JCM OSCE
CMC
Q1
• A 3 year-old boy complained of vomiting and looked
‘blue’ after taken vegetable soup prepared by his
parents. RR 28/min. SaO2 90% RA. Clinical photos were
taken.
• A) What is the clinical finding?
• B) What is the most likely diagnosis?
• C) What investigations will you perform?
• D) What is the antidote and its dosage?
• E) Is G6PD deficiency an absolute contra-indication to
the antidote?
• F) What is the color change of urine after treatment?
• G) What precautions will you give to his parents?
Q1. Pre-treatment 1
Q1. Pre-treatment 2
Q2
• A 16-year-old boy complained of nausea, vomiting, throat
and chest pain for few days. X-ray neck and chest were
performed.
• A) What are the X-rays findings?
• B) What specific physical signs will you look for?
• C) Give 4 causes of this condition.
• The patient was transferred to ICU for further management
and other investigations were performed.
• D) What is the arterial blood gas result?
• E) What is contrast CT neck, thorax and abdomen finding?
• F) What is the most likely diagnosis?
Q2 CXR
Q2 X-ray Neck
Q2. Arterial blood gas
•
•
•
•
•
•
pH
pCO2
pO2
HCO3
Base Excess
O2 Saturation
7.118
14 mmHg
138 mmHg
4.4 mmol/L
-22.5 mmol/L
99%
Q2 CT neck, thorax, abdomen
Q2 CT neck, thorax, abdomen
Q3
• A 60 year-old lady presented with abdominal
pain and shock.
• A) What is the CT abdomen finding?
• B) What are the significant laboratory results?
• C) What is the ECG finding?
• D) Name 4 causes of the pathology in (A).
• E) What is the management plan?
Q3
CT abdomen 1
Q3
CT abdomen 2
Q 3 Complete Blood Picture
Q 13 Liver and
renal function test
Q3 ECG
Q4
• A 66 year-old-lady, with history of DM and HT,
complained of fever, headache and diarrhea for 3
days. BP 90/41, P 126/min, Temp 38C.
• A) What are the significant laboratory findings?
• B) She had recently travelled to Indonesia. Give
one specific investigation you will ask for.
• C) What is the most likely pathogen?
• D) Give 3 differential diagnosis.
• E) What is the treatment for this pathogen?
Q4 Arterial Blood gas
Q4 Complete Blood Picture
Q4 liver and renal function test
Q5




A 79-year-old lady complained of headache
and diplopia for 1 week. Physical examination
showed right third nerve palsy. A CT brain was
performed.
A) What is the CT brain finding?
B) What are the causes of third nerve palsy?
C) MRI was done to delinerate the pathology.
What is the MRI brain finding?
Q5. CT brain
with contrast
Q5
MRI
Plain
T2
Q5
MRI with
contrast
Q6
• A 67 year-old lady with history of DM, HT,
hyperlipidemia, complained of drowsiness for 1 day.
Her medications included valsartan, betaloc,
meformin, diamicron, gemfibrozil. Her vital signs
were BP 118/51, P 23/min, SaO2 99%, Temp 35.8C,
GCS 13/15. ECG was performed.
• A) What is the ECG finding?
• B) What is the most likely diagnosis?
• C) How does the ECG finding associated with the
severity of her condition?
• D) Which of her medication can be the culprit?
• E) What is the AED management?
Q5 ECG
Thank you!