LONG CASE & SHORT CASE EXAM

Finally..i've done my clinical examination today. The last 2 paper mcq 1& 2 will be held on next sunday, so i got 2 days to go through my notes..

Yesterday session, long case exam~i got a 14 years old boy with typhoid fever..alhamdulillah..not a complicated case. I dont even thinking dat it will come out for pro3 exam, pro 2 may be yes.I thought i will get psychiatric case since the examiner dat time were Dr Zahiruddin Othman (Psychiatrist) & Dr Mohd Sapawi ( Cardiologist). Both of them are soooo kind. Dr Sapawi was actually my supervisor during 4th yr posting. So i knew already the way he gives marks..

This patient didnt have any positive finding except for hepatomegaly

Questions that has been ask:
1) Interpret investigations result:

what do you expect in FBC?
WBC:Leucopenia

thyphidot IgM positive~what's yr impression?
It shows dat patient was on acute infection

AST and ALT level 120++ , can you tell me what condition is this?
~it is called transaminitis, an indicator of liver inflammation n infection

If Blood C+S come back with gram negative bacilli, what would it be most likely organism in thyphoid?
Salmonella thyphii

2) How do you manage this patient?

3)What is the complication of thyphoid fever?
Early complication~ perforated bowel
Late complication~he can be transient/chronic carrier

Throughout the discussion, Dr Zahiruddin just keep smiling. Before the session end, Dr Sapawi asked Dr ZO if he got any question to ask..

Dr ZO: What condition in thyphoid that associated with psychiatric?
Thyphoid with Psychosis

(p/s:Nak jugak dia tanya soalan psikiatri..hehe.. Dr Sapawi sengih jek)

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Short case EXAM

EXAMINERS:
1)Dr Tg Muzaffar (Orthopaedic)
2) Dr Ahmad Amir (O+G)
3) Dr Syed Hassan ( Surgery)

Case~ twin pregnancy/ tb arthritis of Left knee joint/ Hirshsprung disease with colostomy

Luckily i got the all diagnosis except for the twin~i just can palpate the leading twin..huhu but for discussion, i able to answer all questions for O+G case..




I like the way Dr Syed Hassan treat me during exam..when moving to last patient~

Dr Syed Hassan~ Come gurl, i want you to examine this child's abdomen.

Hirshsprung disease~this child got a stoma bag with multiple surgical scars
1) Transverse incisional scar with keloid~ due to appendicectomy
2) Midline incisonal scar with keloid

After completed examination:
1) can you name complication intra op for appendicectomy?
Damage to nearby structure~ possibly ureter

what would be the cause for colostomy in this patient do you think?
1) IO
2) Hirschsprung diz

What are the causes for IO in paed? Dont tell me due to tumor..
Maybe becoz of worms
Wahh..clever gurl ( hohoho..itu pun clever ke)

Ix for Hirshsprung?
Abdominal xray, Barium enema

How do you confirm Hirschsprung diz?
By biopsy~ tapi yg ni lupa lak nama biopsy ni~ Rectal suction biopsy

Complication for Hirshsprung?


~CONCLUSION: DOAKAN SAYA LULUS EXAM PRO 3 YE EK~