JCM OSCE

QMH A&EFeb 2014

Case 1

• F/32• LBP for one week• No fever, no neurological deficits• PE unremarkable• Xray LS spine

Case 1

Question 1

• What is the Xray finding?• What could be the DDx?

Question 2

• What could be causative organism?

Case 2

• M/20• Complained of R sided chest pain for one day• No SOB• No history of trauma• PE showed decreased breath sound over R

lung

Questions

• What are the findings?• How do you manage him?• What are the indications for surgical

treatment?

Case 3

• F/21• PMH: Schizophrenia• Sudden onset of colicky generalised

abdominal pain again since after lunch• Small amount BO• PE: abd distension

AXR

Questions

• What are the findings?• Name a few differential diagnoses• What is the diagnosis?

Case 4

• F/50• Found collapsed in hospital canteen• On arrival GCS 14/15• BP 160/70, P 60• Tenderness and swelling over right face

CT face

Questions

• Please describe the CT scan finding• What do you need to look for in physical

examination?• If CT scan is not available, what Xray view will

you order? Any pitfall in this view?

Case 5

• M/77• Trip and fell with head and neck injury• Brief LOC• PE: GCS 15/15• Tenderness over R neck• RUL power 4/5, LUL 5/5

CT brain + neck

CT reconstruction

Questions

• What are the CT findings?• What do you need to look for in physical

examination• What is the classification of this injury?• What are the possible long term

complications in this injury?• Name 2 clinical prediction rules for predicting

cervical injury requiring Xray