Another detailed experience
St1:
bronchiectasis with lf lower lobectomy.
Chronic hemolytic anaemia thalassemia with hepatomegaly and evidence of iron overload
St 2: History:
altered bowel habit and abdominal discomfort digonsed by gp as ibs received mebverine and lope amide but no improvement.
Positive is nocturnal symptoms and h/o travel 1 year back to morroco.
Negative alarms and no fh of cancer.
Concern : cause of my symptoms and why not improving?
Examiner questions dd/ investigations.is ibs is possibility?
St3 :
MvR functioning well without complications .
Proximal myopathy for dd mostly backer.
St 4: Communication :
explain diagnosis of CRF present with uremia.pt is 28 years with h/o high blood pressure checked before while his is attending hospital 6 month ago for procedure but not evaluated and not received treatment. Angry pt.
Another details:
Angry patient
HTN with small kindney
The hidden issue , what cause the ESRF ,
May be the HTN ?! young age no risk factor,
Mostly its GN ,
And the renal failure cause the HTN ,
Needs admision
And renal biopsy
Management of hyper K
What the effect of renal failure on his life !?
How mange the dailysis ,
Surrogate asked about other type of treatment for His life , he want the kidney transplant!!!
The surrogate was asking many questions,
He want to tell family ,
i told we can set together and help you
He want to go home ,
involve the consultant , forgot to tell LAMA
The examer and surrogate,
What do you expect the cause in this age ?!
HTN + no family history = I told GN , he agree.
Doctor , last questiontje examiner , ask me , how to support this patient financially ?!
The bell ring , he told me the bell save you ,
St5
BCC 1 :lady with headache and blurring of vision few weeks on Paracetamol only.
Inside pt with acromegallic features with headache of increase icp and can’t see sides of road unfortunately the surrogate was very bad not well prepared .most of candidates and me gave diagnosis of prolactinoma based on loss of cycle since 4 months, milk discharge from breast and problems with intimate relationship .when we asked about wt gain to exclude acromegaly and idiopathic ich she told no wt gain .examiner diagnosis is acromegaly not prolactinoma
BCC2:
was diabetic uncontrolled hba1c 11 and hypertensive with left foot swelling .case was chacot joint and examiner questions was how to investigate and how to treat and importance of cast .