Identify the above (COCP)

List 4 noncontraceptive uses(menorrhagia, functional

ovarian cyst, endometrosis, acne, hirsutism, PCOS,
Premenstrual tension syndrome, Menstrual migraine, Diet or
Identify the above instrument exercise induced amenorrhea)
List 5 absolute contraindications to its use.
-Nasogastric tube -Hypersensitivity. Pregnancy, smokers >35yrs, PE, MI, DVT,
Indications for use: stroke, thrombophlebitis, breast cancer, undiagnosed
-cardiopulmonary resuscitation abnormal gynecologic bleeding, marked liver impairment)
-diagnosis of extrapulmonary tuberculosis
-necrotizing enterocolitis A 28 year old woman presented at 38 weeks of gestation with
-feeding LBW vomiting, abdominal pain and jaundice. E & U and LFT were
-decompression in intestinal obstruction. ordered. The results are as shown:
Bilirubin (total) 13mg/dl
ALT-------700
AST-------650
E & U & Cr- normal limit
Protein-------5g/dl
What is your diagnosis
Acute viral hepatitis
-list 3 investigations that can help
Serology, LFT, stool culture, US
-list 4 causes of jaundice in pregnancy
sickle cell disease, malaria, pre-eclampsia/eclampsia, HELLP
syndrome, haemolytic anemia, hyperemesis gravidarum, liver
cirrhosis etc
A B C D
Identify the imagelabelled ABCD?
-Vacutainers or specimen bottle
What is the content of tubes?
A. Plain B. Lithium heparin C. EDTA, D. Fluoride Oxalate What is the above
-What are they used for? diagnosis? VVF
A(blood grouping and cross match) B (LFT, EUC etc) C 4 possible causes
(FBC, ESR), D (Glucose Test) Prolonged labour or
obstructed labour,
12 months old boy with 1 month history of poor appetite, teenage pregnancy,
weight loss, fever and leg swelling. On examination, he was obstetric surgeries,
irritable, has cervical lymphadenopathy, pitting pedal edema. traditional practices
The weight was 6kg (expected is 10kg) (eggishiri cut) cancer,
List 3 differentials? cone biopsy, violent
-septicemia, kwashiorkor, TB, HIV rape, radiation therapy
List 5 investigations 4 investigations to carry out
-blood culture, x-ray, Mantoux test, EUC, HIV test) -indigo carmine dye iv
List 3 important aspects of management -methylene blue test
-nutritional, antibiotics, fluid and electrolyte, anti TB drugs, -cystoscopy
counselling) -vagino-cystoscopy
List 5 investigations -color Doppler US
What is bad news? Any news that adversely and seriously
Hematological report: affects an individual’s view of his or her future.
Blast 16%
WBC markedly increased 98% 6 steps in breaking a bad news in the correct sequence
(SPIKES)
List 4 differentials (AML, ALL, septicemia, malaria) 1. Set the stage (privacy, patient comfort, establish rapport)
2. Patient perception (Tell about what you know…..)
3. Invitation (what would like to know eg everything etc)
4. Knowledge: educate about medical situation
5. Explore and empathize with emotions
6. Summarize the strategy and next steps and decision

What investigations is shown?Barium enema
List the abnormalities shown. Narrowing, dilatation of
proximal segment
What clinical sign is demonstrated? Apple core sign of
colon cancer
What is your diagnosis? Fetal macrosomia
Name three risk factors?Maternal obesity, previous hx of
macrosomic baby, gestational DM, post date pregnancy.
Mention two complications Birth traumas (shoulder
dystocia) respiratory fetal distress, unexplained fetal death,
hypoglycemia, congenital malformations (VSD, neural tube
defect)

What is your diagnosis? Rectal prolapse
What are the types?complete and incomplete
What type is shown above? Complete
Identify this
instrument.Ventouse
Indications for use
maternal exhaustion, prolonged second stage of labour, fetal
distress in the second stage of labour, maternal illness where
prolonged bearing down or pushing efforts will be risky
(cardiac conditions, aneurysm, glaucoma etc

Identify this blood

What is wrong with the above karyotype? group sample.
Trisomy of chromosome 21 The blood groups
Diagnosis? Down syndrome contain antigens and
Modes of inheritance: meiotic nondisjunction, robertsonian antibodies. Antigens
translocation, mosaicism, post fertilization mitosis trigger a response while
antibodies tackle the
trigger i.e. the
Identify the above: antigens(in simple terms
foot ulcer 😀). There are four
Possible causes: recognized blood
diabetes, pressure groups. A, B, AB and
sores, Tb, syphilis, O.
pyogenic ulcers, >A has an A-antigen and also a B antibody.
neuropathic ulcers, >B has B-antigen but A antibody
sickleretc [understand this now, if you give an A blood to a B person,
the A-antigen in blood A will trigger the A-antibodies in B.
Semen Analysis Therefore there will be agglutination and hemolysis.
Volume: 1.5ml >AB has both antigens but no antibodies. This is why AB is a
Count: 10 million/ml universal recipient. There's no antibody in its plasma that will
Motility: 60% progressive cause agglutination.
Morphology: 20% normal form >O has no antigens but contain antibodies to A and B. This is
WBC: 15 hpf why O is universal donor. It can give RBC to other blood
What abnormalities can you notice from the above test? groups since it has no antigen that will trigger a reaction.
>hypospermia (2-5ml) PLS NOTE: Antigens are on the blood cells (RBC)
>oligospermia (> or = 20million/ml) Antibodies are in the plasma. When you transfuse, you're
>teratozoospermia (>30%) giving the RBC not plasma.
> increased WBC (<1million/ml or <10 hpf Answers to above are: A, B, AB, O
A, B, AB,O
 Is this a chronic illness?
A patient with cough for three B. No
months and complains of his
cloth getting excessively wet at Urinalysis
sunrise. Appearance-------------------cloudy
What are your differential Protein-------------------------+
diagnosis?There's visible Leukocyte esterase-----------+
cavitation at the left upper Blood---------------------------+
lobe of the lungs. Therefore Specific gravity----------------1.009
differential diagnosis should Diagnosis: Acute pyelonephritis
be more of causes of lung Abnormalities: Cloudy appearance, mild proteinuria,
cavitations. leukocyte esterase
>TB
>staphylococcal pneumonia Mr. SB 60 year old male is a retiree and a known hypertensive
>aspergillosis was admitted to the hospital. He complained of shortness of
>lung abscess breath for 2 weeks and was worsening on the day of
>bronchogenic cancer admission. Besides, he also experienced orthopnea, fatigue,
>septic emboli paroxysmal nocturnal dyspnea and leg swelling up to his thigh.
What drugs are used for treatment? Rifampicin, Isoniazid, What is the most likely diagnosis? Congestive Cardiac
pyrazinamide, ethambutol, streptomycin Failure (CCF)
List 8 clinical features of this system affection. Cough, List 8 clinical features of the diagnosis:Shortness of breath,
dyspnea, tachypnea, hemoptysis, nasal flaring, stridor, orthopnea, PND, lower extremities edema, jugular venous
wheezing, rales/crepitations, intercostal muscle retraction, distention, weak pulse, S3 gallop, tachycardia, hypotension,
apnea) crackles or ralesetc
List 5 causes of the above
A 54 years old patient presents with diarrhea 5 days. Take a HTN, cardiomyopathies, rheumatic heart diseases, coronary
focused history. artery diseases, congenital diseases, alcohol, thyrotoxicosis,
myocarditis, drugs(doxorubicin) etc
What drugs are used in treatment
What is your Digoxin, diuretics, ACEi, ARBs, nitrates, beta blockers etc
diagnosis?Intestinal
obstruction (multiple air
fluid levels)
List five possible
causes of the above?
B. Dynamic and
adynamic
DYNAMIC
>Intraluminal (fecal
impaction, foreign body,
gall stones, bezoars)
>Intramural (stricture,
malignancy) Identify: dialyzer
>Extramural (adhesions, Indication for use:
hernia, volvulus, Increase in urea of >30 and >10 in a day
intussuception) -Increase in creatinine of >600 and >100 in a day
ADYNAMIC -increase in potassium of >6 and >1 in a day
>Paralytic ileus -decrease in bicarbonate of <10mmol/l
>mesenteric vascular occlusion -uremia encephalopathy
>pseudo obstruction -pulmonary edema
List 4 cardinal sign of the above? -uremic pericarditis
Distended abdomen, Constipation, Pain and vomiting -GFR<15mls
Complications:Infection, hemorrhage, hypotension, muscle
An 18yo male works in a company where lunches are often pains etc
catered. One day, the water at the company facility is not
working, but they manage to have the lunch anyway. 2wks
later, he becomes sick. He develops anorexia, nausea, malaise
and jaundice. During the course of the next 4wks, 7 people
who shared in the lunch become ill with similar symptoms.
After a few wks, each of the 7 people completely recovers and
they replace their caterer.
What is a likely dx?
Acute Hepatitis A infection
What investigations would you do?
>Serology
>liver function test
>stool microscopy
 What is your
What investigation is this? preliminary
CT SCAN diagnosis? Atrial
What is your diagnosis? flutter
Brain tumor
Management
Chemotherapy, radiotherapy or
surgery 5 causes of the above presentation?HTN, coronary artery
disease, and cardiomyopathy,diabetes mellitus, in fact most
heart diseases.
Management:Cardioversion, beta blockers, antiplatelets and
anticoagulants
A 5 year old boy from Kwara state presents with acute chest
pain and breathlessness. He also complains of body pains .
especially on his upper and lower extremities. On examination, Diagnosis? Pneumothorax
there was yellowness of sclera. Predisposing factors:
What is the most likely diagnosis? Acute Chest Syndrome, Trauma, copd, pneumonia,
Sickle cell disease sarcoidosis,
What other clinical features accompany above diagnosis chemotherapeutic agents,
Acute chest syndrome, increased susceptibility to infection, radiation therapy, iatrogenic,
dactilytis, hypersplenism, priapism, leg ulcers etc malignancies etc
How will you manage Management:Immediate
Oxygen, analgesics, exchange blood transfusion decompression with a
needle or insertion of chest
A 27 year old Para 3 with LMP was two months ago presented tube. (2nd intercostal space,
to the clinic with left-sided abdominal pain and blood stains in midclavicular line) Treat underlying cause.
her pants. A transvaginal ultrasound revealed a uterus with
absent gestational sac but pooling of fluid in the rectouterine Quickly assess the visual acuity of this patient who
pouch. complained of inability to watch tv using only the newspaper
What is your preliminary diagnosis? Ectopic pregnancy provided.
Next step in management. Exploratory laparotomy Introduce yourself and establish rapport.
What investigations will you perform?beta HCG, Ask to read headline
ultrasound, CBC, laparoscopic investigation Ask patient to read text (at least 2 sentences)
List drugs used in management. Methotrexate, potassium
chloride, hyperosmolar glucose, prostaglandins This patient complained of dizziness. Take the bp from
the (RT) arm only.
This is a 30 years old man. He smokes 3packs of cigarettes 1. Identifies self and establish rapport
everyday for the past 5 years. Counsel him on the need to quit 2. Picks 12.5cm cuff and wrap round with bladder centred
smoking. over brachial artery.
Greet 3. Estimate approximately SBP using radial pulse and inflate
Ask then deflate slowly.
Tell 4. Repeat step 3 using diaphragm of stethoscope over brachial
Help artery with patient sitting.
Explain 5. Then standing ensuring outstretched arm, heart and
Retell/return sphygmomanometer are all on the same level (eg asking pt to
hold sphygmomanometer)
In this counseling, it's important to ascertain how/when the 6. Neatly puts away instrument and thank patient.
patient first started smoking. Point out the carcinogenic risks
of cigarettes. Talk about health implications. Also do not Counsel this 35 years old man diagnosed with HIV.
forget to ask if he/she has noticed any health problem which Greet
can be linked to the cigarette. Ask why does he need to quit. Ask
Also don't forget to talk about modes of quitting: nicotine Tell
patch, electric cigarettes, support group etc Help
Obtain permission to start the process of quitting. Empathize
Retell

Spot diagnosis; ascites
Common causes: Liver cirrhosis, acute viral hepatitis, budd
chiari syndrome, portal vein thrombosis, right heart failure,
constrictive pericarditis, malignant lymphoma, bacterial
peritonitis etc
Complications: spontaneous bacteria peritonitis, hydrothorax
GERD, respiratory distress, inguinal/umbilical/femoral
hernia, scrotal edema, mesenteric venous thrombosis et
Management: treat underlying disorder, dietary sodium
restriction, diuretics, therapeutic paracentesis, fluid restriction
only if serum sodium <120 mEq/L or symptomatic
hyponatremia.
Counselling:
Teach this teenager with diabetes how to inject 40 units of
mixtard insulin already loaded.
-greet and establish rapport
-injection sites: deltoids, abdomen, thighs, buttocks
-rotate injection sites every 3 months in clean area
-inject into area at 90 or 45 degrees
Question: can I reuse the same needle and syringe?
-yes, but you need to keep it clean and don’t share with any
body.
This 30 year old woman has no child and lost her last
pregnancy at 30 weeks following a high fever. She is now 22
weeks pregnant and anxious about this pregnancy. She is Hiv
positive. Advice her on malaria prevention and address her
concerns.
-Introduce yourself and establish rapport
-confirm pregnancy is > 20 weeks by asking (quickening felt,
LMP)
-enquire about allergy to sulphur drugs eg Sulfadoxine
pyrimethamine.
-Pick SP from drug tray and give 3 tablets as DOTS
-indicate repetition of step above in 4 weeks time
-advice to sleep under treated nets
-keep environment clean eg free of standing water, over grown
grasses etc
-seek care at first sign of fever
-reassure
A 45 years old man complains of increasing tightness of his
shoes and wedding ring, bumping into people and objects
unknowingly.
Diagnosis: Acromegaly
Causes of poor vision: compression of the optic chiasma
Common cardiovascular complication: hypertrophic
cardiomyopathy
Two confirmatory tests; insulin like growth factor 1, GH
suppression test following an oral glucose load.
What’s this condition
called: finger clubbing
Stages:
1. Nail bed fluctuation
2. Loss of angle between nailbed and fold
3. Increased convexity of nail fold
4. Thickened distal phalanx
5. Hypertrophic osteoarthropathy
Lung causes of the above: bronchial ca, lung abscess,
bronchiectasis, emphysema, mesothelioma, fibrosing alveolitis.
Mrs. Uju a 37 years old diabetic primipara, delivered a 4.5 kg
baby. She developed heavy bleeding that required blood
transfusion.
What is your diagnosis? Postpartum haemorrhage
What is the most likely cause? Uterine atony
Mention 3 risk factors: Previous hx, grandmultipara,
prolonged labour, multiparity, chorioamionitis etc
Management: Uterotonic eg oxytocin, ergometrine,
dinoprostone, misoprostol), surgical intervention, haemostatic
drugs (tranexamic acid)
Identify parts labelled A to E (Uterine Fibroid)
A-Subserosal
B-Submucosal
C-Intramural
D-Intracavitary
E- Pedunculated
Mrs. Kehinde is a primigravida presenting for her first
antenatal booking. List at least 10 investigations to be carried
out.
Glucose screen, FBC, bood group, rh factor, hepatitis B,
Rubella, syphilis, urinalysis, pap smear, Retroviral screen, US
to determine the gestational age and EDD.
Ms Adesua is a final year law student at 18 weeks gestation
presenting on the account of vaginal bleeding and abdominal
pain. On examination, her cervix was closed.
-What is your preliminary diagnosis? Threatened abortion
-What is your next step in management? Expectant
management and bed rest
 mcv, increased mch, hypersegmented neutrophils,
methylmalonic acid, increased total bilirubin.
Diagnosis: Nutritional Vitamin B12 deficiency anemia

Identify this pathology:

What is your spot diagnosis?
Placenta previa
What clinical feature
characterize the above
diagnosis? Painless bright red
vaginal bleeding, premature
contraction, fetus maybe in breech.
-5 etiology or predisposing
factors previous hx, multiple
pregnancy, increased maternal age, uterine scare (previous CS),
endometritis, cigarette smoking, assisted conception etc
-management: C-section
hypospadias
How is it classified?
Glanula, corona,
subcorona, distal penile,
mid penile, proximal
penile. Penoscrotal, scrotal,
perineal.
Mention three diagnostic clinical features:
Ventral urethral meatus
Dorsal hoody of the prepuce
Splayed and flattened glans
Absence of meatus at the tip of glans
Median grooved atretic distal urethral plate
Chordee
Bifid scrotum
Two major problems if unrepaired
Problems with copulation
Subfertility due to ejaculatory problems
Urinary tract infections
Psychological problems

This is 34 years old lady who noticed a mass in her breast. Diagnosis: cleft lip and
Take a focused history. palate
Problem associated with
A 40 year old male patient presents with dull, persistent upper the diagnosis: defective
abdominal pain, weakness, weight loss and occasional fever. dentition, sucking problems,
He had one episode of hematemesis. Abdominal examination defective speech, defective
shows an enlarged liver with a mass in the right lobe. Liver smell, frequent upper
function tests show elevation of the transaminases and much respiratory tract infections,
raised alpha-fetoprotein. cosmetically ugly etc
-what is your diagnosis? Hepatocellular carcinoma Treatment option: cleft lip-millard’s operation (rule of 10, at
-mention ten clinical features of this organ affection: 10wks old, 10pounds weight, 10g/dl hb conc.) Cleft palate-
jaundice, spider nevi, gyneacomastia, hepatomegaly, fetor von Langenbeck operation done between 9-12months old.
hepaticus, liver flap, oesophageal varices, altered mental status,
ascites, splenomegaly, caput medusa, easy bruising etc Serology:
-what is the definitive treatment of the above diagnosis? HBsAg--------------positive
Liver transplant. IgM anti-HBc------positive
IgM anti-HDV----positive
Identify: umbilical cord clamp Anti-HCV----------negative
Diagnosis: Acute Hepatitis B with Hepatitis D coinfection
Complications of the above diagnosis: liver cirrhosis,
hepatocellular carcinoma, fulminant hepatitis, death
Treatment options: pegylated interferons, antiviral
(lamivudine, adefovir, tenofovir etc)

Quickly assess the visual acuity of this patient who complained

Wbc 3 x 109/l of inability to watch tv using only the newspaper provided.
Platelets 130 x 109/l
Rbc 2.3 x 1012/l -Introduce self and establish rapport
Hemoglobin 6,1g/dl -Ask patient to read the headline
Hematocrit 18% -Ask patient to read text (at least 2 sentences)
MCV 110fl -Thank patient
MCH 45pg
What investigation is this?
MCHC 34g/dl Mammography
Hypersegmented present Indications: screening, diagnostic
neutrophils mammography to evaluate existing
Reticulocytes 20 x 109/L feature of breast disease, obese patients,
Total bilirubin 1.8mg/dl whenever breast conservation is planned,
Methylmalonic 800 to rule out tumor in the contralateral
acid breast etc
What abnormalities can you note? Decreased wbc,
decreased rbc, low hemoglobin, low hematocrit, increased
What are mammographic findings of a malignancy? -mention two fetal complications: birth trauma, birth asphyxia,
Microcalcification, branching calcification, spiculations, ductal fetal distress, still birth, neonatal hypoglycaemia etc.
distortion, mass effect, loss of symmetry, clustering.
CSF
Identify: Genu varum Appearance Turbid
Causes: physiologic genu Protein 60mg/dl
varum, blounts, rickets, Glucose 30mg/dl
hypophosphatemia, metaphysical
Gram stain +ve
chondrodysplasia, congenital,
degenerative disorders etc RBC Absent
Treatment: observation and use WCC 10 cells/mm3
of bracing (2-5yrs), corrective Most likely diagnosis: Bacterial meningitis
osteotomy Complications of the above diagnosis: Acute (seizures,
SIADH, increased ICP, subdural effusions, focal neurologic
deficits etc) Late (deafness, seizures, motor deficits, mental
retardation etc)
Identify: Genu valgus Treatment: Antibiotic therapy, resuscitation etc
Causes: idiopathic, paget
disease, osteomalacia, rickets,
laxity of ligament, trauma,
muscle weakness etc
Treatment: ignore if <7years,
supracondylar osteotomy, treat
underlying cause etc

Urinalysis
A 70-year-old man complains of poor stream, frequency of Color Yellow
micturition both in the day and at night, hesitancy and Appearance Clear
intermittent stream, a feeling of incomplete emptying and Specific gravity 1.010
terminal haematuria for about 4 months; recently he has had pH 7.0
backache. Clinical examination shows no abnormality. On Blood 3+
rectal examination he has a hard, nodular prostate with Protein 1+
overlying fixed rectal mucosa. Glucose Negative
Diagnosis: Prostate cancer Leukocyte Negative
Clinical features of the above diagnosis: frequent urination, esterase
hesistancy and intermittent stream, hematuria, new onset Nitrite Negative
erectile dysfunction, dysuria, metastatic symptoms eg back RBC 20/hpf
ache. WBC 0/hpf
Investigation: PSA testing, Digital Rectal Examination,
Casts 1/hpf
Transrectal ultrasonography, cystoscopy, Prostate MRI,
What abnormalities are in the test shown? Gross
Biopsy.
hematuria, mild proteinuria.
Most likely diagnosis? Glomerulonephritis (nephritic
syndrome)
A 24 year-old lady with a history of vaginal discharge. Take a
List 5 causes of the above? Infection by streptococcus,
focused history.
membranoproliferative glomerulonephritis, IgA nephropathy,
Henoch-Schonlein purpura, Goodpasture’s syndrome,
A pregnant lady presents to the clinic for her first antenatal
wegener’s granulomatosis.
booking. She is diabetic for 4 years and on oral hypoglycemic
Note: nephrotic syndrome will have a different
drug.
presentation with massive proteinuria
-How would you manage her at booking: Switch her to insulin
-mention two maternal complications that can develop in this
pregnancy: PPH, maternal distress, puerperal sepsis,
obstructed labour etc
 Spot diagnosis: hydrocephalus Identify: Forceps
Causes: congenital aqueductal stenosis, Indication for use: Maternal
Dandy-walker malformation, Arnold- exhaustion, fetal distress
Chiari malformation, post infection eg Pre-requisites before use:
meningitis, neoplasm eg tectal plate F-full dilation
glioma, post traumatic brain injury O-outlet be adequate
Differential diagnosis: R-ruptured membrane
hydranencephaly, porencephalic cyst, C-contraction of uterus
subdural hematoma, hydatid cyst, familial big head. E-engagement of head
Treatment: medical (acetazolamide, furosemide), surgery P-presentation be cephalic
(shunting procedures: ventriculo-peritoneal, Ventriculo- S-surrounding visceral
pleural, ventriculo-atrial, lumboperitoneal) (bladder be empty)
Complications: maternal trauma, facial palsy, maternal
Serology bleeding, fetal skull fracture.
HBsAg------------negative
Anti-HBc---------positive
Anti-HBs---------positive Urinalysis
HAV IgM--------positive Color yellow
Diagnosis: Acute Hepatitis A with resolved hepatitis B Appearance Hazy
infection. Specific gravity 1.030
pH 6.5
Partograph Blood Negative
Ketone 3+
Protein 1+
Glucose 4+
Leukocyte esterase Negative
Nitrite Negative
RBC 0/hpf
WBC 3/hpf
Casts 1/hpf
Probable Diagnosis: Diabetic Ketoacidosis
List all abnormalities: hazy appearance, ketonuria, mild
proteinuria, glucosuria.

Differential diagnosis? Pneumonia,

pulmonary TB, Aspiration, lung
hemorrhage, bronchogenic cancer,
sarcoidosis etc

Clinical features of shown system

disorder: cough, sputum, dyspnea,
tachypnea, wheeze, stridor,
hemoptysis, chest pain, hoarseness,
nasal congestion/flaring etc

Identify: Pleural effusion

Xray sign: meniscus sign
Classification: exudates and
transudate
Lights criteria: (exudate)
1. The ratio of pleural fluid
protein to serum protein is greater than 0.5
2. The ratio of pleural fluid LDH
What are the abnormalities: falling fetal heart rate, blood and and serum LDH is greater than 0.6
meconium in liquor, +2,+3 moulding, nonprogressive cervical 3. Pleural fluid LDH is greater
than 0.6
dilation.
Diagnosis: Obstructed Labour with Fetal Distress
-what is your next step? Cesarean Section
Air-fluid level seen in Lung Abscess
MCV 68fl
MCH 20pg
MCHC 30mg/dl
Iron 6µmol
TIBC 98µmol/l
Transferin saturation 15%
Ferritin 12µmol/l
RDW 20%
Reticulocyte 2.5%
Platelets 200 x 109/l
WBC 10 x 109/l
RBC 2.5 x 1012/l
Preliminary diagnosis: Nutritional Iron deficiency anemia Subdural hematoma Epdidural hematoma
Abnormalities: decreased mcv, low serum iron, low ferritin,
high TIBC, low transferin saturation, decreased rbc.

What does the ecg show? Ventricular tachycardia

What are the possible causes? MI, CAD, valvular heart
diseases, cardiomyopathies, electrolyte imbalance, drug
intoxication eg digoxin, procainamide, cocaine etc
Management: treat underlying cause, direct current
cardioversion, amiodarone, lidocaine etc
What is wrong with this xray film?
Air under the right diaphragm.
(Pneumoperitoneum)
Causes: perforated peptic ulcer,
bowel obstruction,
ruptured diverticulum, penetrating
trauma, ruptured inflammatory bowel
disease (e.g. megacolon), necrotising
enterocolitis, bowel cancer, ischemic
bowel, after laparotomy,
after laparoscopy, breakdown of a surgical anastomosis, bowel
injury after endoscopy, peritoneal dialysis etc
Serology:
HBsAg------------negative
Anti-HBc---------negative
Anti-HBs---------negative
What is your next step in management: Susceptible patient
therefore consider vaccination.
Identify: Pregnant woman
Cutaneous changes that occur in pregnant women:
Chloasma gravidarum, striae gravidarum, lina nigra, skin nevi,
vascular spider, skin tags, pimples, dry abdomen, pigmentation
etc
A 24 years old lady with vagina discharge. Take a focused
history.
A 40 year old woman presents with an anterior neck swelling.
What possible questions can lead to diagnosis?
A 28 year old man presents with right lower abdominal pain.
He first felt pain yesterday which subsided after taking
ibuprofen. What possible questions can aid with your
diagnosis?
This 30 years old man smokes 3 packs of cigarettes every day
for the past 5 years. Counsel him on the need to quit smoking.
Counsel this 45 years old alcoholic male on the need to quit
drinking. Remember to assess the level of addiction with
CAGE:
C-ever felt the need to Cut down on intake
A-ever felt Annoyed by what people say about his addiction
G-ever felt Guilty due this habit
E-Eye opener “takes alcohol first thing in the morning”
Final Note:
First, I wish you the very best of luck. Please practice your
clerkings, counselling and physical examinations. There is no
other way around them except by constant practices.
Multiple Choice Questions and OSCE are equally
IMPORTANT.
Please forgive any typo or incorrect answer(s) encountered (I
do hope there’s none).
Do not forget to PRAY, PRAY And PRAY.
Dr. Abugu Nnadozie Livinus.