Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
OBA
EMQ
A. Brachial plexus
1) Chronic presentation : Rotator cuff muscles tear (not frozen shoulder because frozen
shoulder is not chronic in presentation)
2) Baby – Weak upper limbs, presented with flexed fingers (DIP) : Klumpke’s
3) Painful, restricted passive extension of fingers, absent rasial pulse : Volkmann’s
ischaemic contracture
4) Thumb and index finger glass injury : Tenosynovititis
5) Frequent Dislocation : Axillary nerve injury
OSPE
A.
1)
Description of diagram Provisional diagnosis
Case 1 Sunburst appearance Osteogenic sarcoma
Case 2 Punched out (multiple) lesions in the Multiple myeloma
skull
Case 3 Skull with large mass Osteosarcoma
The picture (to me) was non-coloured, hence it was not clear. (Sorry as I couldn’t find the
exact picture to include it here.)
A : Flexor retinaculum
B : Thenar muscle
C : Median nerve
D : Ulnar bursae
E:
3) How would infection travels here? (if I’m not mistaken, do correct me)
TENOSYNOVITIS - infection of RADIAL, ULNAR BURSA & Fibrous flexor Sheath of
Digits-by PENETRATING WOUND. PUS may enter FASCIAL SPACE IN FOREARM
through underneath flexor retinaculum– into SPACE OF PERONA
Name X, Y and Z.
W : Optic radiation
X : Optic nerve
Y : Optic tract
Z : Visual cortex
3) Name C and D
C : Anterior choroidal artery
D : Choroid plexus
Another picture of cerebral haemorrhage (not sure of the questions and answers, the lecturer
was too fast)
MEQ
A. Part 1
A case of osteoarthritis (basically know all about arthritis), old woman, presented with painful knee
Part 2
Radiography shows intra-articular effusion.
6) State a structure in the knee joint and give TWO of its function.
- Medial and lateral meniscus (menisci) : shock absorber, weight-bearing.
- Cruciate ligaments (anterior and posterior) : provide rotational stability,
prevent hyperextension and hyperflexion of the knee joint.
Part 3
Patient was treated with NSAIDs.
7) What are the treatment modalities for this patient besides NSAIDs?
- Exercise
- Reduce weight
- Intra-articular injection of steroid
- Joint lavage
- Arthroplasty
- Surgery
B. Part 1
A case of a lady presented A&E after serious vomiting for past one hour.
1) What might be the cause of her vomiting? Give four (if I’m not mistaken)
- Hyperemesis gravidarum
- Increase intracranial pressure
- Food poisoning
- Ear infection
- Drug intoxication
- Metabolic acidosis
- Migrain
2) What further history should be obtained to narrow down the differential diagnosis? Give four.
- Menstrual history
- Past medical history (drug Hx)
- Hx of food poisoning
- Any associated symptoms such as headache, tinnitus, loss of balance
- Precipitated with aura?
3) Is the vomiting centre located inside the blood brain barrier? Where is the vomiting centre?
No. Area of postrema.
Part 2
4) Give 2 structures in both respective middle wall and anterior wall of the middle ear cavity.
- Medial wall : Oval window (with foot of stapes) and round window
- Anterior wall : Eustachian tube and Internal carotid artery
5) How can infection of the middle ear cause vertigo and vomiting?
- Infection spreads through oval window into vestibules…..
-
- Hence cause vertigo and vomiting
Part 3
2) What are the fractures that might develop after a fall like this? Where does the fracture in
femur most probably occur in this patient)
- Vertebrae/
- Neck of femur (rasanya)
Part 2
Diabetic. Upon pre-surgical procedure, the anesthetist was vigilant to found out that the patient’s
blood pressure was 195/…Hg (very high BP) and her cholesterol level was high.
5) Why was the anaesthetist vigilant?
- High BP high risk of anaesthesia or something (not so sure)
- High cholesterol is a risk for atheroma
Part 3
Patient remained unconscious after the surgery. She couldn’t be woken up. The doctor suggested that
she has stroke.