Monday, September 10, 2012

First Day in IM




The first day of Ward Work in Internal Medicine posting wasn't so bad.

Here's how we spent the day in Orkid 8C, HTAA:

1. We went to patients' bed and talked to them aka History Taking/Clerking. We've met cases like Viral Hepatitis, Renal Failure and Stroke patients.

2. We observed Venepuncture (taking blood from Median Cubital Vein which lies within the cubital fossa) twice today - One is by Dr.Adlina, and another is Dr.Maria's. Our friend, Shake performed the procedure itself. I didn't have the gut to do it just yet.

3. We got to see a Lumbar Puncture Procedure! It's interesting to note that a right technique + experience are required to get the fluid out. When a Houseman failed to get the fluid, Dr. Khairul helped out. He comforted the H.O, saying that to get it right takes time. 

After that, we were asked by Dr.Khairul about Lumbar Puncture (LP) - Indications (Diagnostic, Therapeutic, Drug administration, Anaesthetic), Contraindications (Raised intracranial pressure, Coagulopathy, Malignant hypertension), Complications (Post LP headache, Back pain, Bleeding), Type of Meningitis (Viral, Bacterial, Fungal, Tuberculous). He mentioned that those are among the favourite questions asked by UIA lecturers, adding that he graduated from UIA too :)

4. We had bedside teaching by Medical Officer (M.O), Dr.Liong who was very helpful to teach us how to do Abdominal Examination. The patient has Hepatosplenomegaly and we can observe/feel the spleen was bigger than normal.

5. UIA Senior 5th Year Sister Diana showed us how to percuss the back of patients to hear the sounds. She told us the difference between the dull sound of a patient with Lung Carcinoma and stony dullness of a patient with Pleural Effusion. Brother Akmal chipped in by showing us the important things that we need to know in the Express Revision book.

6. Dr.Naim told us to appreciate patients with Babinski sign, Splenomegaly and something something Click in the end (related to the heart problem). I couldn't get that on paper as he spoke too fast. I managed to write only half of what he said in my notebook. All in all, it's really nice of Dr.Naim to tell us that.   

7. UIA Senior 5th Year Brother Saifuddin briefed us about Short Case, what to say and what not to miss out.

So that was how our first day went :)

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