Hi guys, I'm a 4th year medical student from Lincoln University College. Currently in Internal Medicine posting for 4 weeks. This is my second week in this posting and gotta share what I learnt last week. 

Four groups has been assigned to four different Medicine wards in Hospital Raja Perempuan Zainab (HRPZ) II; Mahsuri, Bendahara, ward 8/8P and also Puteri. My first week is at Ward Mahsuri. 

Then, Dr. Azza gave us a list of specialist in charged for each group. My group was assigned to few specialist there, including Dr. Sinari. She is the consultant of Medicine department. Our favourite specialist for time being is Dr. Grace from Mahsuri ward. She is so nice, graceful and very knowledgeable. She treat her medical officer and houseman so nice that I felt lucky to have her as one of our group specialist in-charged. Bless us. Bless me. 

First day was tiring but there was no bed side teaching. Second day of first week, we went to the ward and introduce ourself to the staffs there. Most of the houseman there are very nice. They include us in every ward round and help us whenever we look blur in the cubicle. The medical officer in charged for cubicle 3 in ward Mahsuri is Dr. Mohd. He is the coolest person there. I mean, as a medical officer, he really concern about the patient and also the houseman under him. Those houseman under him and Dr. Grace were lucky. Other medical officer in the ward that I find very amusing is Dr. Hidayah. She is so rock and cool. She got this mighty confident and a very unique lady, I must say. 

During ward round, Dr. Grace will include us in the discussion as well. She ask questions and also explain about the case, the decision-making, and also the insight of that case. Dr. Mohd also help us and discuss the case briefly so that we understand the case well when the ward round take place. For the first time, I felt like being welcomed by the specialist, medical officer and also all the staffs there. They are too nice. I can't believe that I'm in medicine posting. 

We were given homework at the end of ward round. For me, it is more like a reading list or list of topics that you need to read at home. So here are the list for the 1st week of posting:

1. Hypertensive Intracranial Bleeding 👌

2. Atypical Pneumonia 👌

3. Community Acquired Pneumonia 👌

4. Retroviral Disease 👌

5. Upper GI Bleed

6. Status Epilepticus

👌 = DONE

Till now, I haven't touch those last two topics. Hahaha. Sigh. Then we went for a clinic session. First clinic session was a rheumatology clinic. But we were some sort of not welcomed and kena marah in front of the patient inside the doctor's room. I almost cry but kinda tahan because the fault was not from our side. We did all the things that we need to do; we introduce ourself at the counter. We ask who in-charged for the clinic. We introduce ourself again to the nurses in the doctor's clinic and asked for permission. The person in-charged was not there so we waited outside. Suddenly the nurse came to us and informed us that we can asked for permission from the doctors in the other room. So we all went inside the room and again, introduce ourself to the two medical officers inside that tiny room. It was so crowded. One of the doctor told us to clerk a patient who is currently waiting outside the room. So yeaa. We clerked. We followed the patient went inside meeting other medical officer. And then after everything almost end, a lady came inside the room and marah us for not introducing ourself. We were so puzzled that time as we already did the introduction part and still kena marah. We explained and she was like still perli us about not respecting the clinics. They were not informed yada yada. Sigh. Sometime you buat everything also kena marah. So yeaaa whatever.

Another clinic experience is with Dr. Pong from Respiratory Clinic. She was so nice, so cute, so cool and so friendly with the patient, including us. We sit inside the room and she will ask questions related to each patient that came to see her. We felt like we were welcomed and she teaches us about pulmonary fibrosis that day. 

 

Here are my second week posting reading list:

1. Cushing reflex 👌

2. Renal with hepato involvement

3. Typhoid Fever

4. Pott's Disease

5. Liver Cirrhosis

6. Obstructive Jaundice

7. Upper GI Bleed

8. Status Epilepticus

Date: 18 March 2018

1. Hypergylcemic Hyperosmolar State (HHS) 👌

2. Hypoventilation Obesity Syndrome

3. Cardiomyopathy 👌

4. Uremia

5. Delirium vs Dementia

6. Congestive Heart Failure 👌

7. Upper GI Bleed

8. CVS Murmur Maneuvers 👌

Date: 19 March 2018

1. Asthma / COPD

2. Respiratory Failure

3. CNS Examination

4. Causes of stroke

👌 = DONE

So many things to cover right ? 

credit: pinterest

credit: pinterest

credit: pinterest

 Congenital Cardiovascular Defects
Statistical Fact Sheet 2016 Update (American Heart Association)

• Tetralogy of Fallot (TOF)
• Transposition of the great arteries
• Atrioventricular septal defects (ASD)
• Coarctation of the aorta
• Hypoplastic left heart syndrome

• Congenital heart defects are serious and common conditions that have significant impact on morbidity, mortality, and healthcare costs in children and adults.
• The most commonly reported incidence of congenital heart defects in the United States is between 4 and 10 per 1,000, clustering around 8 per 1,000 live births.
• Continental variations in birth prevalence have been reported, from 6.9 per 1000 births in Europe to 9.3 per 1000 in Asia.
• An estimated minimum of 40,000 infants are expected to be affected each year in the United States. Of these, about 25%, or 2.4 per 1,000 live births, require invasive treatment in the first year of life.

So today is all about the heart. What about it? I'm gonna share to you gaisssss few videos that had been helping me a lot while I'm studying. Of course it is from the youtube channels. The easiest video channel you can search to. Let's start from scratch. 

First, you need to know and understand the anatomy of heart. The landmark and the area of heart. If you go to a new place, you need to know the area, the places and the landmarks right in order to know that new place. So that you won't get lost.

Sign of Pulmonary Diseases

Interpretation of Chest X-ray