5 stations (with real patient)
1. Squamous cell carcinoma
-skin lesion on forehead, give :
Differential diagnosis
Most likely diagnosis
Risk factor
I was asked to palpate the lymph nodes as well. Quite a heartbreak to see this old guy actually :( I think I gave the diagnosis OK but the examiner was quite ermm..strict? Didn't smile at all.
2. Jaundice
-yellow skin and sclera
-what is the cause?
-causes of liver disease
-possible problem with dental treatment
I finished this station quite early and had a chance to chat with the patient. He's very nice!
3.Acromegaly
-describe the man (large hands, coarse facial features, separated teeth)
-cause of the condition, treatment of the condition (medically, surgically, radiotherapy)
-possible medical complications
The examiner was super nice. Had a chance to chit chat with her about why there are a lot of Malaysian students bla bla bla..Pokcik patient ni pun baikk sangat. Cumels je. I always imagine org yg acromegaly ni cam tinggi besar. Eh ke sebab dia duduk? huhu..
4.Facial palsy/stroke
-the examiner did the cranial examination for me. I was asked about the condition.
Basically I suck in this station so I won't elaborate more coz it will cause more heartache. HAHA
5.Parotid gl inflammation
-the patient went out to the loo so I was cut short of 2 mins. the examiner asked me about facial nerve examination sigh sigh sighhhh
-palpate lymph nodes, describe
-palpate parotid gland, describe the swelling
-cause of parotid gland inflammation
I messed up this station too. Hwahwahwa..
During the transition between my 1st and 2nd station, we had like 10 minutes break because the patients needed toilet break, nappy change and kena betulkan position because some of them are immobile. Duduklah melangut kat luar gagaga..
Data Interpretation
1. Picture of a guy with moonface, acne. Patient had ulcerative collitis and underwent a long term course of treatment bla bla bla.
a) Describe the appearance
b) Give 6 Adverse effects of chronic course of therapy (long term steroid I supposed?)
c) Supposed the guy needs to go for surgery, what should you recommend about his medication regime?
2.69 y o, Female,on warfarin mitral valve replacement after rheumatic heart failure. INR record is 3.3 2 days earlier. Went to dental surgery for extraction of 2 teeth.
a)What is inr, what does it indicates?
b)If warfarin was stopped acutely, what are the likely effects?
c)Patient returned because of post extraction infection.Metronidazole and amoxycillin was prescribed.2 days later she went to GP because of nose bleeding, INR is 8. Why?
3. Picture of the Lesion at the side of tongue
a) Give Differential diagnosis
b) What should you check
c)Appropriate investigations
d)Oral complication of treatment (wasn't quite sure what they want with this question)
4.Pt with squamous cell carcinoma proven by 3x3 biopsy is going to surgery. SCC is at buccal mucosa of left cheek. Pt is 50 y o, smokes 20/day, drinks alcohol 40 unit/ week
a) Why kind of perioperative investigations would you undertake, give reasons
b)
c) Possible post op complication, give reason
d)How nutrition should be managed post operatively
5. Pt is Type 1 diabetes mellitus. Molar is abscessed and doesn't resolve with antibiotics. She is scheduled for incision and drainage which to be done at local dental surgery with local anaesthesia.
a) Something like giving comment on : the Need of fasting. Pre op insulin regime. How to schedule treatment
b) The surgery was 90minutes late, pt appear sweaty, agitated and something2 tak ingat. What is the differential diagnosis, most likely diagnosis be given first?
c) Glucose capillary test done, result of the glucose is 2.0mmol/L. How to manage?
Sent from my BlackBerry® wireless handheld