liat plak tuh..lenguh rahang mengunyah...tp at least dpt la rase kan..ilang kempunan...
arinih cbt ngan lisa pon agak best...examined an 11 wks old baby with down's syndrome..die siap ade AVSD (atrioventricular septal defect - jantung belubang org mlayu kate) ! bole nampak die nye heart beating tau tak...dpt rase ventricular heave...bole dgr murmur...a very soft murmur, tp saye tk reti nk characterise whether it's an ejection systolic or pansystolic ke...tp saye mention je la mcm continous..tp lisa ckp takle nk ckp pansystolic ke tak sbb very soft murmur... and kalo pansystolic, heart sounds tuh akan mcm tkle nk beza sbb bersambung je..tp dlm baby tuh both heart sounds dgr elok je... sian sgt tgk baby nih..ade subcostal recession and harrison's sulcus..pendek kate mmg increased respiratory effort la..mase nk palpate die nye apex beat tuh saye rase takut je kalo terpenyek jantung die ke ape sbb bole nampak the heart is beating... seriously saye makin nk jd paediatrician!! tp saye tk brani nk pk masa depan lg..pk dulu pekara yg akan berlaku skrg..abiskan dulu 1st degree..then baru bole pk nk kawin..then pk nk ade baby then pk nk sambung postgrad...
then lisa ade tanye adekah kat mesia ade bronchiolitis..saye mmg tatau...tp saye jwb la 'i think we have bronchiolitis but obviously it's not seasonal'..sbb kat sinih kan bronchiolitis tuh from april to september plg common...saye rase kat mesia ade nye jugak penyakit tuh tp sbb kat tropics mmg la tk ikut musim dan mmg kdg2 tuh name2 penyakit tatau sgt pon kat mesia..normal la kan, ape2 sakit pon sbut 'sakit dlm perut'..sume2 pon generalised... kalo bronchiolitis saye assume org mlayu akan sbut 'sakit paru2'..ape2 yg berkenaan ngan joint akan ckp sakit sendi la sakit lutut la tk kire la rhumatoid arhtritis ke osteo ke ape ke kan...name ubat pon tatau...mak saye sakit bahu arituh pon dokter tulis 'ubat kurang bengkak'..i was wondering tuh ubat ape..antiinflammatory ke ape ke kan..then arituh aisyah demam pon dokter inject 'tenaga'..mami tanye la die inject ape..dokter tuh insist on 'cucuk utk tenaga je'..then mami tanye lg, 'vitamin ke?'..n dokter kate bukan.. omg! dokter, kalo patient dh tanye byk kali tuh maksudnye nk tau specific la kan, maksudnye u are allowed to use jargons la skit2 kn..jgn la assume sume patient tatau pape...mak saye bukan la dokter, tp mak saye cikgu bio..so takkan la tak paham kalo dokter tuh nak sbut die inject ape..kalo tk paham pon at least mention la kan...nih nk assume sume patient bodoh tatau pape... ape barang! tp saye tau tk sume dokter kat mesia camtuh...saye dah nampak trend towards patient education..tp tuh kebanyakannye kat private hospitals la..mmg canggih skrg nih...kat public hospital plak kdg2 tuh takle nk salahkan dokter, workload mmg byk..tp kalo dokter kat klinik biase yg kite g tuh, anda ade mase utk educate the patient kan, so jgn la sambil lewa je assume patient's level of understanding.
oh tidak,saye takmau membebel dh..nanti cpt tua. cukupla eyebag saye yg semakin saggy ini...
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