8 August online exam Passed feedback.

Physical examinations

1. 30 yr of male comes with neck lump which moves with swallowing and was mentioned that
there is some family history on thyroid pathology. Task PE and instruments to use to med std.
Feedback: Pass: did same as Marwan as running commentary of all the thyroid pathologies.
2. 11y old girl having URTI taking amoxicillin presented with generalized rash on truck (no
picture given)
Task 1. Explain to parents in 2 mins, 2. Pe to examiner, 3. PEFE after 6 mins: Cx LAD,
splenomegaly rest normal, 4. DX/DDX.
Feedback Pass: did General hematological examination.
3. 60/f presented with SOB, vitals and cxr s/o hyperinflated chest (just mentioned).
Task: 1. Explain to pt in 2 mins, 2. then to examiner, 3. PEFE after 6 mins all normal except
hyper resonant, 4.Dx/DDx
Feedback Pass: did respiratory pe and short cvs just ruling out murmurs and odema. Gave dx
as COPD.
4. Obs examination: ROM 6 mins to med std then ctg. Feedback Pass
5. 77/f with c/o itch down below. Feedback Pass
Hx: itching for 2 yrs, consulted GP ( don’t remember the answer )
NO pain/ abd pain, discharge, lump, rash
NO fever, LOW,LOA
Bowel/ Bladder fine
Menopause qs: not on HRT, dryness present, not sexual active, 1 forceps birth, no STI
SADMA: Graves d/s since 30 years.
PEFE: Picture was given
DX: lichen sclerosis
Mx: same as Marwan
6. 60/f presented to ED with c/o Abd pain. Feedback Pass
Hx: since today morning, centralized pain, 8/10 pain, cramping, no radiation fever/vomiting
Only nausea since yesterday, bladder fine, bowel opened yesterday.
LUMP over lt groin since 3 months consulted GP ( here I forgot to ask about the
characteristics of the lump to r/o strangulation like red/hot/ tender/change in color noticed
and also forgot to ask about cough)
No LOW/LOA
SADMA: smoker/HTN
PEFE: features on inguinal hernia
DX/DDX: bowel obstruction due to hernia, constipation trauma, mesenteric ischemia, ca
7. 24/f presented with vomiting, antenatal reports were mentioned, ketones ++. Feedback Pass
Hx: nausea/vomiting since 1 wk ( vomiting normal acc to ccvo)
No fever/rash/abd pain
1st pregnancy, naturally conceived, taking FA, no twin hx, no STI
No discharge or bleeding P/V SADMA normal
Dx: hyperemesis gravidarum
Ix: FBC,BHCG,ESR CRP UCS USG
8. 22/M c/o burning micturition. Feedback Pass
Hx: hurt/sting since 3 days no dripping nocturia poor stream decreased flow or change in
color, no rash,ulcer over private area. DISCHARGE present clear, teaspoon size every morning
n smells. Bowel fine no nausea/vomiting
SEXUAL HISTORY: stable now but had multiple partners in last 6 months, no safe sex,
preferred oral and vaginal route.
NO LOW/LOA NO SX done before
SADMA: smoker
DX/DDX: urethritis bcoz of STI ( mention STIs here), hiv,cmv uti
9. 4 months old BIB mother c/o vomiting. Feedback Pass
Hx: vomiting 2 wks (milk rest CCVO normal) breast fed every 3-4 hrs, burbing well
No fever /rash/lump while feeding, bowel/ bladder normal BINDS NORMAL
Dx: GERD with drawing
Mx as rch guideline
10. k/c/o schizophrenia presented with chest pain. FAIL
hx: chest pain in the middle of the chest since 3 days,8/10 radiating to jaw, squeezing
“those ppl r trying to hurt me” she rerating it. NO palpitation, cough n/v/abd pain, not on
meds in think, smoking, took psych hx but done remember.
Dx: MI
Immediate MX hospital referral
I failed this case bcoz obviously it was case of relapse schizophrenia and immediate mx
would be psychiatric referral.
11. Young male with h/o head to head collision yesterday while playing football. Was admitted in
hospital for 24 hrs observation, Ct head showed concussion , is now about to discharge. You
are an intern. FAIL
Hx: headache present overall 4/10. NO vision problem, n/v, weakness numbness, slurry
speech.
mx. redflags, review with gp
I failed this case: in history in forgot to ask about seizers.
12. Mother of young female who was brought in by police to ED from casino. Mania case all the
details were given mentioning the extra spending and getting angry. She spend 200000
dollars. Feedback Pass
Hx for 3 mins: asked about family hx, SADMA, Sexual Hx.
DX n Mx. Told her abt MHA n CAT n admission n specialist review
RP ask me “ wat about the debt”? I said I don’t know will ask my senior.
13. Ankle pain I failed this case..Hx Dx Ix don’t remember. FAIL
14. 40/f with headache. Feedback Pass
Hx: since 12 moths throbbing 8/10, almost 2-3 times/wk , goes on for 1 hr, pcm mot helping
nsaids helping, H/O PRTS AT HOME AND HAY FEVER SEASONAL. Good support, but trying to
manage work n life, f/h sister has the same complaints
NO trauma, LOA, LOW, Lacrimation, n/v, vision problem, fever rash, facial pain
NO OCP, TL done
DX/DDX: migraine, the entire list oh headache causes.