2005/03/10 QEH

...The short cases are more straightforward than I thought. For CVS my case is VSD and AR. CNS: MG (thymectomy scar and tracheostomy scar, mild proximal weakness). Resp: bronchiectasis. Abd: hepatosplenomegaly ?myeloproliferative/lymphoproliferative disorder. Fundi: bilateral optic atrophy, cushing's disease; Locomotor: ankylosing spondylitis (a patient with one deformed MCP joint, asked on DDx of multiple migratory monoarthritis and then asked to examine the back); Skin: scleroderma; Endocrine: Graves' disease (asked to look at the legs: very severe pre-tibial myoxedema and then to do eye examination). I think the short cases are ok, at least I got the diagnosis at the end with some hints for some of the stations.

For the history taking session, the case is a young patient with newly dx DM, found to have liver function derangement and mild hepatomegaly, plus arthalgia, increased pigmentation, decreased libido. Out of panic (coz I got this as my first station) I forgot to ask the risk factors of hepatitis!!! Might fail in this station, I guess...

For the communication skill station, it was a fairly simple scenario asking you to talk to a patient with RA and fibrosing alveolitis who requests DAMA because she wants to see a homeopathic practitioner.

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