OSCE

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OSCE

• Raika Jamali M.D.
• Gastroenterologist and hepatologist
• Sina hospital
• Tehran University of Medical Sciences

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Case 35

• A kidney transplant patient with chronic
  diarrhea. You see the duodenal biopsy.

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• What is the diagnosis?
• Giardiasis
• Sterongiloidosis
• Tuberculoma
• Sarcoidosis
• What is the treatment?
• Metronidazole
• Ivermectin
• Steroid
• Praziquantel

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Case 36

• An old man with RUQ pain and elevated liver
  enzyme.
• You see the splenoportography.

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• What is the diagnosis?
• Hepatic vein trombosis
• Portal vein trombosis
• splenic vein trombosis
• IVC trombosis
• What is the treatment?
• Anticoagulation
• IVC basket
• Angioplasty
• Surgical repair

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Case 37

• Young woman with OCP use presented with acute
  severe abdominal pain and tense ascitis.
• You see the hepatic angiography.

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• What is the diagnosis?
• Hepatic vein trombosis
• Portal vein trombosis
• splenic vein trombosis
• IVC trombosis
• What is the treatment?
• Anticoagulation
• IVC basket
• Angioplasty
• Surgical repair

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Case 38

• An old man with history of CCU admission
  presented with severe abdominal pain.

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• What is the diagnosis?
• Acute mesenteric ischemia
• Portal vein trombosis
• Non obstructive mesenteric ischemia
• IVC trombosis
• What is the best initial treatment?
• Anticoagulation
• IVC basket
• Angioplasty
• Surgical repair

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Case 39

• A young woman with abdominal pain and skin rash.

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• What is the diagnosis?
• Vasculitis of mesenteric arteries
• Non obstructive mesenteric ischemia
• Thromboemboli in mesenteric arteries
• What is the best initial treatment?
• Anticoagulation
• Steroid plus anticoagulation
• Angioplasty
• Surgical repair

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Case 40

• A young girl with severe abdominal pain.

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• What is the diagnosis?
• Vasculitis of mesenteric arteries
• Non obstructive mesenteric ischemia
• Thrombosis in mesenteric arteries
• What is the best initial treatment?
• Anticoagulation
• Steroid plus anticoagulation
• Angioplasty
• Surgical repair

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Case 41

• A YOUG BOY WITH SEVERE ABDOMINAL PAIN, VOMITING
  AND HYPERTENSION.

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• What is the diagnosis?
• Vasculitis of mesenteric arteries
• Non obstructive mesenteric ischemia
• Thrombosis in mesenteric arteries
• What is the best initial treatment?
• Anticoagulation
• Steroid plus anticoagulation
• Angioplasty
• Surgical repair

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Case 42

• An old woman with fatigue and fever from 4 weeks
  ago. A systolic murmur in LSB is heard.

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• What is the diagnosis?
• Left atrial myxoma
• Infective endocarditis
• Vasculitis of coronary arteries
• What is the best initial treatment?
• Anticoagulation
• Steroid plus anticoagulation
• Antibiotic therapy
• Surgical repair

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Case 43

• A young kidney transplant with odynophagia.

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• What is not the diagnosis?
• CMV esophagitis
• Candidiasis
• Pill induced esophagitis
• Herpes esophagitis

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Case 44

• A man with chronic abdominal pain, diarrhea,
  rectal bleeding and severe anal pain for last one
  year.

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• What is your diagnosis?
• Anal fissure
• Perianal abcess
• Anal fistula
• What is the best initial therapeutic strategy?
• Metronidazole and ciprofloxacin
• Infliximab
• Steroid and azathioprine

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Case 45A middle age man with intermitant
episodes of dysphagia. No weight loss.
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• What is your diagnosis?
• GERD esophagitis
• Pill induced esophagitis
• Eosinophilic esophagitis

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Case 46

• An old man presented with dyspnea and RUQ pain.
• Physical examination revealed
• Distension of the jugular vein,
• Spider nevi,
• Bilateral leg edema
• Tenderness in RUQ
• Span of liver 16 cm.

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• What is your diagnosis?
• Constrictive pericarditis
• Pericardial tamponade
• Hydatid cyst
• What is the best initial therapeutic strategy?
• Pericardiectomy
• Antibiotic therapy
• Steroid and azathioprine