L
HGB
10.8 L
HCT
0.322 L
MCV
87.0
MCH
29.2
MCHC
33.5
RDW
15.3 H
PLT
78 L
WBC DIFFERENTIAL
Neutrophil
47.8 H
NEU %
83.0 H
Lymphocyte
2.3
LYM %
4.0 L
Monocyte
1.2 H
MON %
2.0 L
Eosinophil
0.6 H
EOS %
1.0
3.7 - 9.2 x10^9/L
4.30 - 5.90x10^12/L
13.4 - 17.1 g/dL
0.400-0.510 L/L
82.0 - 97.0
fL
27.0 - 33.0
pg
32.0 - 35.0 g/dL
11.0 - 14.0
%
145 - 370 x10^9/L
1.7 - 5.8 x10^9/L
43.0 - 71.0
%
1.0 - 3.1 x10^9/L
19.0 - 46.0
%
0.1 - 0.8 x10^9/L
3.0 - 12.0
%
0.0 - 0.5 x10^9/L
0 - 7.0
%
Question 5
1. Name 4 differential diagnosis?
• Chronic myeloid leukemia, Myelofibrosis, Chronic malaria, Kalaazar (Visceral leishmaniasis)
2. What is the most likely diagnosis?
• CML
3. Name 2 further investigations?
• Peripheral blood smear, Bone marrow biopsy
End
Thank you