OSPE/IOE

OSPE: CXR of 30 years old man with respiratory distress for 4 hours

1. Finding

1. bilateral patchy opacities involving middle and lower zones
2. ET tube, CV line and NG tube in sitQ. 

1. 4 D/D

1. acute pulmonary edema
2. ARDS
3. Bronchopneumonia
4. viral pneumonia 

IOE 

A 79-year-old man presented with disorientation for 2 days.

1. What 4 history will you take from the attendants? •

• Fever/cough, dysuria, skin infection/trauma/ alcohol withdrawal/new medication, diuretics.

2. What are the signs you will immediately look for?

• GCS, pupil, pulse, BP, tempt, RR, skin survey, plantar response, pulse oximetry

3. What investigations will you do?

• CBG, electrolyte, creatinine, ECG, non contrast CT head, CBC with ESR, CRP, Ca, Mg, CXR portable, LFT, TSH, urine RME, urea.

Don’t forget: Metabolic → glucose, Ca, Mg, Albumin

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