Deep Tendon Reflex

Semalam Fariez sempat pergi ward mencari patients yang mungkin membantu untuk OSCE esok. Tak banyak pun yang dapat. Tapi okie la kan, daripada duk rumah, habuk pun takde.

The 1st case, quite interesting : Budak lelaki comel dengan horseshoe kidney. Sempat auscultate heart die je. S1, S2 was audible, no added sound, no murmur. lepas tu Bob nk sentuh die, die da tak nak kasi. mama die kate, "huwa tuhib banat bass " (he likes th girls only ) muahaha.Maka, harapan je la nak buat renal angle test. (tak tahu la kenapa rasa macam renal angle test akan keluar OSCE esok, tapi harap- harap tak keluar.boleh ke mcm tu?)

Waktu keluar dari renal ward tu, Mama die panggil,pastu suruh Fariez tgk-tgk kan details dekat health reports. Ade blood, n urine analysis. Fariez terdiam sekejap, sebab tak banyak pun y fariez faham, tak familiar dgn medical short form (cewah, alasan). tapi die ade tulis "N" at every end of the data. Normal la maksudnya kan.So Fariez cakap, " Mafish musykilah, kullu tamam insyallah. Rabbuna yuawiki. Maassalamah" cepat-cepat beransur.

Gosh! macam mane nk jd Doc ni. I'm lack of confidence!

2nd case : Budak perempuan, muka ill gila, (kesian tau tgk). complaining of difficulty in breathing during activities n sleeping.ade edema lower limb, pastu abdominal mass (enlarge tender liver). Heart Failure ! so kitorang auscultate heart budak tu, S1 S2 cannot be heard, murmur was present. Pan systolic murmur best heard over the mitral area, and propagate to axilla. Grade 3 (sbb takde trill) character..erm.. Harsh kot. Differential Diagnosis?? erm ape je yang buat Pan systolic murmur? Mitral incompetence la kot kan. VSD (ventral septal defect ) ? VSD max intensity dekat 3rd n 4th Left space kn.ntah.

3rd case : Cerebral palsy! That lilttle girl is very skinny. kaki die takde muscle langsung, skeleton only! can u imagine that?  Mak budak tu cakap, die dtg hospital ni sbb ade imtihan (exam). okie that's a clue! confirm la ade cerebral palsy patient untuk exam OSCE esok. kan kan. (saje nk sedapkan hati ) Blur gila waktu tengok patient tu, nak cek reflex? deep n superficial.Liza buat plantar reflex, okie +ve Babinski sign.pastu gembira kan. ^_^ Pastu cek clonus, ade jugak owh, so Patient ni spastic cerebral palsy.

er ape lagi.. masing-masing blur.try jugak cek reflex die. nak buat ankle reflex pun kekok gila.hish, T_T ape la nk jd!Maybe this is the cosequences,  bila kelas da abes lama, lepas sebulan baru nak OSCE kan.(tgk, tgk! nk salahkan OSCE punya timing pulak :P ) okiela. thnks for reading. selamat study ye sahabat-sahabat ku.da~

Video : bukan senang nk deal dgn lil kids. but still, Fariez rasa nk jd pediatrician :)