Clinical Cases Review: Neurological, Toxicological, and Orthopedic Presentations
Explore a collection of intriguing clinical cases including neurological symptoms, toxic ingestion, loss of consciousness, and orthopedic injuries. From CT findings to treatment modalities, delve into differential diagnoses, imaging investigations, risk factors, complications, and management strategies for each unique case.
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JCM OSCE (YCH) July 2023
case 1 45/F complained of headache and left facial pain for 3 months
1. Describe the CT findings 2. What are the differential diagnoses (list 2)? 3. What imaging investigations can be used to confirm the diagnosis(list 2)? 4. What are the segments of ICA? 5. Why did the patient complain of left facial pain ? 6. What are complications for this condition ? 7. What are the 2 modalities of treatment?
case 2 37/F complained of accidental ingestion of 1 pack of rodenticide about 1 month ago, attended mainland China s hospital with unknown treatment given, went back Hong Kong 3 days ago, then developed gross hematuria with blood clot for 1 day
1. What would you do next (list 3 items)? 2. What is the mechanism of action of brodifacoum? 3. What is the half-life of brodifacoum? 4. What are the clotting factors affected? 5. 2 hours later, INR showed > 8 (PT >120, APTT >120), what would you do (list 2 items)?
case 3 65/F found loss of consciousness in the morning she had decrease in responsiveness for 3 days
1. Describe the facial clinical features (list 3)? 2. Based on these clinical features,what is the likely diagnosis? what are other differential diagnoses(list 2)? 3. What are the risk factors for this condition (list 2)? 4. What are the associated complications with this condition(list 2)? 5. What is the mortality rate (even with treatment) ? 6. What are the treatments?
case 4 18/ M fell during playing football, landed on outstretched left hand, then complained of left elbow injury
1. Are oblique views important for elbow injury ? 2. Describe the x-ray findings 3. What is the mechanism of injury ? 4. Name the classification of this fracture 5. What is terrible triad of elbow ? 6. Name 3 long-term complications 7. What are the 2 modalities of treatment ?
case 5 a 22 month-old boy presented with abdominal pain and vomiting with undigested food for 1 day
1. Describe the x-ray findings 2. What is the likely diagnosis? and what is the pathology? 3. What are the risk factors for this condition? 4. What are the significant physical findings in this condition? 5. What is the most important investigation? what do you look for in this investigation? 6. What are the treatments?
