PROFESSIONAL III EXAMINATION MARCH 2016

MEQ1 (MEDICAL BASED)

60yo chinese gentleman with ho hypertension and chronic smoker came with SOB
and leg swelling. BP 180/100mmHg, RR 32bpm, apex beat deviated to left 7th ICS
lateral to midclavicular line, S3 heard, bibasal crept,…

 provisional diagnosis
 2 Investigations to confirm diagnosis and findings
 Causes of decompensated HF in this patient (2m)
 4 Other causes of decompensated HF
 4 Complications of HF
 Outline the management (1m)

MEQ2 (MEDICAL BASED)

3yo boy afebrile, came to ED with seizure lasting more than 15minutes

 immediate management
 history to ask

h/o seizure before, GTC, no developmental prob, no dysmorphism, no family hx,

 Provisional Diagnosis, reason: GTC epilepsy (2m)

 1 Investigation and finding
 Drug for this epilepsy and 2 side effects (2m):
 home management

SEQ1 (MEDICAL BASED)

Discuss the classes of haemorrhagic shock

SEQ2 (MEDICAL BASED)

Differences between BPH and Prostate Ca by symptoms, signs, and investigation

MEQ1 (SURGICAL BASED)

49yo chinese man came with upper abdominal pain with nausea and vomiting. went
back from party last night.

 4 differential diagnosis
 4 Questions to ask in history

chronic alcoholic, pain sharp and radiate to back

 Provisional diagnosis
 Physical examination findings

BP90/60, abdomen slightly distended, mild jaundice, tachycardia, temperature 38.5

 2 important investigation
 Outline principle of management

MEQ2 (SURGICAL BASED)

Primigravida, delivered 4.1kg, soon after delivery, vaginal bleeding with clots

 Provisional Diagnosis
 4 Causes
 Physical examination to confirm diagnosis

soft relaxed uterus, no cervical or vaginal tears, presence of active bleeding with
clots, pale

 Provisional diagnosis
 Management

Hb: 8g/dl, Platelet 150x10^9, PT: normal

 Pharmacological mx (1.5m), Surgical mx (1.5m)

SEQ1 (SURGICAL BASED)

75yo man with non-union of right tibia, history of open fracture 1 year ago due to
MVA

1. Stages of bone healing by callus formation (5m)

2. Define non-union (1m)

3. 4 Causes of non-union in this patient (2)

4. Types of non-union (2)

SEQ2 (SURGICAL BASED)

38yo lady came to ENT clinic due to right facial weakness for 2 days. Was diagnosed
with right facial nerve palsy and bell's palsy. grade 3 of facial nerve palsy.

1. 4 Causes of FNP (2m)

2. Clinical Assessment for this patient (2m)

3. Treatment plan and 2 complications (6m)

MCQ1 (60 QUESTIONS) & MCQ2 (60 QUESTIONS)

OSCE (20 STATIONS)

1. Intraosseous needle

-what

-uses

-2sites of insertion

-2complications

2. study design

-what study design, reason

-advantage 2

-disadvantage 2

-example

3. cervical collar

-what

-indications 3

-steps to apply

4. patient, seizure, csf result given

-interpret 3m

-diagnosis

-3 positive finding on PE

-3 complications
5. laryngeal mirror

-what

-name of procedure perform using this

-4 structures seen using this

-4 indications

6. Partograph

-interpret fetal condition

-interpret maternal condition

-progress of labour

-management, causes

7. 3way foleys catheter

-name

-size: 22fr/ch

-what does the size indicate

-4 indications

-2 complications

8. Case: 38yo gentleman came with hear the audio click

-describe 4m

-diagnosis

-physical examination finding (tactile fremitus, percussion)

- 2 investigation & findings

9. PC: Peak flow meter: instruct bronchial asthma patient on how to use a peak flow
meter and anticipate questions

10. video of gait (parkinsonism)

-what is the gait 3m

-diagnosis 3m

-causes of this gait 4m

11. CXR

-imaging

-describe finding

-differential diagnosis

-other imaging modalities

12. 5yo patient with cyanosis, relieve by squatting, CXR

-2 findings

-diagnosis

- 4 structural abnormalities in this conditions

- 2 complications

13. perform per rectal examination-prostate ca

14. video of knee examination

-name of test: anterior drawers test

-test for what? acl injury

-grading of ligament injury

-other test for this injury

15. HSG

-name

-findings 3m

-2 indications

-2 complications

16. amniohook

-name

-use

-4 requisite

-3complications

17. natural history of disease diagram

-name

-what is the period between exposure and onset of symptoms

-stage for primary intervention

-stage for secondary intervention

-stage for tertiary indication

18. ETT

-name

-size: 8

-3 uses

-3 how to confirm insertion

-2 complications

19. patient came with pain, blurring of vision and mucopurulent discharge of left eye

-diagnosis

-other risk factors from history to ask

-other symptoms

-4tests

20. drug, ampule, fluphenazine decanoate injection BP, prolinate IM

-class of exhibited drug: typical antipsychotic

-MOA

-4 Side effects

-indication drug preferred over oral

-another drug in this group

sorry kalau ada kurang mana2. Ni je yg blh ingat haha. All the best korg semua
utk pro3 exam. SEMOGA BERJAYA!