O&G finale 'runaway' 2012

LONG CASE

- Mdm.Z./ 27 years old/ G1P0/ 37 POA/ EDD = 8-3-12
- k/c/o Bronchial asthma for 20 years on MDI last attack was October last year
- p/w signs and symptoms of labour.
- o/e cervical os was open 3cm and the leakage during admission was not liquor.

Questions asked by Dr. Kamarul Bahyah ( korang cari sendiri la ye !!)

1. Type of asthma treatment that the patient used, what are medications used for asthma that you know?
2. Do you think the leakage is liquor?? i said no.. Your differential diagnosis ?? LL, urinary incontinence, ... etc
3. How to confirm it is liquor?? (aku bagi tau semua test untuk confirm liquor, pastu doktor perli aku balik, semua sekali ke awak nk buat?? then doctor asked me, in our center (HTAA) what is the test used? )
4. If patient came with PPROM (don't use short form masa present ye!!), what do you worry about??
5. How do you monitor patient with leaking liquor in the ward?? --> Pad chart
6. What are components that you monitored in pad chart?? colour, quantity, ... etc
7. Induction of labour ?
8. Methods of IOL?
9. What are complications of oxytocin? UHS, uterine rupture
10. If patient with PPROM, what are vital signs that you will monitor? (dr suruh guna medical term, dr xnk guna eg: temperature --> increased, high or elevated.. cakap je febrile/tachy/...etc)
11. If liquor is continuously leaking, what do you worry about?? what is your plan??
12. Continuous leaking + blood pressure drop, what do you think?? hypotensive shock
13. For this patient, when do you want to deliver her?? within 24 hr
14. etc...

" Okay Afizul, you go back and read regarding PgE, Oxytocin ...etc, because you'll be seeing this again in year 5... unless Nauzubillahuminzalik, if you repeat this again "... then Dr said, ok dah bleh tarik nafas dah.. 

Hahaha..nak berair mata cheq na.. Satu ward dengar suara Dr !!

Actually, i did one case presentation with Dr.Kamarul Bahyah in her room during 2nd week of the posting.  and during the presentation she bombarded me with a lot of questions.. Sampai satu tahap tu, i shed my tears.. pastu Dr cakap, xpe biar depressed sekarang, this is how you learn.. Banyak sangat Dr bg semangat masa tu, sampai je bilik terus nangis (mahalnya harga sebuah air mata, ingat senang ke aku nk nangis) .... InsyAllah, mudah2an I'll be a good and safe Dr..ameenn..

SHORT CASE ( Prof. Hamizah)

- EDD = 8/2/2012, so 

- Please examine this patient 

Pastu aku buat la satu2 sampai habis...Yaqeen giler aku wat (sebab dh banyak practice palpation kat pregnant mother..haha)

Pastu Prof cakap, Afizul, how do you improve your technique of measuring fundus height clinically, can you show me once again?? --> Alhamdulillah, banyak teknik yang Prof refine (but i'm worried because, our SC exam for 3rd yr is assessed from the technique not the findings)

1. POA = 41w (hari xm 15/2/12) --> Postdate
2. If patient came with postdate, what are the signs that you want to look for?? signs and symptoms of labour
3. What do you want to do?? Bishop Score assessment
4. Components of Bishop Score and Total score??
5. Then, Prof gave me the table of Bishop score and she asked me to calculate. I got 5/13 and i said it is not favourable.
6. What is your plan?? Induction of labour
7. Methods of IOL?

Okay, tq..you may go now..

p/s : kalau bleh masa session dgn Mentor, jgn suruh dia evaluate ap yg kite buat tp suruh dia observe btul2, btul ke teknik yg kite buat tu.. kdg2 kite dh rasa yaqeen..laen Dr laen diorang punya teknik and evaluation kan?? so, prepare more is better than less..

InsyAllah, mudah2an..apa yg aku belajar hari ini jd satu semangat untuk aku usaha pada hari2 akan datang.. ameen.. Ya Allah, aku dh usaha sebaik mungkin, segala apa yg akn berlaku, aku redha dgn rezeki-Mu Ya Allah..