1. JCM OSCE (Questions) YCH AED 8 th Oct 2014

2. Question 1

3. F/12 Left ankle sprained 2 days ago Presented with ankle pain & limping gait X ray was performed

5. Question 1 1.What are the X ray findings? (1.5 marks) 2.Which type of fracture does this girl have? (0.5 mark) 3.What is the specific name for this fracture? (0.5 mark) 4.What are the mechanisms of this injury? (1.5 marks) 5.What is the descriptive name for the fracture also involving metaphysis of distal tibia? (0.5 mark) 6.What is the treatment of choice? (0.5 mark)

6. Question 2

7. F/14 Good past health Presented with repeated vomiting x 1/52 Associated with abdominal pain after food Bowel opening normal Thin body build, abdomen soft CT scan of abdomen was later performed

9. Question 2 1.List four important differential diagnoses in this case. (2 marks) 2.CT scan of abdomen was performed. Describe the findings and what is the likely diagnosis? (2 marks) 3.How do you dispose this patient? (0.5 mark) 4.What is the another structure which can be entrapped between SMA & aorta? (0.5 mark)

10. Question 3

11. M/42 Hx NPC 2007 in remission Presented with fever & sore throat x 1/7 BP 139/69 P112 RR18 Temp 39.0 SpO2 98% No stridor or neck swelling XR neck was performed

13. Question 3 1.What are the X ray findings? (1 mark) 2.What is the diagnosis? (0.5 mark) 3.Name 2 common pathogens. (1 mark) 4.What is the initial management in AED? (2.5 mark)

14. Question 4

15. F/55 Good past health, non smoker, non drinker Presented with cough & throat discomfort x2/52 – Throat clear, neck soft, no cervical LN – Chest clear, no added sound – Few high pitched breath sound during expiration – Otherwise systemically well, ambulatory ENT consulted, normal laryngoscopy to VC CXR was performed

17. Question 4 1.Name 3 differential diagnoses. (1.5 marks) 2.What is the positive finding on CXR? (0.5 mark) 3.Name 3 important negative findings on CXR. (1.5 marks) 4.Name 3 important investigations. (1.5 marks)

18. Question 5

19. F/32 Good past health Presented on day 10 post delivery with sudden onset bi-temporal headache and bilateral blurred vision Exam: Right homonymous hemianopia CNs, limb power & sensation normal No cerebellar sign CT brain normal

20. MRI T2 FLAIR (Fluid attenuated inversion recovery) sequence * By the time when MRI was performed, patient had slightly improved visual field

21. Question 5 1.What are the MRI findings? (1 mark) 2.What is the most likely diagnosis? (0.5 mark) 3.What is the alternative important diagnosis? (0.5 mark) 4.Name 3 predisposing factors for this condition. (1.5 mark) 5.Name one proposed mechanism for this condition. (1 mark) 6.What is the prognosis for this patient? (0.5 mark)

22. Thank you