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    Osce Viva

    Uploaded by

    sanketh bhat.s
    The document describes three cases of patients presenting with abdominal symptoms. The first case is a 50-year-old male with abdominal distension, vomiting and constipation. On examination, the abdomen is distended with diffuse tenderness and guarding. The second case is a 54-year-old male with abdominal distension and pain, with a history of laparotomy. On examination, the abdomen is distended but only tender centrally. The third case is a 50-year-old male with abdominal pain, vomiting and constipation, with a right groin hernia present. The document provides questions for each case regarding diagnosis, causes, investigations and management.

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    © All Rights Reserved
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    Osce Viva

    Uploaded by

    sanketh bhat.s
    9 views16 pages
    The document describes three cases of patients presenting with abdominal symptoms. The first case is a 50-year-old male with abdominal distension, vomiting and constipation. On examination, the abdomen is distended with diffuse tenderness and guarding. The second case is a 54-year-old male with abdominal distension and pain, with a history of laparotomy. On examination, the abdomen is distended but only tender centrally. The third case is a 50-year-old male with abdominal pain, vomiting and constipation, with a right groin hernia present. The document provides questions for each case regarding diagnosis, causes, investigations and management.

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    Osce viva

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    The document describes three cases of patients presenting with abdominal symptoms. The first case is a 50-year-old male with abdominal distension, vomiting and constipation. On examination, the abdomen is distended with diffuse tenderness and guarding. The second case is a 54-year-old male with abdominal distension and pain, with a history of laparotomy. On examination, the abdomen is distended but only tender centrally. The third case is a 50-year-old male with abdominal pain, vomiting and constipation, with a right groin hernia present. The document provides questions for each case regarding diagnosis, causes, investigations and management.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    9 views16 pages

    Osce Viva

    Uploaded by

    sanketh bhat.s
    The document describes three cases of patients presenting with abdominal symptoms. The first case is a 50-year-old male with abdominal distension, vomiting and constipation. On examination, the abdomen is distended with diffuse tenderness and guarding. The second case is a 54-year-old male with abdominal distension and pain, with a history of laparotomy. On examination, the abdomen is distended but only tender centrally. The third case is a 50-year-old male with abdominal pain, vomiting and constipation, with a right groin hernia present. The document provides questions for each case regarding diagnosis, causes, investigations and management.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 16

    Osce viva

    -
    Small Bowel Obstruction---1

    • 50y old male pt, known DM,HTN, H/o Pulmonary TB 6ys ago inadequate treatment and follow up
    • Presented with abdominal distension vomiting and obstipation since 3 days
    • On examination-Hr-110 bp 110/60 spo2-98
    • Abdomen distended, diffuse tenderness with guarding ,tympanic on percussion.
    • No bowel sound heard.
    • PR- shows ballooning of rectum

    1. What is the difference between tenderness and rebound tenderness? How do you elicit these findings?
    2. What is your diagnosis? How did you reach this conclusion?

    3. What are the causes for the condition?

    4. What is the next step in confirming the diagnosis and what are the findings that will be seen in this
    confirmatory test?
    5. How will you manage this patient?
    Small Bowel Obstruction---2

    • A 54-year-old man presents to the emergency department with a 4-day history of abdominal distension, central
    colicky abdominal pain, vomiting and constipation. History of exploratory laparotomy for DU perforation 25ys
    ago.
    • On examination : blood pressure and temperature are normal. Pulse is at 90/min.
    • He has obvious abdominal distension, but tenderness only in central abdomen. No guarding or rigidity of
    abdomen. Midline scar noted healed by primary intension. Hernial orifices are clear and rectum is empty on
    digital examination. The bowel sounds are hyperactive.

    1. What is diagnosis? How did you reach to the conclusion?


    2. What are the causes of this condition?
    3. What is the next step in confirming the diagnosis and what are the additional investigations to be done?
    4. How do manage this patient initially?
    5. What are the indications for surgery?
    Small Bowel Obstruction---3

    • 50 y male patient presented with c/o pain in abdomen, vomiting and constipation for 2days.
    • On examination: Pulse: 120 , BP-100/60 Spo2-95% in room air
    • Abdomen is distended with generalized tenderness and guarding. Right groin has 8x8cm irreducible hernia.

    1. What is your diagnosis. How did you reach this conclusion?

    2. What are the other causes for the symptoms.

    3. What are the investigations needed for this patient?


    4. How will you manage this patient in triage?

    5. What is the definitive management?


    Trauma

    • 30y male presented to emergency with alleged history of fall from bike near Udupi early morning. Patient
    complaints of injury to right side upper abdomen by bike handle during accident. No history of ENT bleed ,
    loss of consciousness. No h/o trauma to chest or limbs.
    • On Examination : HR-100 BP-130/80 spo2-98 in room air . Minor abrasion noted over right upper quadrant
    right chest and right upper limb.
    • P/A: soft, tenderness in right hypochondrium but no guarding or rigidity noted. Bowel sounds normal
    • eFAST done in emergency showed perhepatic collection.

    1. ABCDE- primary survey


    2. What is eFAST what are the areas scanned
    3. What is probable diagnosis ? What is next mode of investigation to confirm the diagnosis
    4. Describe grades of liver injury
    5. How will you manage this patient?
    Trauma 2

    • 25y male brought to emergency by bystandards with alleged history of RTA under influence of alcohol at
    9.00pm On Examination : HR-130bpm BP-70/50 spo2-73 in room air . Patient is drowsy. Chest compression
    test negative. No long bone injury

    • P/A: tenderness in right hypochondrium but generalised guarding. Bowel sounds normal
    • eFAST done in emergency showed gross hemoperitoneum with possible liver injury. Ct brain done outside
    shows no head injury

    1. ABCDE- primary survey


    2. What is eFAST what are the areas scanned
    3. What is probable diagnosis ? What is next mode of investigation to confirm the diagnosis
    4. Describe grades of liver injury
    5. How will you manage this patient?
    AETCOM- Carcinoma colon

    • 50 y male nil premorbid presented with constipation and vague abdominal pain more in left side of abdomen
    since 6months. On examination abdomen is soft, non tender, no palpable mass no organomegaly.
    • Colonoscopy was done shows 3x3 cm mass in descending colon biopsy taken and found to be adenocarcinoma.

    a) Introduction
    b) Explain the diagnosis and further investigations to relatives.
    c) Explain the treatment options for this disease.
    d) What are the possible complications of treatment.
    e) Explain the prognosis of disease and follow up for the disease
    xray
    a) Describe the findings on the x-ray. (1.5 marks)
    b) Diagnosis (1 mark)

    - staghorn calculi
    xray
    a) Describe the findings on the x-ray. (1.5 marks)
    b) Diagnosis (1 mark)

    - left lower uretric calculi


    Instrument
    a) identify the instrument (1 mark)
    b) uses or sterilization technique (1.5 marks)

    • -gigli saw
    Instrument
    a) identify the instrument (1 mark)
    b) uses or sterilization technique (1.5 marks)

    • -osteotome
    Instrument
    a) Identify the instrument (1 mark)
    b) uses or sterilization technique (1.5 marks)

    • -scalpel
    Instrument
    a) Identify the instrument (1 mark)
    b) uses or sterilization technique (1.5 marks)

    • -towel clip(Mayos/Backhaus)
    Specimen
    1. Describe the specimen (1.5 marks)

    2. Diagnosis (1 mark)

    Malignant gastric ulcer


    Specimen
    1. Describe the specimen (1.5 marks)

    2. Diagnosis (1 mark)

    intussusception
    Specimen
    1. Describe the specimen (1.5 marks)

    2. Diagnosis (1 mark)

    IC junction tumor

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