Medicine OSCE Latest
Medicine OSCE Latest
Medicine OSCE Latest
AL 2003 Batch
2008
Common areas
Haematology
CVS
Anaemia
Clotting disoders
Blood grouping
ECG
Mx of MI
RS
CXR
LFT
ABG
Common areas
CNS
CSF report
CT
GUT
UFR
Imaging
RFT
Common areas
Clinical signs
Others
Haematology Slides
Niroshan_loku@ yahoo.com
Anaemia
Microcytic anaemia
Hereditary Spherocytosis
Hereditary spherocytosis
Autosomal dominant
Anaemia,jaundice,hepatomegaly
Increased osmotic fragility
Macrocytic anaemia
Leukaemias
AML
Myeloblast cells
Niroshan_loku@ yahoo.com
AML
CLL
Numerous Mature lymphocytes, few smear cells
CLL
CML
Niroshan_loku@ yahoo.com
Numerous
granulocytic cells
At different stages of
differentiation.
MM Plasma cells
MM Skull / bones
Niroshan_loku@ yahoo.com
Reed-Sternberg cell - HL
RS cells - HL
Other Slides
Niroshan_loku@ yahoo.com
Malaria
Uncomplicated
Oral Chloroquine
Complicated
IV quinine
Instruments
Niroshan_loku@ yahoo.com
PD catheter
ECG
Niroshan_loku@ yahoo.com
ECG
RATE
RHYTHM REGULAR / IRREGULAR
CARDIAC AXIS
CONDUCTION INTERVALS PR,QRS
ABNORMALITY IN P,QRS,ST,T
RATE
Heart rate
Normal ECG
Rhythm abnormalities
VT & SVT
55
VT
57
VT
60
Atrial flutter
HEART BLOCK
64
Ist degree HB
Mobitz I (Wenkebach)
Mobitz II
67
2:1
block
68
72
RBBB
73
V1 M wave / RSR
V6 deep S wave
LBBB
74
V6 M wave / RSR
V1 deep S wave
RBBB
LBBB
AXIS DEVIATION
78
AXIS DEVIATION
RAD
LAD
79
RAD
80
LAD
81
LAD
RAD
84
86
LAD
HYPERTROPHY OF HEART
89
LVH
90
RVH
RAH
LAH
91
P mitrale
92
LVH
LVH
RA HYPERTROPHY P PULMONALE
RAH
97
Anterior MI
Lateral MI
98
Extensive anterior
LII,LIII.aVF
Anterolateral
V4 to V6 & aVL, LI
Inferior MI
V1 to V4
Posterior MI
Anterior MI
Anterior MI
Inferior MI
107
Hyperkalaemia
Hyperkalaemia
Chest X-Rays
Niroshan_loku@ yahoo.com
112
L/pleural effusion/haemothorax
R/Pneumothorax
R/Tension pneumothrax
L/ pyopneumothorax
Fibrosis.
Bronchiectasis
Cavity (Lung
abscess)
A welldefined
rounded in L
upper lobe
(white
arrow).>1/2
of the cavity
is filled with
fluid and air
(black
arrow).
Well-defined soft
tissue mass in the
right upper zone and
a smaller mass
medial to it. There is no
bone destruction and no
mediastinal
lymphadenopathy.
coin / cannon ball
shadows
Several,
differentlysized, mostly
round shadows
with the
intensity of soft
tissue in both
lungs. Most of
them are in the
lower lobes
Milliary shadows
Milliary shadows
Hilar lyphadenopathy
Lymphoma
Pericardial calcification
Read: causes for cardiomegaly
C T SCANS
Niroshan_loku@ yahoo.com
EDH
Acute SDH
ICH
SAH
MCA infarct
140
Cerebral abscess
MENINGIOMA in Contrast-enhanced CT
Other Investigations
Niroshan_loku@ yahoo.com
IVU - Hydronephrosis
Bone Scans
Carotid angiogram
V/Q scan - PE
DTPA scan
(Diethelene-Triamine-Penta-Acetic acid)
Although the kidneys are the same size,
the center of the R/ kidney has areas of
decreased radioactivity; the hilum of the
R/kidney is lighter grey. This indicates that
the kidney has hydronephrosis; the pelvis
is so large that the renal parenchyma is
stretched over it.
Left kidneys show peak concentration
(computer generated curve) at about 57min. L/kidney promptly drains (curve
drops rapidly). The computer curve of the
right kidney shows a much more gradual
rise and it continues to rise almost to the
end of the study. This shows that the right
kidney doesn't drain; it is obstructed.
Additional studies demonstrated R/PUJO.
DMSA - HSK
Arterial Blood
Gas analysis
156
pH
HCO3
pCO2
pO2
7.35 - 7.45
22-26 mmol/L
35-45 mmHg
80-110 mmHg
SaO2 97-100%
BE 2 to +2
AG <12-18
157
(24)
(40)
4.7-6kPa
11-15kPa
158
160
161
162
Few causes.
163
Resp Acidosis
Type II Resp failure
Resp Alkalosis
Hyperventilation
(CNS stroke,
meningitis, anxiety,
fever, drugssalicilates.)
Few causes.
Met. Acidosis
Renal failure
Keto-acidosis
Lactic acidosis
Diarrhea
Illeostomy
Renal TA
164
Met. Alkalosis
Vomiting
Freq. NG suction
Hyperaldosteronism
Diuretics
Respiratory Failure
Hypoxia
(PaO2 < 8 kPa or <60 mmHg)
with normocapnia (PaCO2< 6.5kPa)
Type I Resp Failure
with hypercapnia (PaCO2> 6.5kPa)
Type II Resp Failure
165
166
167
168
Fundoscopy
Niroshan_loku@ yahoo.com
DM retinopathy
DM retinopathy (Proliferative)
Ht retinopathy( grade IV) / Papilloedema Ill defined disk margin, enlarge disk, cup
cant see, vessel markings are reduce. Pulsations invisible
Macular star in Ht
Optic atrophy
184
Hepatocellular jaundice
Obstructive jaundice
TRUE / FALSE
185
QUESTION 1
186
List 3 causes?
187
Urinary calculi
TB
Urinary tract malignancy
cystitis
Question 2
188
Question 3
189
TRUE / FALSE
190
It is an EDH
Due to bleeding from middle meningeal
artery
CSF will be xanthochromic
Alcoholism is a risk factor
Patient may have confusion
Physical Signs
Niroshan_loku@ yahoo.com
Acromegaly face
Hypothyroid facies
Thyrotoxic facies
L / 3rd CN palsy
Facial N palsy
Niroshan_loku@ yahoo.com
Oral candidasis
RA - Hand
Niroshan_loku@ yahoo.com
Duputrens contracture
Tendon Xanthoma
NF
Plaque Psoriasis
E. nodosum
Niroshan_loku@ yahoo.com
E. multiforme
Typhus
Snakes
Niroshan_loku@ yahoo.com
Miscellaneous
Niroshan_loku@ yahoo.com
Fatty liver
Macronodular cirrhosis
Niyangala
Good Luck!
Feedbacks to
niroshan_loku@yahoo.com