.OSCE tutorial.

taken from my OSCE tutorial,
I just realized that it was uploaded and due for

submission tomorrow...

alhamdulillah, I managed to answer th

question (copyright)


Case Study
Ms ML, a 21-year-old medical student has been admitted

hospital with a fast pulse and falling blood pressure.

History of presenting complaint
Ms ML tripped and fell at the weekend. Her arm was badly

bruised as she was in pain she purchased some Disprins® in the

corner shop and has been taking 4g per day for the past 5 days.

Past Medical History
Nil of note

Drug History
She takes Mefenamic acid for period pains and occasionally

uses antacids.

Laboratory tests
Hb – 8.4g/dl
Haematocrit (Packed Cell Volume) – 26%
Red Blood Cell (RBC or Erythrocyte count) – 3.1x106 cells/mm3

Diagnosis
GI bleed



p/s side notes, by research

Mefenamic acid
* a group of drugs called nonsteroidal anti-inflammatory
drugs (NSAIDs). Mefenamic acid works by reducing

hormones that cause inflammation and pain in the body.

* relieves pain and reduces inflammation. It is used to treat

headaches, menstrual cramps, muscle aches, dental pain and

athletic injuries

* This medicine can also increase your risk of serious effects on
the stomach or intestines, including bleeding or perforation
(forming of a hole). These conditions can be fatal and

gastrointestinal effects can occur without warning at any time while

you are taking mefenamic acid. Older adults may have an even

greater risk of these serious gastrointestinal side effects.

Antacids
* taken by mouth to relieve heartburn, sour stomach, or acid
indigestion. They work by neutralizing excess stomach acid.

* Some antacid combinations also contain simethicone, which
may relieve the symptoms of excess gas. Antacids alone or in
combination with simethicone may also be used to treat the
symptoms of stomach or duodenal ulcers.

GI bleeding
* can range from microscopic bleeding (th amount of
blood is so small that it can only be detected by laboratory testing)
to massive bleeding (pure blood is passed).

* Prolonged microscopic bleeding can lead to massive loss
of iron, causing anemia. Acute, massive bleeding can lead to
hypovolemia, shock, and even death.