AMC Clinical 2009 Recalls

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AMC Clinical 2009 Recalls
    7 th  Feb Melbourne 2009 1: Generalized anxiety   Young female had palpitation and chest pain had her ECG and all test done everything came normal. On history she is smoking and her sleep has impared due too too much work load, has recently started new usiness. ! #C feed ack, generali$ed an%iety & .'ask take history, e%plain to the patient what is it and why it is happening and manege the case . !wanted to hear epinephrine and norepinephrine effect.(: Permanent sterilization : Youg female taking OC) and doesn*t not want to take any longer wants to dicuss with you the permanent sterili$ation method. 'ask: +iscuss the method dvantages and disvantages uestions: does it affect on my menstruation, weight and se%ual performance and failure rate. -: ADHD  : same as #C handook :   Fever : young female has een getting fever since - months proaly associated sweats.'ask: take the history , ask e%amination findings from e%amination and order the investigation /t was a differential diagnosis and organi$es investigation accordingly. On history she had a travel history scratches on the ody and splenomegaly 5 !a olon  : 0arium ray e%plain the ray findings to the patient , he had diverticulosis and had  een constipated on and off . nswer the 2uestions asked y patient and E%aminer: / t was it hard and tricky / was going to say diverticulosis ut patient dragged me on the right side asking could it e cancer, what investigation to confirm and e%aminer asked that how you will know if it has spreaded. 3: Heada he   father is concerned aout his 4 year old son who is getting headaches. 'ask take history, ask e%amination findings from e%aminer , diagnosis and manage the case. 5ather asked are you sure it is not tumour. 6eadache was related to school situation. 7: #ron de$i ien y anaemia   : 5ather has een concerned aout his ( year old son. +iscuss the  lood results with the father. 'ake the relevant history and management. / was given the growth chart plot the chart and tell to the father if his growth is ok. 8: Arm s%ellin& : young oy was playing tennis notice sudden swelling in her arm : 'ask ask the relevant history , diagnosis and what investigations you will do9On e%amination no redness and tenderness ust painful and pitting oedema / said thromosis E%aminer 2uestions: ;here do you think the clot is9 ;hen you send the patient to emergency then what you will write down in your notes 9 <:  'ar&e $or dates : fundus height larger than the dates: 'ask ask the relevant history e%amination finding from the e%aminer and management. 1=: ( iati a : same as #C hand ook     'ask: take history ask e%amination findings from e%aminer, e%plain to the patient what it is and management.uestion asked y e%aminer which nerve root is affected !single nerve root not the not the whole segment of sciatic nerve. E%aminer continuously asked which nerve root / want to know the single nerve. 11: )ravel advise   young oy is going to 0ali in couple of days who needs your advise what he should do efore he flies . 1(: Abru*tio *la enta  !concealed leeding& : -= weeks !proaly& pregnant lady came in the emergency dept complaining for the severe pain in her tummy. 'ask take the history, ask the e%amination findings from the e%aminer, e%plain to the patient what it is and how you are going to manage. 1-: +xamine the hands  : make your diagnosis / was asked to e%amine the hand and rt hand was acutely infected and tender. / was confused as everything was normal on the left side finding were positive only on rt side therefore / though / should touch the >t hand. 0ut do not forget to mention and act on that !when it hurts please let me know / will cease the e%amination must rememer&. 1: !hest *ain :  #iddle aged man came to the emergency dept complaining of pain in the chest. 'ask take the history: sk the findings from the e%aminer,what investigations you will do : /n the history he had all the risk factor, drinking alcohol, smoking taking meds for diaetes and he was oese aswell. 14: ,enzodiaze*ine overdose : 'ake the history asses the mental status. 'he girl did not have any positive history e%cept she has een taking mariuana with friends. Otherwise no depression, no suicidal idea . she was very hard patient she was not happy when / told her to stay in the hospital she said / want to go ack and / ust took the talets to get good sleep and / am not that mad to kill myself. 6ard one. 13: )erminally ill *atient ex*lain the *alliative are 'he daughter is concerned aout her father who has pancreatic cancer wants to know aout  palliative care, no one lives with her father how can we assist her father in order to provide him a 2uality of life until he is alive. ?he wants to know each and everything efore she goes away as she lives in other city. E%aminer : patient can*t eat anything what you will do 9 February 2009 -e all . Di$$erent version 1. inferior #/ in a 3= year old man with significant risk factors. 'ake 6istory and discuss management (. )ale < month old came for review of lood tests. >esuilts show iron deficiency. 'ake a history and discuss diagnosis and management. Child still on cows milk and no solids. -. (3 year old with lower ack pain sudden onset whilst at work. 'ake history and re2uest e%amination findings and discuss management. ?ciatica . -- year old female with ( children wants sterilisation, discuss and answer her 2uestions. 4. 'ravel advice to a young ounalist travelling to asia 3.E%amination of hand in apatient with osteoarthritis 7. 7= year old came for resuilts of arium enema. +iscuss the resuilt and management plan. >eport states narrowing in descending colon.  8. 17 year old rought in after a drug overdose now stale, do a mental status e%amination and discuss your management plan <. (- year old )rimigravida presents with sudden onset lower adominal pain at -8 weeks. 'ake a history and discuss management. )lacenta aruption, unstale and no fetal heart. 1=. - year old female who presents with recurrent fevers for the past three months. 'ake a history, re2uest e%amination findings and discuss mangement.@Aymphoma 11. 5ather en2uires aout 3 year old daughter with recuurent headaches.@'ension type and ullying at school. 1(. #other with 3 year old child desruptive at school. 'ake history and discuss management. +6+ 1-. ( year old clerk with swollen arm. 'ake 6istory and re2uest e%amination findings and discuss management plan. Every thing negative in history. 1. (- year old primigravida large for dates at -( weeks . 'ake a history and re2uest e%amination findings and discuss management. Aarge for dates ut normal afi 14.daughter of 7= year old with advanced pancreatic ca wants to know aout condition and management@ patient has given consent for disclosure. 13. woman with Generalised an%iety disorder, smokes 14B day and drinks a lot of cough. +iscuss management    March 2009, Adelaide case 1 : a 6 months old child recently came from overseas trip has low haemoglobin and 6 weeks history of diarrhoea. take history , ask for examination findings and counsel mother. buddies whenever dealing with a paediatric case always remember three things to ask : immunization, growth chart and diet history. the child had anemia with falling off the weight for age. fully immunized. very fussy in eating. diarrhoea started 6 weeks ago and is continuing. stools semiformed in nature with no blood. stools not bulky. no history of any recurrent infection, genetic disorder in the family. examination findings : pallor ++, no organomegaly, protuberant abdomen with muscle wasting. no findings in urine. choice of investigation: C!, sweat chloride test, b electrophoresis to rule out thal., stool microscopy and culture to rule out any parasitic infection. #ifferential diagnosis: $. dietary anemia secondary to poor oral iron intake. %. protein energy malnutrition& unlikely' (. parasitic infestation &recent oversease trip to tropics'. ). cystic fibrosis * malabsorption syndrome & unlikely as it doesnt give anemia'. case 2  : examination of a swelling on the face , ust anterior to right ear , dermoid. case 3 : %( year old girl with - pain, beta C/ positive, simple cyst *.*cm on right ovary. case 4 : postnatal depression &typical from 01C book'. case 5 : 6 weeks old child with $ day history of diarrhoea, counsel father. case 6 : %) year old female, 213 %4 weeks back, uterine size (4cm, was on overseas trip, no investigations done. counsel and manage. case 7 : coeliac disease. case 8 : bitemporal hemianopia, eye examination. case 9 : anorexia nervosa case 10 : *5 year old man with prostatism , undergoing 73, counsel. case11 : 6 year old child with limping , perthe8s disease vs transient synovitis of hip. case12 : pneumothorax &typical from 01C book'. case13 : 64 year old lady with lethargy, history and examination findings, investigate & wait till monday as this one was tricky and it was not hypothyroidism'. case14 : 64 year old recently diagnosed with rheumatic arthritis , violin player, counsel. case 15 : %%year man, fell off from motor bike, $* mins unconcious, perform primary survery and counsel the patient and organize relevant investigation. case 16 : 6% year old lady, profuse vaginal discharge , brownish yellow& case of atrophic vaginitis but rule out malignancy by hysteroscopy'. #iscussion of cases: case 2 discussion : 6 month old baby, presented to !# after having diarrhoea. take relevant history , ask for examination finding and counsel the mother. his case was not as straight forward as it looks like and as i had mentioned before that whenever there is a paediatric ase always take proper history.

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Jul 23, 2017
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