osce kwh aug 2013. case 1 m/38 right shoulder contusion after s/f pe: tenderness and swelling over...
TRANSCRIPT
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osce
KWH
Aug 2013
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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
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Questions
• 1) what is the diagnosis?
• 2) what is the classification of the fracture?
• 2) what is the management?
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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
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Questions
• 1) what is the diagnosis?
• 2) what is the associated injury to look for?
• 3) what is the management?
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Case 3
• M/70
• Left shoulder contusion after S/F
• PE: left shoulder in abducted position
• X rays of left shoulder was taken
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Questions
• 1) what is the diagnosis?
• 2) what is the method of reduction?
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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%
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• His BP drop to 60/30 mmHg after admission and return to 130/70 mmHg after 1000 ml gelofusin infusion.
• Urgent CT was performed
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Plain films
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Plain films
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Plain films
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Contrast film
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Contrast films
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Contrast films
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Contrast films
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Contrast films
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Delay contrast films
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Delay contrast
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Delay contrast
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Delay contrast
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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 ?
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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.
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Question
• 1) describe the CT findings
• 2) what is the diagnosis?
• 3) what is the management?
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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.
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Questions
• 1) describe the ECG finding
• 2) what is the diagnosis?
• 3) what is the mangement?
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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.
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Questions
• 1) describe the ECG findings
• 2) what is the diagnosis?
• 3) what is the management?