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Eh, macam mana ni? Ni pesakit perempuan. +_+ Selama ni dalam kelas pesakit lelaki je.
Tuesday, December 10, 2013; 11:21 PM

Bismillah...


9/12/13
Dalam kesejukan pagi winter, aku gagahkan untuk bangun awal. Hajat di hati nak ulang kaji sekali gus semua sistem sebelum pergi exam mid round internal medicine or mini osce. Selesai solat, aku tidak menunggu lama. Terus buka buku satu per satu. Walaupun sudah beberapa kali mengkhatamkan buku ni sebelum ni, tapi sekurang-kurangnya pagi sebelum exam perlu untuk tengaok dan imbas semuanya agar lebih ingat dan tak ada yang tertinggal. Tektik apa kau guna ni nua? Ontah lah. hihi


Kehangatan kopi membantuku tahan mengantuk dan tidak menggigil. Sedang aku baca, tiba-tiba rasa macam masa dah tak cukup untuk baca sistem neuro. +_+ Tiba-tiba dapat mesej cakap exam telah diawalkan sejam. Doktor sedang tunggu kat hospital dan pelajar malaysia baru ada 5 orang. WHAT? Tak berapa terkejut sebab dah biasa. Selama ni pun memang suka ubah-ubah. Mahu tidak mahu, habis tidak habis, terpaksa juga siap-siap pergi hospital. Tapi tapi..nak pakai baju apa ni? Rasa macam nak pakai kemeja. Tapi tengok suhu macam sejuk jew..macam sejuk jew. Tahan ke kalau pakai baju kemeja ni??


Di hospital....

Tidak seperti yang dijangka. Kusangkakan giliranku lambat lagi kerana angka giliranku agak terkebelakang. Ternyata jangkaanku meleset. Hari ini doktor dah sediakan ramai pesakit. Dan setiap orang akan dapat pesakit yang berbeza. Dan hampir separuh akan exam serentak. aaaaaa. Takut takut. Bukan takut apa, takut nanti doktor tanya soalan yang........mencabar sampai tahap master kee..hehe


Tiba giliranku...
Ah, ada doktor tengah duduk di hujung katil. Aku melangkah ke arahnya. 

Doctor : I give you 5 minute to examine the patient. 
(Tertulis di atas kertas di atas katil pesakit yang sedang berbaring, "Comment on the pulse and Auscultate the heart")

Aku melihat pada pesakit. Alamak, pesakit perempuan! Bisik hatiku. erm.. Aku mulakan dengan merasa radial pulse pesakit sambil tengok jam. Regular. 72 beats/minute. Aku ambil tangan sebelah pesakit. Hmm..equally in both side. Aku tengok pada kaki pesakit. Eh, bertutup dengan selimut. Macam mana ni?

Me : er..doctor, do I need to examine all the pulse? The carotid, brachial, femoral....
Doctor : sure. But the most important is the upper limb and lower limb. 

Terus pesakit buka selimut dia...*examine*

Selesai examine the pulse, aku terus memakai stethoscope. Eh, macam mana ni? Ni pesakit perempuan. +_+ Selama ni dalam kelas pesakit lelaki je. Tak pernah lagi aku auscultate pesakit perempuan. Er...

Me : *letakkan stethoscope kat apex of heart. ...... Okay, regular. No murmur. No additional sound. But the second heart sound is quite loud. 

Eh, macam mana nak dengar kat aortic and pulmonary area ni? Macam dah tertutup dengan breast je. T.T  Seriously rasa janggal sangat. This is my first time. Dulu aku dah pun tertanya-tanya kenapa tak ada pesakit perempuan dalam kelas. And now masa exam kena pesakit perempuan. hmmm. Maka aku letak je la kat sebelah kiri sternum. Tu lah kawasan paling hampir dengan pulmonary area. Okay, confirm. Second heart sound is accentuated. Lepas cakap terima kasih kat pesakit, terus pergi kat doktor. 


Doctor : so, what you find?
Me: the pulse is bla...bla...bla....*sambil terangkan kat doktor*. 
Doctor : so, what is the cause of inequality of both radial pulse?
Me : erm. Maybe there is of obstruction of the artery such as if the is atherosclerosis, thrombus or thrombus.
Doctor : Okay. That's from inside the vessel. What else?
Me : maybe there is compression of the artery from outside...
Doctor : compress by what?
Me : Can be tumour...
Doctor : and the most common cause????
Me : erm...
Doctor : when the apex of lung compress the artery.
Me : so when the lung enlarge and compress the artery, the radial pulse will be unequal? 
Doctor : yes.
Me : oooo. hehe


Doctor : what you find in the heart?
Me : I heard ...bla...bla...bla *sambil terang dengan panjang lebar*
Doctor : so, what is the cause of accentuated second heart sound?
Me : erm...*mitral click ke? ke prostatic valve ni? Membebel dalam hati*. Second heart sound is produce by closure of aortic and pulmonary valve...
Doctor : yes..then?
Me : pulmonary stenosis? (main tibai je jawab)
Doctor : no, if there is pulmonary stenosis, the sound will diminished. 
Me : ooo. yes yes I agree. Maybe there is ventricle enlargement.
Doctor : maybe. But what is the most common cause?
Me : *buat muka berfikir*
Doctor : The most common cause is pulmonary hypertension. 
Me : oooo. hehe *sambil angguk2*
Doctor : that's all. 
Me : okay. Thank you doctor. =)


Alhamdulillah. Selesai mid round exam. Lepas ni belajar sungguh-sungguh lagi ye. Keluar wad ambik gambar. hihi 













Bergambar je lebih. kbai



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