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25-year-old man presents with weakness and numbness of his lower limbs. He just recovered from a recent chest infection. On examination, deep tendon reflexes are absent and sensation is absent. CSF from a lumbar puncture shows a normal cell count and glucose but raised protein level. The most likely diagnosis is?

Answer: guillain barre syndrome (GBS)

Clarify your answer: GBS usually develop after respiratory infection or diarrhea which caused by campylobacter pylori infection.

ORTHOPAEDICS

Scenario 1:

A builder fell from a height of 30ft and landed on his left foot initially before he sat on his bum.

Q1: What would be his likely complaint and where are the likely injured regions?

Q2: What is his likely history of presenting illness?

Q3: What are the likely physical findings?

Scenario 2:

25 year old motorcyclist was referred from Hosp Bt Gajah. He sustained closed # of the right femur, open # of right tibia, # dislocation of the left ankle. He has been resuscitated and stabilized.

Q1: How will u monitor the progress of the patient?

Q2: How will u manage the patient?

Scenario 3:

34 year old man complained of pain in the right leg, after road traffic accident. He was not able to move his right leg, but there was no loss of consciousness.

Q1: What are the likely physical findings? Give reasons to support ur findings.

Q2: What are the likely complications?

Scenario 4:

A 28 year old male, fell on an outstretched hand. Complained of pain in the right elbow, Unable to suppinate, pronate and flex the elbow. On examination, there was slight swelling of the elbow and tenderness of the lateral part of the elbow.

Q1: What are the differential diagnoses?

Q2: What are the clinical features of fracture of the clavicle?

Q3: What are the compartments in the extensor surface?

Q4: What are the compartments in the anterior surface?

Q3: What is the difference between stable and unstable fracture?

Scenario 5:

A 7 year old boy complained of weakness of both limbs, progressively worsening over 2 months duration. He also had back pain and woke up at night.

Q1: What are the possible aetiologies?

Q2: What further history would u like to ask the boy?

Q3: What are the likely physical findings?

Scenario 6:

65 year old rubber tapper presented with bilateral limb pain and crepitus on the joint. Pain got worst over the last one year, and there was no abnormality, deformity of the knee, only knee spur, but no gene varum. He also had intermittent painful episodes on his knee over the last 5 years, each time the pain lasts for about a week or two. He is usually unable to walk during this period of pain.

Q1: What is the likely aetiology?

Q2: If x-ray is taken, what are the likely findings?

Scenario 7:

15 year old boy presented with fever and painful swelling of her left thigh, just proximal to the knee joint. The swelling gradually increased in size over the last 2 months. She has been seen by her GP and was given medications, her fever has subsided but the swelling did not subside. She is still able to walk to the toilet. On examination, there was a diffuse swelling of the left thigh. The swelling was warm, firm and measured about 7x 5cm (more prominent on the medial aspect. There was no sinus, no attached to underlying bone.

Q1: What further history would u like to ask the boy?

Q2. What are the differential diagnoses?

Q3. Describe pathophysiology of each diagnoses.

Q4. How will u manage this boy?

Q5. What investigations will u request for?

----------------------------------------------GOOD LUCK-------------------------------------------------

or psychiatry:

· osce- 1 interactive station, 1 video

· things to concentrate in osce: depression(suicide ), schizo, bipolar, alcohol dependence, dementia, eating disorder, extra pyramidal symptoms, ECT..

· meq & emq- study as much as u can....

· paeds: asthma, nephrotic, thallasemia, muscle dystrophy, cvs prob, broncholitis, fluid management

· ortho: sciatica. falls, colles fracture

· opthalmology: diabetic retinopathy, hypertensive retinopathy,

· rheumato: rheumatoid arthritis, gout, SLE

· infectious: dengue, typhoid

· medicine: stroke, heart block, atrial fibrillation, liver cirrhosis, copd, gullain barre

· surgery: ....???

· O&G: study everything..too hard to predict

MITC: also too hard to predict..... temporal arteritis

- Atrial fibrillation
- Liver function test interpretation
- Hepatic encephalopathy
- decompensated cirrhosis
- Gout
- Ophtal - 1 emq je - primary acute closure glaucoma
- stroke
- localised brain lesion
- thalasemia (paeds)
- ca stomach
- ca breast
- inguinal hernia differentiate with scrotal swelling
- Lower limb CNS examination
- O&G - PIH,GDM, fibroid. - ad byk lagi rsnye.
- Psychiatric - DSM IV - mania,depression, schizo
- anti depressant, anti psychotic (Side effect) Extrapyramidal syndrome
- suicidal assessment

paeds- dr tharam selalu masukkan jenis2 rash..ada banyak gmbr2 rash and identify rash apa..
utk emq-mostly kuar soklan pelik2 drpd buku sunflower..banyak penyakit or syndrome entah hape2 kuar. one of my phase 3 b friend said, bila dah terdesak sgt, tak sanggup nak abiskan buku sunflower tu, pi tgk kat index, cuba usha2 diseases2 yg pelik2 and rare, then, flip through pages tu, baca sket2 utk dptkan superficial knowledge. emq dia tnya soalan2 superficial je.