MEDICINE OSCE SLIDES

1.TRUE CUT BIOPSY

IMG_2024

  • LIVER BIOPSY
  • THYROID BIOPSY
  • RENAL BIOPSY

Contraindications:

  •  LOCAL INFECTION
  • COAGULOPATHY
  • ABSCESS FORMATION

2. X RAY CHEST PNEUMOTHORAX

IMG_2026

  • JET BLACK SHADOW ON LEFT LOWER ZONE
  • COLLAPSE LUNGS
  • TRACHEA SHIFT RIGHT SIDE

3. LIVEDO RETICULARIS.

IMG_2030

  • ANTIPHOSPHOLIPID SYNDROME
  • SLE

C. URINE EXMANIATION

COOMB TEST

4. KOILONYCHIA

IMG_2040

  • B. MCV
  • SERUM FERRITIN
  • TIBC
  • TRANSFERRIN SATURATION

C.IRON REPLACEMENT THERAPY

BLOOD TRANSFUSION

5. KOILONYCHIA

IMG_2046

B. IRON DEFICIENCY ANEMIA

C. IRON PROFILE

6. CHEST X RAY PLUERAL EFFUSION

IMG_2051

B. HOMOGENOUS OPAQUE SHADOW  ON LEFT SIDE WITH

LOSS OF CARDIO-PHRENIC AND COSTO-PHRENIC ANGLE

  • T.B
  • PNEUMONIA
  • SLE
  • CCF
  • RA

7. INSULIN SYRINGE

IMG_2052

  • D.M
  • HEPARIN
  • B-INTERFERON

8. RHEUMATOID ARTHIRITIS

IMG_2057

B.SWAN NECK DEFORMITY

C. ANTI CCP

9. CLUBBING OF FINGERS

IMG_2063

  • CIRRHOSIS
  • COPD
  • BACTERIAL ENDOCARDITIS

10. JAUNDICE

IMG_2068

  • HEPATITIS
  • HEMOLYTIC ANEMIA

C. LFT

SERUM BILIRUBIN LEVELS

11. MALAR RASH

IMG_2070B. ANA, Anti-dsDNA

C. Hydroxychloroquine

12. BELLS PALSY

IMG_2073

  • 2. Corticosteroids
  • Physiotherapy

13. SPINE X RAY ANKYLOSING SPONDILITIS

IMG_2079

B. BAMBOO SPINE

  • C. BRIDGING SYNDESMOPHYTES
  • FUSION OF VERTEBRAL JOINT

13. CUSHING SYNDROME

IMG_2085

  • THIN PAPRY SKIN (5)
  • BUFALLO HUMP (7)
  • SKIN STRIA (3)
  • CENTRAL OBESITY (2)
  • TRUNCAL OBESITY (4)
  • SKIN BRUISE (6)

14. ACHLASIA CARDIA

IMG_2088

  • B. CHAGAS DISEASE
  • AMYLOIDOSIS
  • SARCODOSIS

TREATMENT:

  1. PNEUMATIC DILATION
  2. ENDOSCPIC DILATION
  3. HELLERS MYOTOMY

15. LP NEEDLE

IMG_2095

  • B. CSF EXAMINATION
  • INTRATHECAL INJECTION
  • SPINAL ANEASTHESIA
  1. C. RAISED ICP
  2. INFECTION

16. PEAK EXPIRATORY FLOW METER

IMG_2103

  • B. 450 – 600ml (MALE)
  • 350-550ml (FEMALE)

17. BRONCHIECTASIS.

IMG_2105

  • B. HELICAL CT SCAN
  • CHEST XRAY

Complications:

  1. COR POLMONALE
  2. RESPIRATORY FAILURE
  3. AMYLOIDOSIS

18. BRONCHIAL ASTHMA

IMG_2108

  • PFT
  • 20% DIURINAL VARIATION ON PEF DIARY
  • DECREASE IN FEV1 OF >15% AFTER 6 MIN EXCERSICE
  1. OXYGEN THERAPY
  2. INHALED BETA AGONIST
  3. INHALED CORTICOSTEROIDS

 

19. PLUERAL EFFUSION.

IMG_2111

B. AS SAME AS ABOVE

  • C. PA CHEST X RAY
  • ULTRASOUND
  • DIAGNOSTIC TAP

20. SLE WITH ANTIPHOSPHOLIPID ANTIBODY SYNDROME

IMG_2115

  • DOPPLER ULTRASOUND OF LOWER LIMB
  • APTT
  • Anti-dsDNA
  • URINE DR

IMG_2120

21. MENINGITIS

IMG_2121

  • B. LUMPER PUNCTURE – CSF EXAMINATION
  • BLOOD CULTURE
  1. CEFTRIAXONE 2g 12 HOURLY
  2. STEROID THERAPY

21. C.A PNEUMONIA

IMG_2126

  • CHEST X RAY
  • BLOOD CULTURE
  • SPUTUM CULTURE
  1. C. PENICILLIN G
  2. AMOXICILLIN

DR.QADRI

1.MITRAL STENOSIS WITH ATRIAL FIBRILLATION

IMG_2133

  • CHEST X-RAY
  • ECHOCARDIOGRAPHY
  • ECG

2. HYPOTHYROIDISM

IMG_2139

  • THYROID ANTIBODIES
  • TFT
  • ECG
  1. C. IODINE SUPPLEMENTS
  2. LEVOTHYROXINE

3. 3rd CRANIAL NERVE EXAMINATION

IMG_2149

  • EYE MOVEMENT
  • PTOSIS

B. CAUSES

4. CHEST X RAY PLEURAL EFFUSION

IMG_2154

  • D/D HYDRO-PNEMOTHORAX
  • MASS LESION

5. ADDISON DISEASE

IMG_2163

  1. SHORT ACTH-STIMULATION TEST

GLUCOCORTICOID= HYDROCORTISONE

MINERALOCORTICOID= FLUDROCORTISONE

6. ACROMEGALY

IMG_2166

  • 2.TRANS-SPHENOID SURGERY
  • OCTREOTIDE
  • PEGVISOMANT
  • BROMOCRIPTINE
  1. ?

7. HYPERTHYROIDISM

IMG_2171

  1. GRAVES DISEASE
  2. TOXIC ADENOMA
  3. DE QUERVAIN THYOIDITIS

TREATMENT:

  • PROPYLTHIOURACIL
  • CARBAMIZIPINE
  • RADIOACTIVE IODINE
  • SUB-TOTAL THYROIDECTOMY

 

8. G.B SYNDROME

IMG_2178

  • CSF FINDINGS= ALBUMINOCYTOLOGIC DISSOCIATION
  • ELECTROMYOGRAPHY

9. DIABETIC KETOACEDOSIS

IMG_2181

  • URINE KETONES
  • ELECTROLYTES
  • ABG

TREATMENT:

  1. FLUID
  2. INSULIN
  3. ELECTROLYTE REPLACEMENT
  4. ANTIBIOTICS

10.HYPOGLYCEMIA

IMG_2189

B. BLOOD SUGAR

C. 25% DEXTROSE WATER SOLUTION

11. ECG

IMG_2192

RATE = 60

12. IRON DEFICIENCY ANEMIA

IMG_2193

  • MENSIS HISTORY
  • DIET INTAKE
  • WORM INFESTATION

13. WILSON DISEASE

IMG_2197

B. AUTOSOMAL RECESSIVE

D. PENICILLAMINE

14. T.B

IMG_2200

15. CHEST XRAY – PLUERAL EFFUSION

IMG_2203

A. LEFT SIDE= HOMOGENEOUS OPACITY WITH BLUNT CARDIOPHRENIC AND COSTO PHRENIC ANGLE

RIGHT SIDE= JET BLACK SHADOW

  • B. DIAGNOSTIC TAP
  • GRAM STAIN
  • CULTURE
  • ULTRA SOUND

16. CHRONIC MYELOID LEUKAEMIA

IMG_2210

  • B. RNA ANALYSIS= BCR/APL GENE PRODUCT
  • CHROMOSOME ANALYSIS = PHILADELPHIA CHROMOSOME
  1. C. IMITINIB/DUSATINIB
  2. BONE MARROW TRANSPLANTATION

17. UMN LESION

IMG_2218

2. CT SCAN

18. DENGUE

IMG_2219

19. 5th CRANIAL NERVE EXAMINATION

IMG_2226

B. CAUSE=

20. LYMPHOMA

IMG_2225

21. TYPHOID FEVER

IMG_2232

22. PRIMARY BILLIARY CIRRHOSIS

IMG_2235

23. DISSEMINATED T.B

IMG_2242

24. SPONTANEOUS BACTERIAL PERITONITIS

IMG_2243

25. CEREBRAL MALARIA

IMG_2247

26. D.M

IMG_2251

A. EXERCISE, DIET CONTROL

B. METFORMIN

27. STROKE

IMG_2264

28. PNEUMONIA

IMG_2279

29. HYPERTHYROIDISM

IMG_2272

30 MEGALOBLASTIC ANEMIA

IMG_2277

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