Internal med exam

I'm glad that the exam was done in a group.A group of 3 students.

when i came to the ward and all other student had started their history taking.

and i started to panic.but thanks god.i managed to handle the emotion.

My hands was not trembling while takin the patient Blood Pressure,

like i used to.:D well, i proud of myself for that.

Among the Questions that the Doc asked (of which that i can recall):

- Tell me General look of the patient.

(The 1st thing that i noticed in the patient was her red cheek.)

Anyway, the patient was well conscious, oriented and cooperative.

She has no special decubitus,having Malar flush (Mitral facies)..

-in your mind what cause the Malar flush?

Mitral stenosis.

-The patient extemities is cold, and why is that so?

-What is the triad of Decrease Cardiac output?

-Take the pulse of the patient and comment about it.

-Take the BP.

and it was 90 for systolic and 60 for diastolic.the patient is hypotension.

(tho i was not that very sure, and i would like to do it again, but i didn't,

i just collect all my confidence and say it like im sure bout it)

and the questions of the BP goes on...
-what pressure indicates systemic highpertension?

-What are the importances of palpatory method?

-tell me about auscultatory gap.

-which patients may have that gap.

-other uses of sphygmomanometer.

-tell me about the Hess's test.

-types of dyspnea,give the meaning of orthopnea.

-tell about the grading of dyspnea.

-for the 2nd patient i was asked to comment on the patient tounge.

the tongue show bluish coloration which indicates cyanosis.

and the doc dont seem to be satisfied, and asked more.

what are the points that u shud comment about the tongue?

gosh,i swear i never read about it! i as far as i can remember i've not learn it in the class either.

-then the doc asked bout the neck vein.

the vein was pulsating and congested during expiration.

thnks god, the doc didnt asked bout what cause that condition.

as i have nothing in my mind bout that.

-some of my clique was asked to do percussion of the liver.

and i was surprised to know that the liver was shifting downward.

-the doc also asked what are going to do in ascites patient.

easy Questions.alhmdulillah.

so, that's all bout the exam..after the exam we went to KSP.(kafe Sri Putra) yeah!