woohoo..after that 16 hour nap, i am once again rejuvenated..yeap, i’m probably one of few and possibly the only girl who could sleep for 16hours non stop..haha..
so i am OFFICIALLY A FIFTH YEAR now..hehe..which brings along the title D.O.C.T which is 2 alphabets less glamorous..hahaha..what the hell..
so this post is gonna be all about that last exam internal medicine..i have to write this down so that i’ll remember this for years 2 come..
first of all, with a 7day-recovery period between neurology and internal medicine, there’s only so much to squeeze into those remaining brain cells..plus on top of that with my temporarily-went-missing endocrinology notes (!!!!) which mysteriously turned up in kok meng’s room ( haha, yeap i’ll be mentioning this again!! ) only added up to the tension..
only when you start reading that you realize that there’s so much more to it than one thought..with the drugs and dosages..i had set a timetable for myself so that i’ll have enuff time to read through and repeat all the material, but as always, it was not seen through..then came all stories about all those people who are gonna bring it back home and we were suddenly counting the number of people who would actually turn up on the exam day..the ketam also came to tempt me into postponing and i had to postpone for a day..i just wasnt done..
called back home to inform my parents..they of cos said that i shud go and just do it..they said all the right things that they were supposed to say of cos, but the thing is, internal medicine is like THE HEART AND SOUL of medicine itself, and if you dont get this right, you probably dont deserve that title before your name..and for the life of me, i couldnt even remember half of the drugs and dosages so that one day was crucial..
by the next morning, i was set to just go and do the best i can..you know, i am not really into the superstitions and stuff but sometimes, some things do catch my eye..like when my file fell smack on the floor..those who’ve been to my room would know how messy my table is all the time and the amount of things that can be on it but nothing falls over..hmm..then 2 minutes before i left for exam, i got an sms from rhun ping and i was about to read it when suddenly the phone slipped, i made a grab for it and knocked a glassful of water all over the table and over my internal notes..that has NEVER happened before ever..wiped it all up, picked up my soaking wet pieces of paper and ran downstairs,feeling freaking weird and i was sure i was gonna get andrevna..was gonna exit the hostel when i saw it was raining and i had to rush back upstairs to get my coat..and when we reached the hospital, we were initially turned out by the assistant cos it wasnt our exam date..oookkkaaayyy…then eventually she cooled down and gave me my patient..who was already discharged..so i got another..
i asked her what was bothering her and she told me she had an infarct..haha, then i had to explain to her that i was havin an exam and i was supposed to figure that out for myself so the both of us komplot not to tell the teacher..so i took down her history and all the details..then i asked her how it all happened and she told me that it was all due the stress after her husband suddenly passed away after an MI too and started tearing, which was VERY VERY AWKWARD for me..god, i hate to see people crying..then, came the physical examination and my, she was a huge lady and i couldnt auscultate her apex beat!!! becos she had such huge you-know-whats and i could only percuss her upper heart border..
then while i was percussing her abdomen, the teacher came in and asked me percuss the liver, which the patient refused to allow..somehow i managed to persuade her, scribbled my diagnosis and treatment and submitted the report, on which the teacher wrote “Correct diagnosis, correct treatment plan, knows how to percuss liver”..
took my ticket and set down to prepare the answers..got chronic renal failure, status asthmaticus and an ECG..at that moment, there was only strongin there and you know him, his booming laugh and slurring speech..then ilya and panova made their appearance, panova as always, ilya wearing a baggy cream t-shirt (cute!!!)..then came andrevna and the assistant called out my name!!! took a huge deep breath and collected my stuff, made my way to her, set down my stuff..gave her my patient’s report, she saw the “knows how to percuss liver” and pointed it out to ilya, and the both of them had a good laugh over it…
then came the question session, which i think i answered pretty well..then came status asthmaticus treatment and i missed out the glucocorticoids, which i later added..then she asked whats the dose and how i would administer it..i told her iv and she said by the time it takes effect your patient would be dead..i was like, errrrr, if the patient is in come, thats the best way..she said the patient is not in coma..ok, then we can give it orally or inhalation..and she said, you dunno how to treat status asthmaticus, you never went for lectures..HARR?? that pissed me off..i told her that i go for all my lectures..then she turned to tatiana and asked her if she delivered the lecture and tatiana said yes, she did but she was quite out of time..and panova from the other side menyampuk and said that in general, the 4th years lecture attendance was pretty terrible, but she said that i always came for her lectures and tatiana said yes too, so yeah that shut andrevna up..
next came the ECG and i’ll tell ya that it looked pretty normal to me..there was STdepression and Tinversion in the leads V1 2 3 and nothing more..so that was definitely not an MI and i dont think it was angina either..so i pointed out those things to her and though it looked like fibrillation, i think it was most probably just the muscle twitching..then she asked me to count the QRS time and it was 0.16sec so thats prolonged and i told her so..she asked me what it meant and i replied that its BBB..she asked which kind..and i can tell you that in the V1 was the slightest of an M shape and nothing else in the other leads, so i tembak la, told her that i think it is right la..so ECG passed..
she said ok, your mark is a 4 becos you dunno how to treat status asthmaticus..i said HAH??? and she said yeah, your patient died, what to do?? i was like ok thats true, whatever la, getting a 4 from you is a big enuff thing oredy..then she hesitated a bit and said, ok, maybe an extra question..i was oooo, ok and started thinking of all the possible things she could ask..but andrevna being andrevna, of cos she wud ask either rheumatic fever, rheumatoid arthritis or infective endocarditis or something of the sort, she asked the diagnostic criteria of rheumatic fever and i pap, pap, pap to her ny..vsio..so she said okay, its a 5 but with 3 BIG MINUSES and i was like, whatever la fren..
and thats the story of my andrevnian encounter..after that, came back home, woke up the roomie and all of us went to fantastika, i managed to stuff 5 pieces of pizza and a caramel cocktail, tapao-ed one slice back home and slept til the next morning..
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