JCM OSCE YCH 3/7/2013

Question 1 F/57, slip and fell land sustained left wrist injury What are the x-ray findings & diagnosis? What is the treatment? What complication is expected if she was put on short arm dynacast?

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 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 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 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 3.7 - 9.2 x10^9/L RBC 3.70 L 4.30 - 5.90x10^12/L HGB 10.8 L 13.4 - 17.1 g/dL HCT 0.322 L 0.400-0.510 L/L MCV 87.0 82.0 - 97.0 fL MCH 29.2 27.0 - 33.0 pg MCHC 33.5 32.0 - 35.0 g/dL RDW 15.3 H 11.0 - 14.0 % PLT 78 L 145 - 370 x10^9/L WBC DIFFERENTIAL Neutrophil 47.8 H 1.7 - 5.8 x10^9/L NEU % 83.0 H 43.0 - 71.0 % Lymphocyte 2.3 1.0 - 3.1 x10^9/L LYM % 4.0 L 19.0 - 46.0 % Monocyte 1.2 H 0.1 - 0.8 x10^9/L MON % 2.0 L 3.0 - 12.0 % Eosinophil 0.6 H 0.0 - 0.5 x10^9/L EOS % 1.0 0 - 7.0 %

Question 5 1. Name 4 differential diagnosis? 2. What is the most likely diagnosis? 3. Name 2 further investigations?