Showing posts with label Academic. Show all posts

Long and shorts (i)

Alhamdulillah the long and short cases were finished yesterday with countless thanks to Dear God. As a good bunch of my friends elsewhere have yet to get their short and long cases over with, I am going to share a couple of questions that I was asked during the cases, just if they would be of some help ;). These are upon discussions with some friends after we did the cases. Let me know if you think otherwise okay.

[E= Examiner, S= Student, P= Patient]

An overweight gentleman in his 60s sitting in a chair with a cast on his right forearm.

E: I want you to assess this gentleman's speech.

S: Ok. Hi my name is Sarah a final year medical student (looking at the patient). I'm going go ask you some questions and give you some instructions for you to follow, is that ok?

P nodded.
S: May I know are you right- or left-handed?
P showed his right hand.

S: Ok can you describe the room for me?

P: errhmmerrhmmerghh.. (with fingers pointing to what he was saying, quite decipherable but with marked difficulty).

E: What are you assessing there?

S: Expressive dysphasia.

E: Ok. Is there a problem?

S: Yes, he has difficulty with the expression. E nodded.

S: I'm going to give you some instructions for you to follow and I want you to do them when I say 'now' alright. Close your eyes, lift up your left hand and touch your left ear. Now.

P closed his eyes, lifted up his left hand and touched his left ear. Perfecto!

E: So what are you assessing there?

S: Receptive dysphasia.

E: Any problems there?

S: He is able to follow the instructions correctly so no receptive dysphasia.

E: Ok. Do you want to ask him about names now?

S: Yes. Looking at patient. Can you tell me what is that? Pointing at a glass of water.

P: errghher j-u-g aaaa-o-ff-- waa--ter---r

E: What did he say there?

S: A jug of water.

E: Is there a problem?

S: Yes. It wasn't a jug!

E: Ok continue.

S: Would you like me to continue with the naming?

E: Hmm no. So having done the tests so far where do you think the problem is?

S: He has expressive dysphasia so the lesion is in the Broca's area.

E: Ok now look at the patient's face. What do you see?

S: The face nearly looked normal to my eyes so I decided to ask him a question. Can you smile for me, a wide smile.

P smiled. Very minimal weakness that it was difficult to ascertain whether that was due to poor effort.

S: Can you close your eyes really tight?

P closed his eyes. I was a bit unsure because both eyes were closed equally tightly. Should have tried to open them but wasn't too confident as was just asked to observe.

E: What do you see there?

S: Some drooping of one side of the face.

E: Which side?

S: Patient's right side.

E: Whereabout, show it to me.

S used her finger to point at the right nasolabial fold.

E: What do you think is happening?

S: Facial nerve palsy.

E: How would you further distiguish the types?

I knew he was going to ask me this!

S: Can you wrinkle your forehead please?

No problems wrinkling the forehead.

E: What does that mean?

S: The patient is able to wrinkle his forehead which means that the forehead is spared. This is an upper motor neuron lesion.

E: Alright now look at the patient's right arm, what do you see?

S: There's a cast on the patient's right forearm.

E: What do you think has happened to the patient?

S: Syncope...er stroke.

E: Stroke! Which lobe and which side is it?

S: Left frontal lobe. Broca's is in the inferior frontal gyrus to be exact. Contralateral side in this case.

E: What is the blood supply to that part of the brain?

S: Middle cerebral artery.

---------------

If you managed to do this quicker the examination could go on into the causes of facial nerve palsy, management of different types of stroke as such. So if you get this, do it way better ya.


Thanks juniors! So schweet :). Only noticed this today in the surau, after the exams :S. It's the thought that counts after all isn't it?

[To be continued]

P/s:

Make prayers for us the Galwegian final meds pleasee ;) ;) ;). Thanks loves.
I'm doing neurology for the intern shadowing which starts tomorrow week. Does this mean I should become a neurologist, or a neurosurgeon hmm...
Next case: How do you know if an AFib is stable or deteriorating?

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E for English (ii)

I couldn't believe how could I have forgotten to include this tip in my last post.

This is not the best image in the world to project those verses but I don't have time to find a better one I'm sorry. They are taken from the Holy Quran, Surah Taha verses 25-28 which translate:

"My Lord! Relieve my mind (25). And ease my task for me (26). And loose a knot from my tongue (27). That they may understand my saying (28)."

Recite this prayer if possible at the beginning of your day ;). [Doesn't necessarily have to be a one-off thing]

Along with this a reminder to myself especially, to always purify our intention that may Allah shield us from arrogance or any of its kind be it hidden or superficial.

************

Another tip that I find useful to improve our English: Mailing list subscription.

I thinks there's obviously loads of them out there but what I'm on are:

dictionary.com- their emails come everyday I think. They're piling up unread in my folder ~~oops~~. Because you know when you're on a holiday or away to a jungle or somewhere where internet access just doesn't exist then you come back to your civilized home to find a mouthful of words to be learnt that you go "Ok I'll do it later!". Then another 'later' comes the next day. [That's how the sad story began.] I think I'll have to unsubscribe and resubscribe to this again to make me feel less guilty so that the cycle will start over and I won't be missing any words.
idioMeanings.com- their emails come without a pattern as far as I'm concerned. Could be everyday, could be once in a few months. So, urm... surprise! :S

But again, try to memorise and if possible, use these new words and idioms so that they stick to your head pretty well ya ;).

I know you might not fancy receiving tonnes of emails everyday hitting your inbox (well, just two or less from these websites actually) so use filters to literally filter the emails that you receive. In this way they will go to their respective folders right away accordingly without you putting effort into sorting them out :).

How to make filters?

Hmm... too long a story. That isn't in the package :P. Ask a friend @ Mr Google @ Mr Youtube will ya?

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Fertility Clinic

Today was our first day of Obstetrics and Gynaecology rotation for this semester. I'm attached to Dr Egan's team this time around with my colleagues and we spent our time at the Fertility Clinic this afternoon.

It's actually rather inappropriate to use 'infertility' that the term 'subfertility' is being used instead. Subfertility means the inability for a couple to conceive after 1 year of regular sexual intercourse. From 2pm to 5pm I saw 4 couples who came in to see the doctor to get their problems sorted out. And they presented with various possible reasons of subfertility be it of maternal or paternal origin.

Endometriosis, unilateral tubal ligation, overweight, poor sperm motility or just 'unknown' were the pertinent reasons for their presentation. Some have tried tablets and everything to help them conceive but they all haven't seemed to produce good results.

I wonder what does it feel like to have a child (I hope my mum finds it exciting to have us!). I believe it's going to be fulfilling and life would seem more worth-living. Pretty sure about that really. That is as long as the child is meant to be born. What if he/she was an unwanted product of free sex? (And why am I writing short sentences, I don't know)

That's why nowadays we find babies trashed in the bins, flushed into the toilet, swarmed by the ants under a tree and left on the boot of a car. They were treated as if they were valueless. As if it was them to blame for the mistakes committed by their parents.

Only if their mean parents knew how hard it has been for the other couples to conceive...

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Exam Mode

I suppose exam season is the season where people would get nervous most, disheveled most and freaked out most. Let alone when we got loads of bright friends around whom apparently did not seem that nerdy diligent in front of our eyes yet scored perfectly high in every single exam despite the night-outs as such. Aren't they just good at balancing their time proportionately? [And you, Sarah? :S]

It happened that this one day I went home over the lunchtime following the morning tutorials and made it late to the lecture at 2 pm. I was praying hard along the walk to class yearning that it wouldn't be Dr Dunne who's giving the first lecture that afternoon on paediatrics. If you want to know the reason for that, it's because he loves to 'torture' the latecomers with questions 'assuming' that they must have known more than the rest that brought them late to class. A smart approach in alluring us to turn up early to the lectures ya?

Well in a way I thought that's a good technique in getting our mind sort of working throughout as the nerves inside will keep our mind more dynamic even if we got in early. The idea of the possibility to be the next person asked is absolutely daunting! After all you know what 'fortunately' it wasn't Dr Dunne who delivered the lecture that day and in fact it wasn't even paediatrics lecture that was the first on!

After 3 lectures back to back I finally reached home, slowly opened the door of my room and picked up my phone that I forgot to put into my pocket before I left the house.

1 unread message.

"U r late!"

I smiled reading that message on the screen. It was to my least expectation that my attempt to sneak into the lecture theatre quietly without anyone noticing was a failure- I was caught red handed!

It was long after I last spoke to or even saw him. The sender was my Irish colleague who was in the same clinical attachment group as I was last year. The 6 months together in the group got us to know each other quite well as compared to before where everyone in the small group would probably hardly notice each other in the class. He's that friendly type of person who showed interest in knowing more about Malaysia and religion, which of course are the things that I'm apparently into as well.

Reply message- clicked

"I was so disorganized today that I even forgot my phone.
So just read your text there! ;)"

Send message- clicked

1 minute later.

"Lol. You're just lost without me!"

Nearly laughed my lungs out before I clicked: Reply message.

"Lol indeed!"

The End.

*********************

Exams are just around the corner so just to let you know that you will less likely be seeing updates on this blog for the meantime. Anyhow I'll be back soon, insyaAllah ;).

"But seek, with that [wealth] which Allah has bestowed on you, the home of the Hereafter, and forget not your portion of lawful enjoyment in this world; and do good as Allah has been good to you, and seek not mischief in the land."
[Al-Qasas, 28:77]

Bittaufiq wannajah fil imtihan to the those fighting with books- just like I am ;)

* On paediatrics attachment at the moment thus the above picture. And insyaAllah am presenting a case this Wednesday, do make prayers for me ya!

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Galway Excursion

Fancy spending some engaging yet enlightening time outside Galway?

This year PPIMG proudly presents:

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Exams!

Yesterday was a special day for the ex-final meds. I believe all the pain and sufferings they once had to go through were finally gone after knowing that they're now officially doctors- which literally means that they're now licensed to kill, lol!

I was there when the results came out as we just finished our tutorial the hour prior. Purposely planned to stay in CSI to wait for the heart-pounding fate to be announced. Anyhow the happy faces got me inspired to study harder, as I knew and always know that 'no pain, no gain'. So Sarah, you have to be more focused and diligent you know; God please grant me the strength!

Imagine our lifelong dream has eventually come into reality, isn't that surreal? MashaAllah. All the years spent buried in the books seemed to pay off and another chapter of their life is about to begin, how wonderful that is. I'm happy for y'all, CONGRATULATIONS! Don't forget to gratitude and remind ourselves that this victory came into place with His permission alone so thanking Allah should be ahead of everything.

I checked my Facebook account today as I always do and had a look at the updates that showed up at the homepage. Of course the ex-final meds were expressing their happiness with their facebook status and all, but what that captured my attention were their pictures. I am able to group them the Muslim Malaysian doctor-to-bes into two cohorts. I reiterate, I'm talking about the Muslims now.

One cohort celebrated their success in Eastern Tandoori, a halal Indian restaurant in town. I think they just had a simple celebratory dinner together with another non-Malaysian Muslim, in a proper manner. Proper for me is being well behaved, no unnecessary physical contacts and dressed in a respectable manner. In a nutshell the things being taught by the Quran that is, as the book is our manual isn't it?

The second cohort celebrated their joy in a way absolutely in contrary to the above. In a pub with their Irish classmates dressed in a way that could've been more decent, I looked at the pictures with a deep sigh. O Allah please help and guide us to Your way. We are just a humble, weak creation of Yours and we certainly wouldn't be able to bear your chastisement which resulted from our own fault.

This is reality. Indeed, excellence is one of Allah's way to test people. Not merely poverty, plights and deaths are called tests but happiness is, too. To be honest I'm afraid if me myself is thrown into this second cohort when I'm given such an achievement in the future. So now I'm writing this down not to say that I'm good enough but more importantly to always remind myself not to get easily allured to worldly temptations that would lead me astray to a way I shouldn't have given a chance to. InsyaAllah.

"O you who believe! Why do you say that which you do not do? Most hateful it is with Allah that you say that which you do not do."
[As-Saff, 61:2-3]

Anyway we're in the exam season again. MCQ scheduled for this Friday, written paper the Friday after and an OSCE on the following Friday. 3 weeks back to back. Finish with 3rd year after that, insyaAllah. Got a long and crooked way to go before becoming a doctor, still. Hope we'll pull through anyway with His Blessings.

Not to forget I'm wishing all the teachers, not just occupational teachers but everyone who teaches, ever taught or will teach a big big Happy Teacher's Day!- Malaysian date [16th May]. To my mum too who's a teacher, Happy Teacher's Day, I know she wouldn't be reading this though lol. Just realized that Ireland doesn't have such a day, what a pity huhu.

Pray for all of us for our exams and everything! Thanksss!

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Colonoscopy

Colonoscopy in my own layman term is basically a procedure where you put in a scope or camera into the large bowel aka colon through the back passage to have a look inside on what is going on in there.

So today one of the questions asked by Dr Barbur [apologies if the spelling was wrong] was what are the indications of colonoscopy?

- Bleeding PR [Haematochezia]
- Iron deficiency anaemia
- Unexplained weight loss
- Epigastric pain of unknown cause [>2 months]
- Screening of colorectal cancer in patients with known Crohns disease or Ulcerative Colitis
- Screening of colorectal cancer
- Chronic diarrhoea [>2 months]
- Altered bowel habit, mainly constipation
- Acute diverticulitis
- Preoperative colonoscopy

Good night!

Galway, 12.26am

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