12-14-2008, 05:58 PM
Dear Friends;
Whoever took exam and posted his/her cases here, I used to copy and paste and save. As per zain request, I am posting here as it is. best regards,
rocky
Hi guys, I gave my step 3 ccs today.(110608)
Here are the cases
new onset DM
depression
acute intestinal obstruction
meningitis
ADPKD with hyperkalemia
JRA
DCM in CHF
ca colon
My friend gave yesterday. His cases are
depression
acute intest obstruction
ADPKD with hyperkalemia
DCM in CHF
DUB
DKA
TCA poisoning
SLE
Hypertension with aortic stenosis and exertional angina
DKA(111108) (Atah, cases ended very early and he got 99 on120708)
Stable angina
depression
Diabetes Mellitus
Chronic renal failure
Meningitis
Elderly Pregnancy
acute intestinal obstruction
Dilated cardiomyopathy
1)My first case DCM ended once i admitted, treatd with antifailure measures, ran a few tests to find etiology, got the echo and cardia consult- 8 mins
2) A case of neonatal sepsis/memingitis ended after i stabilized baby, sent cultures, did LP and gave antibiotics and baby improved and started feeding, 9 mins
3)DKA- once i diagnosed it, started fluids, Insulin, monitoing ABG, Glucometer, Ketones, sent cultures, started antibiotics, sugar levels falling- 10 mins.
4)CKD- Stabilized, gave ca gluconate, dextrose insulin, salbutamol nebu, nahco3, I?o chart, diuretics, oral calcium, called over nephrology, he was to be shifted for Dialyysis, it ended. 6 mins!
5)Intestinal obstruction- Diagnosed, stabilized, got surgical consult, prepped for surgery, ended- 8 mins
So you get the genearal idea right? Most cases i felt i was on the right track but before i could shift the patient or anything the 5 min screen would pop up! Dunno what that means
DKA (111208) drdave104, cases ended very early and he got 82 on 120708)
Cystitis And Pregnancy
Duodenal Atresia Newborn
Hep A
Osteoporosis
Splenic Hematoma (same as UW case)
MRSA Post Op Line Infection
Maniac Episod
TURP (111408)
AAA
(111808)
1. My first case is endometrial ca..I could not give orders like consult oncology, ct scan abdomen and pelvis but I got the write diagnosis and counselling for the patient did biopsy, order surgery consult for BSO TAH...
2. My second case is Psychiatry case and He is agitated, stressed out, having aggressive sex and saying that he is the president and he has sleepless nights and his urine toxicology is negative, BAC is nil ..I just gave IV lorazepam he did not improve and then I have given I V haloperidol and psychiatry consultation..He improved and I made the diagnosis as Acute mania.
3 rd case was a patient with chest pain and rales all over the lungs..EKG showed AWMI ..so given aspirin, morphine, NTG and IV lasix..ordered thrombolysis with STK ....did ekg, cxr negative for dissection, consult cardiology, given B blocker, scheduled for angiography and stent..But he did not improve at all has S3 and s4 on auscultation...could not write the
Osler-Weber-Rendu...or hereditary hemorragic telangectasia ??????
4th case is L antecubital fossa erythema after removal of IV line on day 3 as he was hospitalized to be treated for duodenal Ulcer..I have taken x ray, blood cultures, CBC, BMP, UA..he has fever..so given nafcillin, tylenol..his fever did not come down nor the infection or leckocytosis on CBC..so i D/C nafcillin started ceftriaxone and vancomycin but no use at all...
5. Nephrotic syndrome---I have done all the investigations and then I ordered IV albumin and oral prednisone and ordered him to come back after 1 week and the case ended..I have made the diagnosis and given all orders
6. MVA spleenic laceration I did well
7. DKA I did well
8. He is anemic and has facial telangiectasias 45 yr old male ...all work up is negative and I did iron studies, copper studies and Autoimmune hepatitis studies to rule out live failure but all are normal...I transfused 2 units of blood and write the diagnosis as anemia But could not find the reason for blood loss as FOBT is negative and UGI endo is negative USG normal..
9. 8 months of diarhhea...stool gram stain showed gram negative bacilli and gram positive cocci but sigmoidoscopy and fobt are negative and no other symptoms so I put him on ofloxacin and metronidazole and his diarrhea improved ..so I put the diagnosis as gastroenteritis
Acute manic disorder 111808
UTI with 12 week prenancy
chid abuse
osteoporosis with compression fracture
acute diarrhea
HNT with adrenal mass
DKA
MI
Acute hepatitis (5 visits q3days)
Prostrate carcinoma 111908
hyperosmolar nonketotic coma
domestic abuse
16 month child with fever
patient with high blood pressure, sliglty eleveated ldl on 1st visit
teenager with high risk sexual behavior found to be pregnant
multiple sclerosis
duodenal ulcer
DUB
111908
pleural effusion( SLE)
-colon cancer
-infant meningitis
-pregnancy(45 y old)
-IV abuser with bacteraemia and pneumonia.
-DM newly diagnosed
-3 y old with arthritis( could not figuer the diagnosis)
-hypertension.
1. child with Fe def anemia 112008
2. 2. in patient post op ccf
3. 3. newly diagnosed dm with hypercholestrolemia
4. 4. HUS
5. 5. uterine fibroids(easy case but i screwed it up)
6. 6. Polymyalgia rheumatica
7. 7. anaphlylatic shock
8. 8. Hepatic encephalopathy
9. 9. Torsion of ovary
112308
- Know your cardio drugs, what their functions are, how they differ... this too was on my exam and unfort I blanked out on some of that info.
- Know your psych drugs, i.e. typical vs atypical antipsycotics.
bacterial endocarditis,
DKA,
pregnant 43 y/o female,
HTN management in office,
small bowel obstruction,
sinus infection that also presented with asthma (office pt, gave him neb tx first and sent him home with antibiotic - amox),
a-fib,
aortic dissection,
unconscious female with possible drug overdose/suicide attempt,
new onset dementia.
112508
DM
Hypoglycemia
cough and hemoptysis in a COPD .. Afebrile patient 36 C .. I dont know what was the problem/ seems idiopathic
child abuse
intussusception
hip fracture
UTI
pregnany
hyponatremia following TRUS
112608
GERD ,
TURP ,
Preemployment review ,
Breast Ca ,
Colon Ca ,
MI ,
TIA
Aortic dissection (masked and tough case)
120208
Most of the questions were..very straight forward....
Only ER questions were long...I was almost out of time in those blocks.
I found same questions in different wordings..2 times....it was about vaginal discharge (Bacterial vaginosis)...both about treatment..
6 Dermatology slides”
Contact Dermatitis ( Hospital employee wearing gloves)
Scabies
Rosacea
Herpes of Vagina
Diaper Rash
pityriasis rosea
I will try to post more....feeling very tired now...
120308
70 yrs lady with vaginal bleeding...office..endometrial hyperplasia...couldn't finished ...i forgot the treatment
Spleeninc Laceration---completed
DKA---couldn't write final diagnosis...
Folic Acid deficiency Anemia due to Alcohol abuse..
Acute Mania...couldn't send the patient home--
Nephrotic Syndrome--completed
A young man with 2 months of diarrhea---FOBT positive...completed
Acute Anterior MI...completed
Septicemia---from IV line after Hospitalization for hematemesis
120408
1. Presentation as fatigue, mild depression and constipation which turned out to be Hyperparathyroidism with Nephrolithiasis - quite confusing.
2. Office visit for management of borderline hypertension, DM type 2 and hypercholesterolemia.
3. Incomplete abortion with heavy bleeding and ?acute PID.
4. Sickle cell child with pain abdomen which turned out to be cholelithiasis.
5. 6 day old baby with jaundice and ?viral meningitis. Could not tell, am still confused...
6. TIA with Atrial Fibrillation
7. Small bowel obstruction - straightforward
8. Post-menopausal bleeding which was due to endometrial hyperplasia without atypia - I also messed up this as I was confused as to what to do.
9. Post-op atelectasis.
120508
1. Intussception in child
2. Non hodgkin lymphoma HIV patient
3. Fracture pelvis
4. Bacterial meningitis in young man
5. Physical child abuse
6. HELLP syndrome
7. Panic disorder In young female
8. Obesity in 16 years old african american boy
9. Diverticulitis
120608
1. Presentation as fatigue, mild depression and constipation which turned out to be Hyperparathyroidism with Nephrolithiasis - quite confusing.
2. Office visit for management of borderline hypertension, DM type 2 and hypercholesterolemia.
3. Incomplete abortion with heavy bleeding and ?acute PID.
4. Sickle cell child with pain abdomen which turned out to be cholelithiasis.
5. 6 day old baby with jaundice and ?viral meningitis. Could not tell, am still confused...
6. TIA with Atrial Fibrillation
7. Small bowel obstruction - straightforward
8. Post-menopausal bleeding which was due to endometrial hyperplasia without atypia - I also messed up this as I was confused as to what to do.
9. Post-op atelectasis.
121108:
1. Anaphylaxis
2. AAA rupture with back pain
3. Alzheimers dementia
4. Old lady UTI/ Sepsis
5. peptic ulcer from nsaids
6. Acute MI
7. DKA
8.Woman with multiple sex partners, HIV +ve first work up
9. Polymyalgia rheumatica
121208
1-Domestic abuse
2-child with OM
3-Cholecystitis
4-Teenager with pregnancy
5-Patient with traumatic rib fracture: Did not get better until I ordered Nerve block
6-TSS...do not forget Tempon Removal
7-PUD...needed endoscopy and test for H.pylori and triple therapy for 14 days
8-PID...
9-I cannot remember the last one
121208
Menorrhagia leading to iron deficiency anemia,
22 month child with irritibility,
Diabetic nephropathy and retinopathy,
Hypersensitive reaction,
polymyalgia rheumatica,
rectal bleeding in child, CHF,
right adenexal mass,
hepatic encephalopathy