Wednesday, October 02, 2013

Of GWR, OC and Teachings

GRAND WARD ROUND

It was not as bad as I thought it would be. Mr.Shahidan took us in 2A Ward. We need to provide a summary, diagnosis, management and current status of the patients. And we discussed a little about problems of the patients.

Like Fat Embolism Syndrome. The triad of FES are respiratory distress (ARDS), neurological problem and skin rashes. Usually occured 24-72 after traumatic injury to long bones.

Why patient put on traction? To reduce pain is the main reason!

Mr.Shahidan also showed us a bit of knee examination on a patient with Osteoarthritis. You can feel the crepitus of this makcik! She was about 70 years old if I am not mistaken. Her knees were in varus position! 

She was planned to undergo Total Knee Replacement (total hemiarthroplasty), meaning that we only replace the neck of femur, but we keep the old original acetabulum. You know how much that operation costs? RM6900!! So expensive!

As Mr.Shukrimi said, ORIGINAL is always better than the artificial! God already gave you the perfectly-designed bones, NO ONE can ever create something similar to them! Even the artificial ones will have wear-and-tear effect, so they are definitely not perfect!

And do we have to pay for our bones? Noooo... we get them for FREE!! 

So please take good care of our bones okayy!!!


CASE PRESENTATION

Prof Kamarul took us for Long Case session. We discussed on distal radial fracture of a 7-year-old Orang Asli boy. Our class was in his office at Post-Graduate Department, IMC.

Ok. Pop Quiz:

How many small bones do we have in our hand?

EIGHT!

Good. What are they?

She Looks Too Pretty, Trying to Catch Her
(Scaphoid Lunate Triquetrium Pisiform Trapezium Trapezoid Capitate Hamate)

Need a visual help? Here here:










ON CALL

You must be thinking : Ohhh. On call again?

Heyy we need to do at least 10 times of on calls okayyy!!

Last night we were with Mr.Ariff. There were 5 new admissions : Close comminuted fracture of midshaft of right femur, Fracture of 5th metatarsal bone of left foot and fracture of middle phalanx of left foot, Necrotising fascitis, Distal fibula fracture and Open dislocation of PIPJ and fracture of right index finger.

My friends (Yun, Pipah, Izani, Irfan, Kuwe) and I spent our time at A&E, clerking new admissions before Mr.Ariff came. We covered all of the new patients! :D That's what you are supposed to do when you are on call! Hehehe

Then we followed Mr.Ariff doing his round with MO. After that, we had a bit of discussion towards the end.


BUSY WEDNESDAY

So this morning, the five of us had teaching session with Mr.Ariff at about 830am, then followed by Mr.Shukrimi at 10am. 

See how dedicated our mentors are? Jangan jeles okayyyy~~~ Hehehehe

Okay. What are the P's of ischemic limb in compartment syndrome?

1. Pain out of proportion
2. Pallor
3. Parasthesia
4. Paralysis
5. Perishingly cold
6. Pulselessness
7. Pulse oximetry reading (low oxygen level)
8. Pain on passive stretching of involved compartment

Next one. What are the points in history that are suggestive of compartment syndrome?

1. Continuous excruciating pain that keeps increasing in severity, not relieved by painkillers
2. Shiny-looking swelling, usually accompanied by blisters
3. Wooden hard muscles

Oh. I presented my case on Right Leg Venous Ulcer with Mr.Ariff this morning. And I got my first signature! Yay! (Yeah I know it's already week 3, by right I should have three signs by now - but heyyy I am startinggg)

SEMINAR ON ORTHOPAEDIC EMERGENCIES

With Mr.Fazli. He explained stuff in simple terms and I was able to understand the lesson easily!

The topics that we covered just now:

1. Compartment syndrome
2. Joint dislocation (Shoulder, hip, knee)
3. Fat Embolism Syndrome

And two other topics will be postponed to this Friday, on Cauda Equina, DVT and PE.


Ahhh. I have written too much! Sorrryyyy hehe

Okay okay. I bet you are bored with the medical stuff and all, so here, watch a music video:


The singer is a Malaysian!! :D


And the doodles on some of our ortho lecturers I made during Taaruf Week. Hehe.

Okay. I'm gonna do my Case Write Up now. 

You have a good day! :)

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