Tuesday, March 24, 2009

bersama Dr. Fuad

Cth soalan :

7 year old girl was admitted for history of recurrent low grade fever, loss of appetite and loss of weight with a persistent nocturnal cough of 3 months duration.

a.Ask 3 relevant question and state the reason to arrive to a diagnosis.

Dr cakap kalau soalan mcm ni kita jwb berdasarkan apa d/d yg ada dlm kepala kita. Walaupun x diminta d/d, we should have a few list of them in our mind.

- Cara jwb can either be in point form or in form of a question. Contohnya:
Point : Hemoptysis
Question : Do you have hemoptysis?

- Kalau bole kita tnya symptoms lain yg associate with our d/d. Maksudnye kalo bole, jgn asyik tnya regarding your cough je, is it productive or non productive, what color is the sputum, and bla bla bla yang asyik cough-related je.

-Cth lain, kalo patient tu dtg dgn chest pain, and dia suh kita tanya more questions to that patient. Jangan letak semua ke 3-3 jwpn tu LORDSANFARO psl chest pain tau. Tp varies ur question. Eg:
-1st soalan mungkin leh tanya psl pain tu.
-2nd soalan tanya laa soklan2 yang mungkin berkait dgn pulmonary system or cvs.

- Remember: Jgn la kita asek tnya regarding chest pain dia je. Fhm x? huhu ~

Then dr tambah sikit info dlm soalan tu:

7 year old girl admitted for history of recurrent low grade fever, loss of appetite and loss of weight with a persistent nocturnal cough of 3 month duration. She had attended a few private clinic and was given a few courses of antibiotic but there is no improvement. A few enlarged lymph node in the posterior triangle was found on both side of the neck.

b. List 4 investigations that you plan to do with reason
Sputum culture and sensitivity > to isolate the causative organism if there is infection.
Jangan laa jawab reason tu asyik nak “to rule out” je.

Cth: Sputum C &S: to rule out bla bla bla… [dgn erti kata lain, pandai2 laa guna bahasa bunga2 yg boleh impress the examiner ] – ni hanya macam in terms of membungakan bahasa je. Dengan erti kata lain, polish ur language!

• Dr kata, utk reason tu tulis la elok2 sket, ayat penuh, sbb kdg2 examiner tatau apa yg kita maksudkan.

•Dr pesan, kalo soalan tu dia tanya psl investigation, ensure baca soalan btul2.. Sama ada dia tanya give investigations TO CONFIRM UR DIAGNOSIS, ataupun just investigations. Kalo to confirm diagnosis tu, x kan nak check FBCs lagi kan? So, to confirm a diagnosis ni, lebih kpd mcm BLOOD C&S ke.. Mcm tu laa..

•OK, let say if the question asks u like this:
–State 4 possible causes/conditions that can cause pallor in this patient.

•Cara jawab dia is to give diseases that can cause anemia.
•Jangan plak jawab: increase RBCs destruction, reduce RBCs production… [sebab this kind of answer lebih tepat utk dijawab utk soklan yg tanya mcm “State 4 possible MECHANISMS”]. Understand? :P

•Pesan Dr lagi, this phase, Dr kata emphasize pada pathogenesis and pathophysiology.

•Dr ada kata lagi, students used to be confused between pathogenesis of RHD and IE, so kena laa tau psl RHD and IE [tak tau kluar ke x, cuma just take note je laa psl ni]..

•Understand? Kalo x fhm, tanya tau.. Selagi Allah izinkan, Insya Allah, pihak kami akan membantu..

Ok, all the best! May Allah bless our effort yang x seberapa ni :)

sharing is caring 11 :)



CT scan said...

syukran aina=D

Ibnu Shaukani on March 24, 2009 at 8:02 AM said...

ena rai, thanx a lot!!!

praise be only to Allah =)

Anonymous said...

salam...maaf..yg aina suruh tanya further question bout hemoptysis tu...kite xle la nak tanya do you have hempotysis?
patient mana reti medical jargons...btw...thanks a lot to aina...wassalam...

`Aainaa Nur Raihana Abdullah on March 26, 2009 at 8:21 PM said...

Waalaikumussalam.. ye ye.. x perasan part tu.. should ask like.. "do you have blood stained sputum?"

thanks for correcting me :)



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