~~Clinical Exam Case~~

Just finished my Clinical examination: Paediatric case

Long Case : 4 yers old malay boy with

1) Cerebral palsy with Left sided dyskinesia due to kernicterus?

2) Right Hemiplegia due to subdural hemorrhage (at 10months age)

3) Global developmental Delay

4) Epilepsy (at 1 year)

-has multiple hospital admission due to recurrent chest infection, AGE & seizure

-Achillis tendon release R limb due to contracture

O/E

-Scar for Left subdural hemorrhage (bentuk ladam kuda)

-Patient has Rt UMN lesion of UL & LL

-Choreoathetoid movement of Lt UL & LL

-Drolling saliva at Rt side

-Gait hemiplegic? (xtaula..pelik sgt gait die)

-Developmental-about (9month-1 year) of age

-He is making incomprehensive sound (tak bleh cakap lagi)

Discussion:

What do you think the age of the patient now?

Why he had hemiplegia?

What is your diagnosis?

How u investigate?

How you want 2 differentiate between non-accidental injury? (seyes xbaca lgsung bab ni) - i ans look for other injury such as abdominal injury,MSK & other scar

What specifically in eyes finding for (NAI)?

how about brain finding in (NAI)?

Since he cannot talk, how he communicate with his mother?

How do you manage this patient?

What is the affect of this disease to the family member?

Is it affect his dad carrier?

he still cannot talk,is he underwent speech therapy? how many time?

Any special shoes finding in patient with hemiplegic gait?

wakaka...semua soalan basically about psycosocial issue...

So, kenela ask about psycosocial....

Terus rasa cam blur jer pas habis exam....uhukuhuk

Choreoathetoid CP + Rt sided Hemiplegic due to Subdural hemorrhage

Short cases

1) Medicine- Mitral regurgitation, loud P2 (Chronic Rh heart diease)

2) O&G - Multiple pregnancy

3) Surgery - Bilateral Direct Hernia

~Finished theory, Welcome Clinical Exam~

I've just finished 3 consecutive days of theory exam paper

Tuesday (20th April 2010) - Paper MEQ

Get Stroke case for medicine, Urinary stone for surgery, febrile convulsion for paediatric and postpartum hemorrhage for O&G...Sounds like easy, but because it soo easy until i cannot even answer the simple thing.. Im too focusing on the hard topic like cancer, obstructive jaundice, multiple sclerosis, GBS, bla bla bla.....

(tula..lain kali jangan target2..baca je semua.. kan dah susah bila soalan lain yg kuar..jadi blurr..)

Wednesday (21th April 2010) - Paper MCQ&PBQ

Most of the questions are quite tricky and only some of it straight forward..huhu

Medical based Q- Not enough time...waaa~~ Because most of medicine questions are in scenario form & takes time for reading also...

Surgical based Q- Boleh la.. this paper had extra left time (sempat check2 lagi tu chewahh).. but a lot of gambling too~~~ Surgical based questions ask lots about the epidemiology...mane ingat maa.. especially orthopaedic questions..huhu

Ya Allah...berikanlah kami petunjuk....

Debaran di dalam dewam peperiksaan

Thursday (22th April 2010) - OSCE

We had 5 OSCE sessions, held in our new faculty building, and it was well conducted & the quarantine room is also comfortable...

1) Radiology Chest Xray- Multiple fracture

2) Surgery- Chest tube

3) Anatomy- Lower limb specimen (common peroneal nerve)

4) Microbiology under microscopy- Cryptococcus neoformans

5) Histopathology - Colon cancer

Berehat sekejap di depan library selepas habis exam

Post exam syndrome- .... migraine + blurr + terpikir2...huhu

Ok..Enough thinking about the past!! no need to think bout it.. Coz nothing can even change my answers..huh..

Now, i have to focus on the upcoming exam which are the most threatened and feared..

~~~Clinical Examination~~~

Hopefully i get a case that i familiar about...and i hope to get more benign examiner...

(Ya Allah, berikanlah aku kelapangan, pemudahkanlah urusan ku Ya Allah....)

Good Luck kawan2 merangkumi Housemate saya..

Dari kiri Kak der, kayyu, chettie, atefina, tiey & adlin

Terima kasih atas segala ilmu yang korang berikan, halal kan makan minum & maafkan salah dan silap ye..

Tak lupa juga kepada Encik Khalis kerana telah banyak membantu saya sepanjang jadi medical student kat Uitm ni, halal kan makan minum & salah silap kita yer...... Saya sayang awak...

(Happy aniversry 2 yer 7 month kita musim examla..hehe..bz exam kan)

"We are no more a student but not yet a doctor"

We have 2 Fight to get the tittle as a doctor...Perjuangan masih belum selesai...

Semoga kita berjaya mencapai apa yang kita usahakan selama ni