SOB with noisy sound

60 years old Malay Lady with history of thyroid carcinoma (undergone surgery to remove the gland two years ago) presented to A&E with shortness of breath and noisy sound for one day duration.

1) Describe the finding in the X-Ray
2) Explain the pathophysiology of the noisy sound
3) Outline the management for this patient

Right lower limb pain after accident

A 39 years old Malay lady was fetch by EMD after involve in motorcycle accident. Patient complaint of pain and unable to move his foot. The picture shows the right lower limb of the patient together with her lower limb x-ray.

1) Explain your findings
2) What is your diagnosis
3) Name one classification used to grade this condition
4) What is complete management for this patient?

SOB after MVA

A 56 years old motorcyclist presented with shortness of breath after alleged collision with car. Physical examination reveals decrease air entry to the left side of chest together with stony dull percussion on middle and lower zone of the lung

1) Give two findings in the above X-ray
2) What is your diagnosis?
2) How are you going to manage this patient

Fingers stuck in bicycle chain

A 6 years old Malay boy presented to A&E department after his fingers stuck into bicycle chain. On arrival, his heart rate is 120 bpm, BP is 100/70 and respiratory rate is 25 breath per minutes

1) Describe the findings in the X ray
2) Comment on his vital sign and give conclusion on his status.
3) Outline your management to this patient


for answer to this question, click [here]

Sudden onset SOB with pleuritic chest pain

a 40 years old Malay man with known case of TB suddenly develop shortness of breath associated with left sided pleuritic sided chest pain

1) Describe the findings in the above X-ray
2) What is the most probable diagnosis?
3) Outline your management to this patient



For answer & discussion to this question please click [here]

progressive shortness of breath for one week duration

A 55 years old Malay man presented to the clinic with the chief complaint of progressive shortness of breath for one week duration. he is a smoker and smoke for about 20 cigarettes per days for 20 years.


he also complained of cough since three years ago with yellowish sputum.


1) What other question you would like to ask and why?
2) What investigation you would like to perform?
3) what is the most probable diagnosis in this patient?


Good luck

fall case

66 years old chinese lady was brought up to ED after alleged fall in the bathroom.

1) state the findings in the above picture
2) what is your possible diagnosis?
3) Outline the management for this patient


Good luck