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Make osce case on dka ,blunt abdominal trauma , secondary sponatous pneumothorax in copd

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OSCE Cases

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Here is a summary of what is inside each station:

Station 1 — Diabetic Ketoacidosis (DKA)

Patient: 19-year-old female, T1DM, 2 days of vomiting, abdominal pain, missed insulin.
  • ABG showing high-anion-gap metabolic acidosis (pH 7.18, HCO₃⁻ 7, AG 25) + ketones 3+ on dipstick
  • 25 marks across: focused history, ABG interpretation, diagnostic criteria, investigations, fluid/insulin/K⁺ management protocol, monitoring, and complications (cerebral oedema, hypokalaemia, aspiration)
  • Viva: why insulin is held until K⁺ >3.5, Kussmaul breathing, the 5 precipitants of DKA

Station 2 — Blunt Abdominal Trauma

Patient: 34-year-old male, high-speed MVA, BP 88/56, left abdominal guarding and seatbelt sign.
  • 25 marks across: ATLS primary survey (ABCDE), haemorrhagic shock classification (Class III), splenic laceration diagnosis + Kehr's sign, FAST examination, emergent laparotomy decision-making, massive transfusion protocol, damage control surgery
  • Viva: why CT is contraindicated in the unstable patient, damage control surgery definition, most commonly injured organ in blunt trauma

Station 3 — Secondary Spontaneous Pneumothorax in COPD

Patient: 67-year-old male, severe COPD (FEV₁ 42%), sudden left chest pain, SpO₂ 82%, absent left breath sounds + hyper-resonance, trachea deviated right.
  • 25 marks across: PSP vs SSP classification, why COPD patients tolerate pneumothorax worse, controlled O₂ targets (88–92%), chest drain indications/safe triangle technique/size (20–28 Fr), CXR interpretation, tube thoracostomy complications, surgical indications (VATS)
  • Viva: why NRB mask is dangerous in COPD, tension vs large simple pneumothorax, PSP vs SSP differences
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