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Osce 01ans

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Osce 01ans

  1. 1. OSCE for VII semester 13-11-2001 <ul><li>The slide will change automatically in 2 minutes </li></ul><ul><li>Each slide carries 4 marks </li></ul><ul><li>Answer to the point </li></ul>
  2. 2. <ul><li>Identify the instrument </li></ul><ul><li>Mention 2 of its uses in the examination of the nose </li></ul><ul><li>Mention 4 causes of white patch on the tonsil </li></ul><ul><ul><ul><li>1+1+ 2 </li></ul></ul></ul>
  3. 3. <ul><li>Tongue depressor </li></ul><ul><li>Uses: cold spatula test for patency of airway </li></ul><ul><li>posterior rhinoscopy to assess posterior part of nasal cavity </li></ul><ul><li>4 causes: vincent’s angina, infectious mononucleosis, diphtheria, agranulocytosis, leukemia, malignancy tonsil. </li></ul>
  4. 4. <ul><li>Which tuning fork will you prefer? </li></ul><ul><li>Give 2 reasons for your preference. </li></ul><ul><li>Name 4 causes of conductive hearing loss. </li></ul><ul><ul><ul><li>-1+1+2 </li></ul></ul></ul>
  5. 5. <ul><li>C 512 </li></ul><ul><li>Reasons: within the speech frequency, less overtone, longer duration. </li></ul><ul><li>4 causes: meatal atresia, otitis externa, otitis media, barotrauma, foreign bodies. </li></ul>
  6. 6. A 4-year-old child presents with hoarseness of 4 months and moderate stridor of 4 days. <ul><li>What is the most probable diagnosis? </li></ul><ul><li>Name 2 investigations you will do to confirm the diagnosis. </li></ul><ul><li>What is THE surgical treatment for the above condition and what is its prognosis. </li></ul>-1+1+2
  7. 7. <ul><li>Juvenile laryngeal papillomatosis </li></ul><ul><li>Flexible/ rigid laryngoscopy </li></ul><ul><li>Microlaryngoscopy and excision for biopsy </li></ul><ul><li>Microlaryngoscopy and excision with microcautery. </li></ul><ul><li>Receurence rate is very high, may regress after puberty </li></ul>
  8. 8. A 5-year-old child presents with chronic nasal obstruction, mouth breathing & snoring and bilateral recurrent ear aches. <ul><li>What is your most probable diagnosis? </li></ul><ul><li>Name 2 investigations which will help you confirm the diagnosis. </li></ul><ul><li>What is THE surgical treatment? </li></ul><ul><ul><ul><li>1+2+1 </li></ul></ul></ul>
  9. 9. <ul><li>Adenoiditis </li></ul><ul><li>Nasal endoscopy, plain x ray lateral view of the neck- soft tissue exposure </li></ul><ul><li>adenoidectomy </li></ul>
  10. 10. A 36-year-old male presents with watery rhinorrhoea, sneezing spells and hyposmia since 2 years. Nasal endoscopy shows the following picture. <ul><li>What is your diagnosis? </li></ul><ul><li>Name 4 differences between nasal polyp and turbinate. </li></ul><ul><li>Name 2 drugs that may relieve the patients symptoms. </li></ul><ul><ul><ul><li>1+2+1 </li></ul></ul></ul>
  11. 11. <ul><li>Nasal poly( ethmoidal) </li></ul><ul><li>Nasal polyp: insensitive to touch, pale in colour, soft, probe test positive </li></ul><ul><li>Turbinate: may bleed to touch, reddish in colour, firm, probe test negative. </li></ul><ul><li>Drugs: sodium cromoglycate, loratidine </li></ul>
  12. 12. A 55-year-old male presents with a right sided hard painless neck swelling of 3 months duration associated with right sided tinnitus. <ul><li>What is the most probable diagnosis? </li></ul><ul><li>Name 2 appropriate investigations to confirm the diagnosis. </li></ul><ul><li>What is THE treatment of choice? </li></ul><ul><ul><ul><li>1+2+1 </li></ul></ul></ul>
  13. 13. <ul><li>NPC </li></ul><ul><li>Nasal endoscopy, FNAC </li></ul><ul><li>Chemoradiotherapy. </li></ul><ul><li>6500 rads, 250 per day 5 days a week for 5 weeks. Cisplatin 5 fluorocil </li></ul>
  14. 14. A 25-year-old patient presents with (R) ear discharge of 3 years duration and severe headache, neck rigidity and vomiting of 4 days duration. Otoscopy showed the following findings. <ul><li>What is the probable diagnosis? </li></ul><ul><li>Give 2 appropriate investigations to confirm your diagnosis. </li></ul><ul><li>Name 2 types of brain abscess. </li></ul><ul><ul><li>1+2+1 </li></ul></ul>
  15. 15. <ul><li>CSOM, atticoantral type </li></ul><ul><li>Examination under microscope, x ray lateral view of mastoid </li></ul><ul><li>Temporal lobe, cerebellar </li></ul>
  16. 16. <ul><li>Name the type of nasal packing. </li></ul><ul><li>Name 2 important causes of epistaxis in elderly patients. </li></ul><ul><li>Name the 4 arteries that form the Kesselback’s plexus. </li></ul><ul><ul><ul><li>1+1+2 </li></ul></ul></ul>
  17. 17. <ul><li>Anterior nasal packing </li></ul><ul><li>Hypertension, accident, CCF </li></ul><ul><li>Septal branches of : anterior ethmoid, sphenopalatine, superior labial, greater palatine </li></ul>
  18. 18. A 13-year-old boy presents with acute right sided facial pain, purulent nasal discharge and fever of 3 days duration. His X-ray is shown below. <ul><li>Identify the radiograph and its view. </li></ul><ul><li>What is the finding? </li></ul><ul><li>How will you treat this case if refractory to medical treatment. </li></ul><ul><ul><ul><li>2+1+1 </li></ul></ul></ul>
  19. 19. <ul><li>Plain x ray, occipito metal view </li></ul><ul><li>Opacity in the right maxillary sinus </li></ul><ul><li>Surgical drainage- antral washout </li></ul>
  20. 20. <ul><li>Mention 2 findings in this pure tone audiogram. </li></ul><ul><li>What is the type of hearing loss? </li></ul><ul><li>Pure tone audiometry is both qualitative and quantitative test (Mention True/false). </li></ul><ul><ul><ul><li>2+1+1 </li></ul></ul></ul>
  21. 21. <ul><li>Air bone gap, both air conduction n bone conduction threshold are raised </li></ul><ul><li>Sensorineural hearing loss </li></ul><ul><li>true </li></ul>
  22. 22. Thank you Please proceed for the clinical examination in the hospital

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