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JCM OSCE. TMH AED Nov 2013. Case 1. M/66 Known HT FU private c/o Chest pain since 1 hour ago BP 133/84 P 65 T 36 Physical exam unremarkable Chest X-ray unremarkable. Name the ECG abnormalities. What are the possible territories involved?. Name the most likely culprit artery.
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JCM OSCE TMH AED Nov 2013
Case 1 • M/66 • Known HT FU private • c/o Chest pain since 1 hour ago • BP 133/84 P 65 T 36 • Physical exam unremarkable • Chest X-ray unremarkable
The patient is in a local hospital where PCI is unavailable. • What is the preferred treatment according to the latest AHA guidelines?
Suppose tenecteplase was given for thrombolysis, however the patient developed VF arrest & cardiogenic shock after ROSC.
Case 2 • M/44 • Known HT • c/o Severe low back pain • BP 192/112 P 67 T 36 SpO2 99% (RA) • CT was performed
This condition belongs to a spectrum of diseases. What is the spectrum called?
Case 3 • F/55 • PH: Ca rectum with total mesorectal excision & ileostomy 1 year ago • Closure of ileostomy 2 weeks ago • c/o Persistent wound pain, swelling, low grade fever
Case 4 • F/47 • PH: Schizophrenia • DO 40 tab amisulpride (800mg/tab) 10 tab ativan (1mg/tab) 1.5 hours ago • BP 81/31 P82 SpO2 100% GCS 14 Pupil 3mm
(a) What is the most important cardiac toxicity of amisulpride overdose?
(b) Name 4 other drug classes causing similar effect as in (a)
(e) How long should an asymptomatic patient with normal ECG be observed?
Case 5 • F/54 • Fall when walking downstairs in bus • c/o R knee pain