My pracTical Day HeRe

Salam to everyone there..... nih nak sambung cter aku nih... hehe... harap aku x menambah-nambah(aku kan suker menambah-nambah nih)..........

Aku dibawa masuk ke ward 5 in which im not the one suppose to be in-charged with bcoz the ward only for heavy duty cases eg for H1N1,chronic pneumonia,PTB(Pneumonia Tuberculosis) and any other end stage respiratory problem………. Aku siap pakai mask agi masuk tempat tuh. Aku risau gak. Takut x pepasal aku kene sakit lak kan… yerlah sebab virus nih kan asbab penyakit……….. then I was introduced to my superior…… so, I introduce myself……..

“salam doctor, im Muhammad akmal zakaria, a first year medical student of alex university of egypt”
Then superior aku reply. “salam, which year..first year.. can u understand anything then?”
aku pon cakaplah…….. “we were taught in systematical way doc. We have taken subjects by block system.. I’ve taken the musculoskeletal system,ANS,general pathologies & infection” aku pon mengarut lah sikit depan dier………….. then dier pon kate “let c later how”

aku dah start berdebar dah wktu tuh…… then, aku masuk ward 4 (female medical) dier bawak aku round ward…. Aku ternampak ader satu makcik tuh baru lepas cardiac surgery… tapi doctor endorse her a dopamine. So, aku pon bertanyer……. “y they gave the dopamine instead of dobutamine, isn’t that the dobutamine is better in that case?”
superior aku pon tanyer doctor yg endorse kan ubat tuh… naper bagi dopamine……. Then dier suruh tukar ke dobutamine……… (waktu tuh aku rasa macam practical nih senang giler sebab semuer tuh kiter dah belaja) pas tuh lak ader medical rep. nih datang sepital jual ubat……. Aku pon ikutlah superior aku layan dier…….. pas tuh dier tanyer aku whether aku tahu x apa tuh volsartan…. Aku pon jawab lah pasal ARBs…. Then dier kater “alex university is very good lah……. U know everything”

tapi at last aku ngaku yg praktikal nih memang susah……… next day dier jumper aku kat ward 3 (male medical) ader pakcik nih mata dier kero sikit… then dier ader macam nak jatuh lak tuh………. Eye ball dier x lah move ke medial side either of them…….. then my superior asked me “akmal do u know wat is this? Which nerve palsy shows these sign? What is the syndrome? I will give you rm50 if u could answer me”
waktu tuh aku dah rasa macam aku bukan medical student…I couldn’t answer any of that answer… aku x paham aper yg dier tanyer dan aku x paham aper yg nak aku jawab……… lepas tuh dier pon kata “that’s basic CNS lah akmal, u told me u have learnt that isn’t it?”

aku senyum jer…. then he asked me to read it over and he will asked it again tomorrow. Aku pon terus tulis dalam buku pink aku (my notebook)…
my next pt was a DKA (Diabetic Keto Acidosis) then, my superior told me; “This DKA pt will occasionally will be comatosed due to increase ketone urine level. There is no urgencies, only we need to do a fluid correction and insulin Tx (treatment). and fyi, after 2 days jer, that DKA pt terus coma sebab dier ader predispose Renal impairment… sian dier…… last I heard, she’s dead… al-fatihah…

then later ader satu uncle nih got ascite (perut buncit due to fluid increment).. then my superior asked me; “do u know what is the fluid thrill?” aku said I don’t know… then dier ajar aku on how…. We need someone else to aid us…. We placed one of the hand on the middle of the pt abdomen. Then, the other hand put at the left lateral of the abdomen. The other hand of our other person, we do a palpation on the other medial lateral end… if we could feel the thrill, so it indicates the fluid intraabdominal…..

itu jer kot for now… aku bagi dulu some of the usually used acronym:
ABG: arterial blood gas
VBG: venous blood gas
CRF: chronic renal failure
CCF: chronic cardiac failure
RBBB: right bundle branch block
LBBB: left bundle branch block
LOA: loss of appetite
GM: glucose level
DM: diabetic mellitus
PD: peritoneal dialysis
MDI: method dose inhaler
CVG: bypass surgery
HCT: hematocrit level = PCV (packed cell volume)
MCV: mean corpuscular value level
CA: cancer
AGE: acute gastro enteritis
HPT: hypertension
CE: cardiac enzyme
LE: liver enzyme
COPD: chronic obstructive pulmonary disease
GERD: gastroesophageal reflux disease
IVD: intravenous drip
IHD: ischemic heart disease
SOB: short of breath
FBS: fasting blood sugar
BGL: blood glucose level
LST: liver testing test
CVA: cerebral vascular accident (stroke)
BUSE: blood, uric acid, serum & electrolyte
GCS: Glasgow coma scale
ICB: intra cranial bleeding
OD: once daily
BD: bi daily
TDS : three times daily
PTB; pulmonary tuber culosis
B/PNEUMONIA: bronchial pneumonia
TRO: differential diagnosis
USA: unstable angina
D/S : dextrose saline
N/S: normal saline
AF: atrial fibrillation
DRNM: dual rhythm no murmur ( for Cardio Vascular System)
ESRF: end stage renal failure
Ix: investigation
UMN: upper motor nerve
LMN: lower motor nerve
AEBA: acute exacerbation bronchial asthma
SJS: steven Johnson syndrome
CXR: chest x-ray
AXR: abdominal x-ray
APTT: activated partial thromboplastin time
MI: myocardial infarction
CC: chief complaint
SNT: smooth non tender ( for abdominal examination)
PUD: peptic ulcer disease
PC: platelet count
C/S : culture & sensitivity
AFP: alpha feto-protein test
AFB: acid fast bacilli test

Others tuh, maybe aku x tahu agi. Let me know later.. kalau yang aku terluper. Alter I’lla dd it up…

Salam…………