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OSCE answers (Part two)

A collection of 22 clinical cases covering various conditions in gastroenterology and hematology, including gouty arthritis, infective endocarditis, spherocytosis, hairy cell leukemia, megaloblastic anemia, gastric outlet obstruction, and more.

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OSCE answers (Part two)

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  1. OSCEanswers(Part two) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences

  2. Case 12 • Attention to the monosodium urate crystal on polarized light microscopy and the tophus. The correct diagnosis is gouty arthritis • Intraarticular steroid is already considered the best treatment in gouty knee monoarthritis.

  3. Case 13 • Attention to the Subungueal splinter hemorrhage and Janeway lesions (non-tender, small erythematous or haemorrhagic macular or nodular lesions on the palms or soles only a few millimeters in diameter) . The correct diagnosis is infective endocarditis. • Intravenous antibiotic is the best treatment .

  4. Case 14 • Attention to the Spherocytes. The correct diagnosis is Spherocytosis . • Folate supplement is recommended in this case with mild anemia.

  5. Case 15 • Attention to the hairy cell. The correct diagnosis is Hairy cell leukemia. • Bone marrow transplant is the best treatment option.

  6. Case 16 • Attention to the hypersegmented neutrophil . The correct diagnosis is megaloblastic anemia. • B12 supplement is the best treatment option. • Shilling test might help in defining the etiology.

  7. Case 17 • The diagnosis is fecal impaction.

  8. Case 18 • Attention to the food material in stomach and empty duodenum. The correct diagnosis is gastric outlet obstruction.

  9. Case 19 • Acute viral hepatitis does not match with the patient diagnosis. • In acute viral hepatitis the ichterus appears when the fever is decreased.

  10. Case 20 • Diagnostic paracentesis should be considered for the diagnosis of ascitis etiology. • Shock liver do not match the patient diagnosis according to history.

  11. Case 21 • The patient is a case of severe preeclampsia. Termination of pregnancy is the best treatment strategy.

  12. Case 22 • Considering the increased gamma globulin level, autoimmune hepatitis is the best diagnosis. • Steroid is the best treatment in this patient.

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