OSPE 1

A 72 year old man presents from a nursing home with 4 days of increasing confusion. His
GP letter notes that he has a history of dementia, hypertension and ischaemic heart
disease. The following laboratory results were obtained on his arrival in the emergency
department.

(a) His Glasgow Coma scale is 13(E3, M6, V4). What is meant by V4 and E3?
E3
V4
(b) Interpret the laboratory results shown above.
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(c) State FIVE additional history that you would like to elicit from the family
members.
1. ________________________________________________________________
2. ________________________________________________________________
3. ________________________________________________________________
4. ________________________________________________________________
5. ________________________________________________________________
(d) Enumerate FOUR physical examination findings with justification that help you
narrow your diagnosis.
1. ________________________________________________________________
2. ________________________________________________________________
3. ________________________________________________________________
4. ________________________________________________________________
(e) Name TWO investigations
1. ________________________________________________________________
2. ________________________________________________________________
OSPE 2
Shown below is a kidney-ureter-bladder film demonstrates abdominal distention, hepatic
portal venous gas (arrow), and a bubbly appearance of pneumatosis intestinalis
(arrowhead; right lower quadrant).

(a) Based on the film shown above, what is the most likely diagnosis?
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(b) Which of the above findings is associated with poor prognosis?
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(c) Name two (3) risk factors.
1. _______________________________________________________________
2. _______________________________________________________________
3. _______________________________________________________________
(d) Discuss the principles of management.
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(e) State two (2) prevention strategies.
1. ________________________________________________________________
2. ________________________________________________________________