10th Batch MBBS IIUM Blog

Photoshoot session for yearbook

Qarnikuri

Salam semua..

Rasenye each posting dh dpt briefing drpd wakil2 yearbook.

So photoshoot session boleh dimulakan bermula weekend ni..

untuk makluman semua, berikut merupakan contoh gambar2 yg akan diambil..

standard format adalah background putih mcm 3 gambar kt bawah ni...

Model 1 - HafizJo

Model 2 - Rodhy

Model 3 (yg x tahan gelak) - AJ

lokasi; mane2 bilik yg ade dinding putih besar

1. Rumah aku (Bukit Sekilau, utk brothers)

2. Ruang legar nk masuk common room JHC

3. Bilik pingpong tgkat 4 KOM, IMC

background mmg putih semata2... korg kene mainkan peranan utk mewarnai gambar korg sendiri..

Namun...

xdpt dinafikan, ramai dlm batch kite yg kreatif..

so aku xnak sekat mane2 kreativiti yg ade hanya kerana idea kami yg terbatas ini...

Maka, sape2 yg ade idea kreatif utk gambar sendiri, boleh la request..

contoh2 seperti berikut..

Model 4 - Amy.. Masa ; malam, lokasi ; simpang nak ke Tanjung Lumpur.. background; lampu2 jalan..

Model 5 - Sariu.. Lokasi; pantai kt Terengganu (xingat name tempat..), Masa; petang yg kemendungan Background: ape2 yg ade kt belakang.. asalkan lawa..

Model 5 & Model 6 - Sariu dan Akram.. Lokasi: Gerai keropok kt Kemaman.. Masa; Tengahari yg berangin.. background; warna-warni barang2 kedai

kpd sape2 yg still konpius, aku nk xplain sket lg... berdasarkan budget skrg, untuk sorg dpt 1 page mmg xmampu... So, skrg ni kene share2 page.. either

2 org/page,

3org/2 pages,

4 org/2 pages,

5 org/3 pages

dan seterusnya.....

contoh; group pic 3 org, dlm 2 pages...

tapi jgn la smpai 13 org per 7 pages.. mcm kumpulan nasyid wakil daerah la plak...

dan pastinya korg ade lg byk idea2 yg best..

ape yg korg perlu buat, plan elok2, then bgtau wakil yearbook setiap posting.. kerjasama anda amat diperlukan.

harap photoshoot ni dpt dihabiskan dlm posting ni..
ingat, sume org nak amek pro exam.. begitu juga dgn kami...

Penangguhan photoshoot hanya dibenarkan khas kpd ibu2 mengandung... diorg dibenarkan tangguh smpai dpt baby.. so boleh amek gmbar dgn baby dan suami..

Category: 18 comments

Considering Sabah??

Lady_D

After attending the "Life after MBBS: So what's next?" program, it triggers me to think and reconsider again about where to apply for my housemanship.
I've already listed a few options in my mind but when one of the speaker mention that "while you are single, take this opportunity to find new experience and work away from home.."
plus Dr Fahmi also said something like "Well, go to Sabah and Sarawak..Its a nice place you know.."
So, I wonder, how is it like to do housemanship outside the semenanjung? (Sabah and Sarawak in particular)
Luckily, we have our seniors who are now working there.So, i decided to ask for their opinion. Zaim was one of the early person who was very kind enough to respond and share his 6 months experience working in Hosp QE, Sabah..
I hope that it is worth sharing it here..and i'll try to find other opinions from those who are now working in Sarawak too and i will share them here when they respond ..;)

Housemanship in Sabah
msg via Fb by Zaim

It'd only my first posting here so I may not see the other aspects of working here but so far I enjoy being in Sabah, and working is not too bad tho there are up and downs.

First, transportation and lodging is not easy. If you are really keen on coming to KK, you must arrange lodgings early. We had a hard time over here. The temporary dorm provided is not adequate and taxis and rentals are expensive for long term. 1 taxi ride avg RM 20 even if youre going some place very nearby. Food is not too bad tho a bit more expensive.

Working in KK ull be rotating thru 3 hospitals Likas for peds and ong and A&E, sabah medical center for ortho and surg, Queens for a&e and IM. the first two are airconditioned. Likas can be freezingly cold time oncall.

Sabahan people are very friendly in general and very warm. Their language are also softer and the people are more carefree. There are some language barriers but not in most cases. So far theres no rascism issues that ive heard in sabah, in O&G the racial dstribution is pretty equal. Means that malays are minority but still were treated equally. MOs are less strict than back in HTAA i think.

Workload in O&G byk gila. If ur oncall in labour room and be able to sleep, you are very lucky and labour room is a stressful intense place. Wards are almost always full. HOs ramai over here but if ur enthusiatic ull be able to learn alot as the cases over here are interesting. Eclampsia is common, ive seen 4 cord prolapses, abruptio are almost weekly. In O&G ull have to at least attempt to perform 3 Csecs and ERPOCS and Vaccuums which are compulsory. hands on memang bagus and being in a tertiary hospital ensures u have MOs to teach you well.

KK is a small town tho slightly bigger than Kuantan I think. Malls byk, alot of fast food and seafood. Byk tempat melancong tho ecotourism is promoted heavily. Scuba Kinabalu climb are a must. Every weekend I try to go somewhere. And everyday to work ill pass the beautiful sea making going to work a bit less stressful.
From my batch Nurliyana NAzri, she was in peds. Seniors ade ramai, Fatin salwani, munirah, fatehah. Tawau side ade kurshid, dayah, aiman and liyana (wife) Hawa nordin Sandakan ihsan, samirah,
Try asking them for feedback.
After a short time here Im really considering being in service here long term.
Its a really nice place.

Category: 10 comments

Beautiful Story Of A Pious Muslimah And A Kind Muslim Doctor

Zuhairi Zainuddin

Assalamua'laikum.

If you have 5 minutes of free time, hopefully you can spend some time watching this video, clipped from a lecture by Sheikh Muhammad Hassan as he tells a very beautiful and moving story.

Indeed Allah will really help muslims that ask for His help, insyaAllah.

Category: Tazkirah 1 comments

So What's Next? Life After MBBS

Hisservant

So What's Next? Life After MBBS

Tentative Programme

Category: 0 comments

So Whats Next? Life After MBBS...

ZaroL

salam.saya mewakili rakan2 seposting ingin mengucapkan selamat h

ari raya aidil adha.sehubungan dgn itu, pihak kami ingin meminta cadangan untuk topik2 yg dirasakan penting untuk ditekan

kan dlm topik2 berikut.

1)tackling life as a HO by dr. Azura

2)options after graduation by Prof Tahir (academician), Mr Faidzal (surgeon/clinical lecturer), Prof Jamal (Public Health)

3)how to make a different as an IIUM graduates by Prof Arif

4)marriage, family n career by Mr Azril, Dr Suhaiza n Dr Soraya

untuk memberi cadangan, nyatakan no dan letakkan cadangan anda.postkan ke notes ini atau sile msg directly to me through facebook, ym, skype, or hotline.sekian. terima kasih.

p/s:kitorg da ade sedikit sebanyak tp still memerlukan idea sbyk mungkin untuk menambahkan lg manfaat projek ini.

Category: Group Project 1 comments

Di sebalik ucapan takziah...

Hana Insyirah

Salam Takziah buat sahabat kami, Hadzri.
Kami memohon pada Allah, agar Hadzri bersabar dalam menghadapi segala ujian dari Allah. Dan sesungguhnya selepas kesulitan itu pasti ada kemudahan.

Daripada Ummu Salamah r.ha, isteri Rasulullah saw. berkata, “Aku mendengar Rasulullah saw. bersabda, ‘Tiadalah seorang hamba yang mengalami musibah, lalu ia mengucapkan:

إنـّـَا لـِلّـَـهِ وَ إنـّـَـآ إلـَيـْهِ رَاجـِعـُونَ

اللّـَهـُـمّ أجـُرْنـِى فـِى مـُصـِيـْبـَتـِى وَأخـْلـِفْ لـِى خـَيـْرًا مِّنـْهـَــا

(Sesungguhnya kita adalah kepunyaan Allah dan sesungguhnya kepada-Nya kita kembali. Ya Allah, berilah aku pahala atas musibahku, dan gantilah untukku dengan yang lebih baik darinya), melainkan Allah Swt. pasti memberinya pahala dalam musibahnya dan menggantikan untuknya dengan yang lebih baik darinya.”
Dia (Ummu Salamah r.ha) berkata, “Ketika Abu Salamah r.a. meninggal, maka saya berdoa dengan doa yang diperintahkan oleh Nabi saw. kepadaku, sehingga Allah Swt. memberikan pengganti untukku suami yang lebih baik daripadanya, iaitu Rasulullah saw.”

(HR Muslim)

Di sebalik ucapan takziah, tahniah juga buat Hadzri kerana terpilih oleh Allah utk menerima ujian berat ini, yg mungkin tak mampu dihadapi oleh kami yg lain.. sayangnya Allah pada Hadzri dan keluarga Hadzri, hingga Dia menitipkan ujian ini untuk menambah iman kalian, insyaALLAH...

"Sesiapa yang Allah inginkan padanya sesuatu kebaikan, (Allah) akan mengujinya" (Hadis sahih riwayat al-Bukhari)

Dan semakin berat ujian seseorang, itu sebenarnya merupakan reflection kpd tahap keimanannya. Buktinya, para Nabi diuji dgn tahap ujian paling berat.. kemudian, ujian yg berat juga diberikan kpd para sahabat, tabi'in, dan umat Islam seterusnya mengikut tahap keimanan masing2 yg bertingkat-tingkat..

"Manusia yg paling besar ujiannya adalah para anbiya' kemudian golongan yg sama imannya seperti para anbiya'. Seseorang itu diduga berdasarkan pegangan agamanya. jika dia berpegang kuat pada agamanya maka akan ditambah lagi dugaannya. jika pegangan agamanya lemah atau sederhana maka dia diuji bergantung kpd pegangan agamanya itu"
(Hadith sahih riwayat Ahmad, Bukhari, an-Nasaie dan Ibn Majah)

'A'ishah juga pernah berkata,
"Sesungguhnya aku belum pernah menyaksikan seseorang (menderita) kesakitan yang lebih parah dari apa yang dideritai oleh Rasulullah Shallallahu ‘alaihi wasallam." (Hadis sahih riwayat al-Bukhari)

Akhir sekali sahabat sekalian, semoga kita semua beringat,

"Apabila manusia telah meninggal dunia, maka terputuslah segala amalannya kecuali tiga daripada amalnya, sedekah jariah, ilmu yang dimanfaatkan dan anak (lelaki atau perempuan) soleh yang berdoa untuk simati" (Hadith sahih riwayat Muslim dlm an-Nawawi, Syarah Muslim : juz 1 hal; 9)

Moga Hadzri dan kita semua sentiasa menjadi anak yg soleh...

Allah berfirman dalam hadis qudsi yang bermaksud,"Tiada balasan bagi seseorang hamba-Ku yang telah Aku ambil kembali kekasihnya, kemudian orang itu mengharapkan pahala daripada-Ku, melainkan orang itu akan mendapat balasan SYURGA." (Hadis riwayat Bukhari).

Category: 2 comments

Ghaus & Tim in MMA News Bulletin

admin@10thbatch

An article sent by Dr. Zamzil Amin which regards to 'Kuantan Biggest Morning Tea' event was published in MMA News Bulletin vol. 40 no. 9 (September 2010 edition)..

http://www.mma.org.my/LinkClick.aspx?fileticket=e6fxOhUAAmw%3d&tabid=70

Category: Photos, Program, Suka-suka 1 comments

Zulhijjah dah sampai !!

s_eth

Ibnu ‘Abbas, Rasulullah shallallahu ‘alaihi wa sallam bersabda,

« مَا مِنْ أَيَّامٍ الْعَمَلُ الصَّالِحُ فِيهَا أَحَبُّ إِلَى اللَّهِ مِنْ هَذِهِ الأَيَّامِ ». يَعْنِى أَيَّامَ الْعَشْرِ. قَالُوا يَا رَسُولَ اللَّهِ وَلاَ الْجِهَادُ فِى سَبِيلِ اللَّهِ قَالَ « وَلاَ الْجِهَادُ فِى سَبِيلِ اللَّهِ إِلاَّ رَجُلٌ خَرَجَ بِنَفْسِهِ وَمَالِهِ فَلَمْ يَرْجِعْ مِنْ ذَلِكَ بِشَىْءٍ ».

"Tidak ada satu amal saleh yang lebih dicintai oleh Allah melebihi amal sholeh yang dilakukan pada hari-hari ini (yaitu 10 hari pertama bulan Dzul Hijjah)."

Para sahabat bertanya: "Tidak pula jihad di jalan Allah?"

Nabi shallallahu ‘alaihi wa sallam menjawab: "Tidak pula jihad di jalan Allah, kecuali orang yang berangkat jihad dengan jiwa dan hartanya namun tidak ada yang kembali satupun."

HR. Abu Daud no. 2438, At Tirmidzi no. 757, Ibnu Majah no. 1727, dan Ahmad no. 1968, dari Ibnu ‘Abbas. Syaikh Al Albani mengatakan bahwa hadits ini shahih. Syaikh Syu’aib Al Arnauth mengatakan bahwa sanad hadits ini shahih sesuai syarat Bukhari-Muslim

_______________________

Baca selanjutnya >>>

(Klik) Meraih Limpahan Pahala Di Awal Zulhijjah

Perkara yg dibincangkan:

Kelebihan Beramal di Sepuluh Hari Pertama Bulan Dzulhijah
Amalan yang Dianjurkan di Sepuluh Hari Pertama Awal Dzulhijah
Keutamaan Hari Arofah
Jangan Tinggalkan Puasa Arofah
Puasa Hari Tarwiyah (8 Dzulhijah)

Semoga kita semua sama-sama beroleh manfaat.

Wsslmkm.. ^_^

Category: Tazkirah 1 comments

jadual IM

Syed Ajmal

Category: Announcement 0 comments

bukan HARI biasa

bolapi87

long case with Dr S

(patient was very drowsy during history taking, one thing u ask, a word came out, so it took longer taking history, and patient not much cooperative as well)

50 M/M restaurant manager D8 admission

k/c/o HPT, DM and heart failure

c/o loss of consciousness on the day of admission

occur in the car in the evening

preceeded by palpitation, sweating and lethargy

denied chest pain, shortness of breath, vomiting

denied aura, seizure, fever, headache, neck stiffness

claimed taking lunch prior to LOC

claimed compliant to medication

PMH DM, HPT x 3 years heart failure x 3months

FMH of IHD and stroke

SH Smoker 30packs years

O/E alert, conscious, tachypneic on NPO2, good hydration, obese type 2

pallor, pulse irregularly irregular, JVP not raised, bilateral pedal edema

precordium: apex beat displaced, no parasternal heave or thrills, s1 s2 heard with no murmur, bibasal crept detected with no hepatomegaly or ascites

dx: ccf

ix:

ECG

CXR

FBC

BUSE

RBS

Mx:

ABC

IV diuretics

ACE-i

ARB

b-blocker

NB: there's much to tell but hard to convey, this is my time, maybe tomorrow, someday who knows there'll be yours, just get better and better k!

Short case with Dr C R:

Dr C R: patient has progressive shortness of breath, examine respi system

general:

elderly chinese male tachypneic with NPo2 dehydrated, cachexic, branulla and cbd attached

pallor and clubbing, but no jaundice or cyanosis

no nicotine staining no HPOA no flapping tremor

pulse was 72b/min regular and good volume

no injection marks, no BCG scar, no raised JVP

left horner's syndrome, good oral hygiene, trache deviated to the left,

2FB tracheal tug, multiple cervical lymphadenopathy, pitting pedal edema up to mid shin level

chest:

pectus carinatum, no dilated vein, no scar,

chest expansion reduced on left side, dullness at left middle zone, stony dullness bibasally, otherwise hyperresonance, tactile fremitus and vocal resonance almost equal bilaterally, reduced air entry on the left side middle zone, vesicular breath sound heard with generalized crepts

dx: lung collapse secondary to lung carcinoma with underlying aecoad and pleural effusion

what u need to know?

1. causes of tracheal deviation ipsilaterally - fibrosis, lung collapse

2. features of fibrosis - dullness and increase vocal resonance and tactile fremitus

3. features of lung collapse - dullness and normal vocal resonance and lung collapse

4. causes of lung collapse - malignancy: obstruction of bigger airway leads to collapse of distal airway, TB: big hilar lymphadenopathy leads to blockage of proximal airway, bronchiectasis: obstruction by copious mucos in the airway

5. pleural effusion and pneumothorax cannot cause lung collapse because it only compress the lung externally and yet lung still can expand a little

Re-exam short case with Dr A S:

examine cvs (another patient with heart failure)

almost same questions were asked but with some additional questions:

1. right sided heart failure features

2. left sided heart failure features

3. copd causing heart failure - right congestive heart failure, not both side congestive heart failure

4. causes of heart failure - thyrotoxicosis, anemia, ihd,hypertension, valvular heart disease, infection, pregnancy, cardiomyopathy

5. causes of hypertrophic cardiomyopathy

6. causes of dilated cardiomyopathy

7. causes of atrial fibrillation

8. causes of irregularly irregular pulse

9. causes of syncope

10. causes of LOC

11. relation between heart failure and arrhythmia (pathophysio)

12. explain vasovagal syncope

13. explain cardiogenic syncope

14. classification of obesity

15. treatment of heart failure both in stable and acute onset

16. mech of action of betablocker

17. mech of action of digoxin

18. side effect of betablocker

19. side effect of digoxin

20. mech of action ACEi

21. side effect of ACEi

(reminder: i did give 4-5 answers for each Q yet still not enough, maybe at least 10 answers would satistify them, wondering how much medical student's brain can remember multiple systems with thousands of pathology with millions of etiology and drugs to remember, in my point of view if u can remember at least one is fine, about 5 is good enough and 10 of those is superb)

Study hard guys, dont be like me ^^

this is link for some dialogue during my long case(for those who wants to know only)

Download

Category: Exam 5 comments

Sharing is caring...My O&G clinical exam...

jepa yg baik lg jujur

LC (Dr Dahlia) - 26yo, G2P1, @ 38/52 plus 2 days, with history of secondary subfertility, admitted for IOL in view of GDM under s/c insulin, antenatally she diagnosed GDM at 9/52 POA complicated with symptomatic UTI treated with antibiotic, vaginal candidiasis not on Rx and asymptomatic mild anemia

Questions:

1. Normal value MOGTT, BSP, frequency of BSP
2. What investigation u want to do in view of her dx of GDM at 9/52 - HbA1C, detailed scan
3. Complication of GDM - antepartum, intrapartum, postpartum (maternal, fetal)
4. When patient first admitted what do u want to do?
5. When u want to do IOL?
6. How u want to assess pt before IOL?

SC (Dr Suhaiza) - G4P3, with 1 previous scas due to PP type 4 (there's Foleys catheter tag at her ber)
Abdomen - normal exccept 1 well-healed suprapubic scar

Questions:

1. Why patient was admitted? - IOL...what indication? (Post date, underlying medical prob maybe)
2. How to counsel for trial of scar in this patient? Do u want to recommend her for SVD or LSCS? Why? - SVD provided that baby is not big, no evidence CPD, prev successful trial of scar...
3. Complication of IOL? - uterine hyperstimulation, uterine rupture, failed IOL, cord prolapse, risk of PPH
4. Do u think this patient has PP? why? - no because normal lie, fetal head has engaged...

Category: Exam 2 comments

O & G clinical

syazwani

Long Case :

1. Post Date (EDD+8/7).e/a for bishop score and IOL.K/C/O Bronchial asthma.Last attack 2 years ago.Not on medications currently

a. MOGTT- How to do MOGTT

b. Interpretation MOGTT/HbA1c

c. How to manage GDM

d. Weight gain-N weight gain in pregnancy

e. IUGR/SGA

f. Post date

i. Complications of post date

ii. Why the fetus get complication

iii. Types of IOL

iv. IX before IOL( more on U/S)

2. (dr nurhazinat) Leaking liquor w underlying asthma, PIH ,anemia w resolved UTI

a. TX PIH

b. Dif MX of LL (preterm/term)

c. Advice b4 pt goes home (if preterm)

d. Sx of UTI

e. Cx of LL

3. Epilepsy in pregnancy w rash (housewife,32,g4P3 presented w epilepsy tx started at 24 w POA,already had 5 attacks during this pregnancy,no significant antenatal HX

1. DDX of epilepsy

2. Differential o rash +investigation

3. Describe the rash

4. Scenario-pt has herpes infection, already term, will you allow delivery?

5. This pt, contraction already 2:10 moderate, now EDD how would you manage?

4. 35+ y/o Malay lady/G6P5 @EDD +3/7 Hx of anemic during pregnancy (current) .no other med illness

1. How to tx IDA –Types,route

2. Mx-PT postdate ,having contraction, still in ward.Would you send her to LR? Yes.bcz risk of stillbirth,IUD,etc.placental insufficiency (term)

5. GDM

1. Cx of GDM

2. MX obstructive labour-big baby,shoulder dystocia mx

3. IOL

4. Sugar control-BSP

6. 25, G1p0 @28 W

1. Preterm labour w UTI sx

2. Came w contraction +show

3. From definition till mx

7. (dr hazinat)27 y/o Malay : contraction pain +show at 33 weeks.POA-no LL,white discharge (vaginal) for 1 week .No other significant HX.DX: preterm labour 2dary to genital tract

a. Ddx

b. Ix-explain reason

c. Mx-dr tekankan yg ni .die tanye mx after discharge sekali.eg u/s b4 dischrge-make sure amniotic fluid cukup.no SI,No douching, come asap if S&S of chorioaminiotis etc

1. Dr tanye more on clinical ,xde BMS

8. 30 y/o Chinese/malay/g2 p0 +1 @26 w POG admitted due to high bp

a. Cx of metyldopa

b. Cx of PIH

c. How to ix

d. How to manage PIH

9. 36Y/O teacher e/a for expectant mx for asx pp.basically no sx.accidentally dx during reg antenat check up @ 28 weeks POA.Type III PP.Referred fm KK to HTAA @ 34 w.plan for CS at? Not sure how many week

a. If bleeding at 36w-w ,no pain.wait or not?no .directly do cs

10. 30 y/o mom @ 34 w w bronchial asthma and GDM (dr khaled)

a. Asthma control

b. Medication

c. Mx of delivery

d. GDM

i. How to dx GDM

ii. HOW TO DO ogtt

iii. Mx of delivery

iv. Indction of labour

v. Types

vi. How

11. 25+yr malay G3P2 at 26 w dx w persistent protenuria since booking.2-3+ no sx of IE. presented w epigastric pain, n/v/ headache EXCEPT HIGH BP.treated at PE room .given medication.sx resolved.but BP Stable .NEVER rise.plan for U/S next week.otherwise pt had no signs –no edema,no urti sx,no family hx of renal,hpt ,connective tssue dx like SLE (dr suhaiza)

a. What ix to proceed?

b. KUB u/s?

c. Normal value of creatinine?

d. C3?c4?

1. Same pt (dr sudesan)

a. Causes of protenuria in pregnancy

b. How do you manage (ix and tx)

c. Show how you check for hyperreflexia

12. Pt with type 1 DM admitted for IOL @ 38 weeks with Hx of undiagnosed PCOS, 3x APH, UTI symptoms, candidiasis

13. 30/Malay/G2P1@ 39 week + 2 days PIH on PGE p/with HPT during antenatal f/up, admitted for further Mx of HPT.

1. Classification o HPT during pregnancy

2. Management

3. IOL-Types and Cx

14. 35/Malay/G3P2 @ 37 weeks POA complaint of sudden gushing of fluid 9 hrs PTAAntenatally: anemia, asthma, previous Hx of C-sec, GDM diet, transverse lie

1. Mx of asthma

2. Causes of transverse lie

3. Cx in PROM and Mx

15. 25/Malay/ G2P1 @ 35 weeks POA with GDM, complaint on and off contraction pain with no show/LL ONLY whitish vaginal discharge n itchy

1. Calculate POA

3. Dx

4. Ix

5. GBS

16. 23/Malay/ G1P0 @ 32 weeks, PPROM, with LL for 14 days

1. Cx

2. How to Dx

3. What to do when pt come

4. What to do if No labour

5. Can it be chorioamnionitis

17. GDM on insulin, plan for ELLSCS. Antenatally: anemic. Previous Hx of GDM on diet, C-sec (prolonged labour)

1. How to Dx GDM

2. When to do BSP

3. Insulin storage/medication

4. Pre-op medication and preparation

5. Iron requirement in pregnant women

D: zanaridah- LONG CASE- with Dr bahyah

Patient is 37 years old housewife, G7P3+3(history of abortion for the 2nd, 4th, and 6th pregnancies at 2-3 months), diagnosed having diabetes mellitus 4 years ago on OHA (metformin).… some question yang dr tanya are,

1. Apa definition of recurrent abortion? Patient ni recurrent abortion ke?

-patient ni bukan recurrent abortion.. sebab recurrent abortion is the occurrence of repeated (three or more consecutive) pregnancies that end in miscarriage of the fetus.. the keyword is CONSECUTIVE… , patient ni tak..

2. Tell me all the symptoms of UTI?

3. What are the sites of skin infection that we should look for in diabetic patient?

4. after history, dr suruh examine patient depan dia..

5.then discussion mainly on diabetes and its complications in both mother and fetus.

- complication tu, kena list elok2.. divide kepada maternal and fetus… during antepartum, intrapartum and postpartum

6.then dr tanya pasal future plan of the patient.. dh complete family or not.. and the method of contraception.

-lesson I learnt: don’t ever tipu dr.. if xbuat or tak tanya patient certain things.. mengaku je.. if tak tahu nak jawab.. pun mengaku je.. jangan merepek..

Short case:

1. Uterus smaller than date+ 1 prev scar

a. Causes

b. How to investigate (more on u/s)

c. How to manage –IUGR, sga, 1 prev scar

2. Dr Roszaman- Big baby (4.2 KG) for ELSCS

a. Difficult to palpate the fetal head.y?patient contracted that time.(true) .fetal head engaged (false)

b. What is ur plan (ELSCS ->y? dx early,can plan LSCS

c. What will you do if patient goes to spont labour?to assess CPD by History and clinical.Hx- how big baby ,how prolonged labour prev,shoe size,height

d. Clinical-sacral promontory,ischial spine,ligament,subpubic angle,etc

3. Uterus larger than date

a. Ddx

b. Method to determine EDD

c. Parameters to observe in fetal scan

d. How to trace result

4. Examine abdomen (young women with prev scar going to OT.Refuse Trial of scar (reason y pt going to OT For csec

5. Breech +LSCS scar

a. Scar tenderness

b. Causes breech most prob + scar

c. Cx of PP

6. Obese, 35 yo G2P1 @ 32 w POA

a. Examination :clinically 36 w fundal height SFH 35 cm

b. Larger than date.causes

c. Details about macrosomic baby

i. Weight

ii. Complications

iii. Etc

7. Prof mokhtar.transverse lie -TL

a. How do you manage

b. Option of tx

c. Expectant mx

i. What ?

ii. Pros n cons

d. Cx of TL

e. Btw TL & breech in which ECV has high chance of success

8. PPROM

a. How to manage

i. Ix and mx in ward

9. Pregnant lady @term for cs (dr suhaiza).Exam:scar-csec,laparotomy scar

a. Indication for csec & laparotomy

b. What is her current csec for?

10. Pregnant lady w scar

a. Trial of scar

b. Contraindication

c. How to check /confirm date? Book/u/sound

11. Uterus larger than date

1. Causes/DDx

2. Cx-shoulder dystocia, fetal distress

3. Mx of shoulder dystocia

12. Uterus smaller than date

13. Unstable lie

1. Defn

2. Causes

3. Mx

4. Cx

14. Transverse lie with underlying PP type 2

1. Causes of abnormal lie

2. When to do C-sec

3. Cx of PP with 1 previous scar-placenta accrete

4. Is the position of the baby back important in C-sec case?- Yes, easier to take out the baby during C-sec if the back facing the mother (easy to grab the legs)-Dr Sudesan

15. 1 previous untried scar

1. How to examine the scar

2. Cx of PP with 1 previous scar-placenta accreta

16. Transverse lie in PP type III.+Pfannenstiel scar

a. Tell me diff types of PP

b. What is the risk this pt has?placenta accreta

c. How do you manage placenta accreta?

d. How to deliver the baby

e. How do you prepare for C Sec

D:
Zanaridah: SHORT CASE-with Dr Raja Ariff

(patient was at bed 24, near the ward entrance.. wearing the white gown for OT)dr: This patient, 28 year old, Gravida 2 para 1… LMP: etc,

1.calculate the patient’s POA and EDD
2. examine this patient’s abdomen..

Me: (start examining the abdomen)- buat running commentary.. I noticed there was a Pfannenstiel scar.. so, cerita pasal scar tu.. 16 cm. well healed , no evidence of hypertrophy or keloid formation. When measure SFH is was 4 weeks larger than date… clinically pun dh besar… singleton fetus, longitudinal lie, the head was 4/5 etc

3. Pfannenstiel scar is due to? Me: caesarean section, myomectomy , etc
4.., what is the important thing here?Me: uterus larger than date
5. what are the possible causes of uterus larger than date in this patient?
6. what are u going to do? How do u manage this patient?
7. possible indication of C-sec in this patient?

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