DKA ( sing along)

Fariez just type semula the lyric, to make it easier for u guys to sing along.
(well, if only u consider this song as a song)
happy holidays studying guys!

If a kid shows up in ketoacidosis,
u better go ahead n make the diagnosis
oftype 1 diabetes right now,
and in this case u better know how

to quickly get the kid out of this mess
cuz DKA can lead to death
grab a UA and a glucose finger prick,
n get your blood gases really quick

U should assess dehydration firstly
cuz the kid's whole body is extremely thirsty
but to keep the Glasgow score from getting low
U'd better give your fluids really slow.
If u correct too fast u'll cause edema
around the brain ,which may seem a minor problem,
but it's NOT.
cuz that brain is the only one she's got.

with DKA
some kids will say
they did'nt know they had DM

Believe what they say
cuz DKA
is the presenting complaint in 25% of them

u should also draw a set of lytes,
BUN,creatinine, and CBC, right?!
Check the anion gap, i will be high
and quickly consider other reasons why
the anion gap might be headed toward the sky
the"MUDPLES" mnemonic is worth a try
Check the blood for beta-hydroxybutyrate
and confirm the level of phosphate.

And know that total pottasium decreases
due to all the diuresis
even if serum pottasium looks high,
Due to acidemia, there's a shift
of pottasium out of cells and ultimately into piss.
Ketone n sugar draw too much water into the filtrate,
and the water drags sodium,K, n phosphate.

with DKA
u must wacth K+
n u'd better
check the other lytes too

with DKA
the signs kids display
are here for
 ur quick review~

Kussmaul respiration,
orthostatic hypotension
and distinctly fruity breath
vomitting n nausea
signs of coma
give the kid inslin to prevent death!

We've throughly discussed fluid repletion
but an insulin drip is required from completion
of correcting all the signs of DKA
As u give insulin, u should see pH
Slowly rise if u give it times
Don't give bicarb, that's a crime!
Just drip the insulin and keep checking the bicarb
it should climbs if u don't let your guard
down

With DKA,
There's a low pH
and a compensatory drop in CO2

To make DKA
just go away
u know exactly what to do

Give insulin
and run fluids in
and monitor for neuro change

U'll save the kid
and know what u did
was rescue him from pain

Ewah-ewah bercuti!

1.Happy holidays Alexandrian Medical team! Rasanya semua orang patut bersyukur dapat cuti seminggu sempena Hari Raya Haji, kat Malaysia tak dapat kot cuti seminggu. kalau negara laen,ntah-ntah time raya kene jugak pergi lectures/classes n all.ye tak? maka ucaplah alhamdulillah :)

2.Semalam balik dari seminar ibadah pesakit,da magrib da waktu tu (berjalan kaki ke rumah) jumpa 3 couple,adek-adek, yang lelaki baju basah (baru lepas mandi pantai kot). berjalan dgn muka ewah-ewah innocent nya.ish2.

3.Fariez sepatutnya spend kan masa cuti ni bercuti ke Hurgada!! tapi lepas timbang tara dgn benda laen, which is study.fariez terpaksa tarik diri. sangat berat hati.huwaa~ dan fariez akan jeles dgn diorang-diorang y pergi. tapi bila di fikir-fikir kan, the rest yang pergi tu, mmg semuanya jenis pick up, u know, jenis genius kan kan.study last minute will not be a problem to them.saya ni?? tak boleh.. so bai bai, have fun la korang! fariez kene make sure yang fariez betul2 study cuti ni.huh. kalau tak mesti fariez myesal sangat2.

4.rasanya ni 1st time raya kat Mesir tanpa sambutan.Like previously, every year PCI (Perubatan Cawangan Iskandariah ) akan adakan majlis sambutan hari raya, dgn tema yang berbagai, ada jamuan makan, ada persembahan, ade games sume.Pelik nya, kenapa tahun ni takde?? can anyone explain?

5.Raya thaun ni 17 november eh?? seriusly? OMG!
kebetulan sangat.. Birthday Mr Firuz hari raya puasa, Birthday Naim hari raya haji. eh eh.

6.Selalunya kalau la fariez give up, fariez akan cari org untuk share dgn org tu apa y fariez rasa. n selalu nya, akan okie la.. tapi 2 hari lepas, orang yang selalu bagi kata-kata semangat kat fariez pulak give up, dan fariez tak dapat nk tolong dia. rasa helpless sgt. Pastu sedar, ALLAH kan ada.

 "awak jgn give up okie! just keep going,slow-slow pun takpe.pastu kita doa sama-sama, mintak ALLAH mudahkan.hokay! *hug*"

7. Cikgu bahasa arab saya, Asma sgt comel tau.lawa.cantek.tinggi. kalau sy lelaki, mesti da jatuh hati dgn Asma. ah, boleh ke mcm tu?

8. tak suka lah dgn surgery department. suka-suka je last minute nk tukarkan orang msuk elective oncology! tau tak fariez da berangan dari dulu-dulu lagi nk main-main dgn endoscope! kecewa. hancur harapan. da la fariez jenis tak suka bila kene paksa-paksa ni.haih.

9.okie nk tgk ANTM. aza kate ade kejutan.

10.Tkay da dapat Gold medal untuk Zombie. oh tahniah cik housemate!

 okie bai bai. Kol sanah wa ento tayebeen!

happy birthday kak Fatin !

 P/s: birthday kak fatin diraikan oleh ahli rumah dan kawan-kawan terdekat yang sudi dtg di Pizza Queen,Green Plaza. (gambar last takde kne mgena dgn birthday kak Fatin, saje upload ;)

Becoming a Pediatrician

once said that the elective course that we choose should be in line with our desire profession or interest, u know like example, i'm imaging myself as a paediatrician in future, so i may choose an elective course that related.(if there's any) . Elective course gave us an oppotunitie to explore more and get extra knowlegde bout the course that we've choosen.

And it should encourage u to attend every class of elective course. Because u are the one who are eager to be in that elective course.Isn't?? but why on earth, some of students escape from the class??  it's not that i have a problem with that,i don't mind pun.cuma rasa mcm, wa~ overnye kau ponteng smpai berhari2,tak rasa bersalah eh??

anyway, fariez pilih Neonatal Care as my 1st elective course for this semester. Some may want to know, how bout the classes..so far okie la.. got silibus n timetable, nampak lebih systematic compare to Radiology class which i took last year. cuma , class sepatutnya start pukul 9, but usually ( i mean the last few days ) the class started one hour late(more or less). itu menguji kesabaran jugak la.but starting next week, i think ,that will no longer be a problem, bcause the Doc allow us to go around the NICU, and make a noenatal examinations as much as we like.that's just great!!

This neonate was the 1st case we were xpose to.It's break our hearts when we saw this poor baby. berat betul ujian buat bayi kecil ni.She's on a battlefield at a very early stage of life.Dr Hassan said, even if she could survive, she'll facing a neurodevelopmental problems.Again, my heart broke into pieces :(

very tiny lil fingers. ( grasping reflex present )

Muka baby ni suci sgt! cant stop comparing myself with them. macam, aahh, banyak nye dosa-dosa compare dgn korang-korang y putih bersih suci murni ni.(i really hope they grown up to be a good person!)

12pm, is feeding time, the most exciting session  i guess :) bukan baby yang excited, org yang nk bagi susu y excited. the pic above as a prove :P

this is during resuscitation session, done on newly born baby.Muka baby tu subhanallah, mmg sama sebijik macam muka mak die.kagum betul dgn ciptaan Allah.

 :) :) :) ( senyum banyak2)

Saadah, Husan, Mizah, n Amira.it was a very tiring day, we were standing through all the session, but yet mereka masih mampu untuk tersenyum. :)

that's me! singing a soothing lullaby while feeding the premature baby :) btw, he has a very shiny beautiful eyes! I adore his eyes very much.

i cant help to not telling u guy bout this baby. she been there for a quite sometimes,well actually, she's ready to be discharged. but nobody wants them.how sad! oh, lupe nk ckp, die ade kembar.their mum ran away, and left them. sedey betul.sgt :( ramai org yang nak anak kembar, boleh pulak mak die tinggalkn diorang.till the procedure done, they will afterwards given to orphanage.

Bukan kah kita sepatutnya bersyukur?

Hello Inspiron.

i may sound a lil bit emotional so please ignore. or better do not read through this entry.

Yesterday, i'd spend more than 5 hours arguing with those egyption dekat Suk Komputer. urgh! i know it's not good to hate people, but i can handle it no more (some advise; jgn benci kat orang ) tapi tak boleh, rasa benci jugak.maybe i need a powerful detergent or clorox or something y boleh bersihkn hati. Bencil laaa. "Kenapa org arab ni suka menipu? kenapa eh??ape diorang igt duit haram tu bagus la?ee yuck!!"

Rasa traumatize betul, especially with those sweet talker Egyptian salesman. blwek!
tapi sekarang Fariez da okiela, totally free from adrenaline rush. The 5 hours of arguing worth me a new Black Inspiron Mini.I'd bought a gorgeous red Inspiron mini last week, and just discover that the keyboard is somehow arranged wrongly, straightaway i rush to the store where i bought it.

As the matter of fact,i'm really not sure how to respond with the salesman.Shud i give him a smile n complaint gently, or just come with a plain angry face( bcause he seem to gave me a rejected laptop,yup, that's purely what i had in mind ),but then i decide to act naturally.

The saleman actually laugh at me for complaining bout the laptop which triggers my anger.Die kate takde orang nk guna symbol ~ , symbol < ..mase tu, i was like, huh?? bukan ke awak sepatutnya gave me some empathy?or shud not? da la mende tu tak okie.pastu gelakkn fariez sbb guna those symbol. eeei!

Then,angrily i order him to fix it or else i want a new laptop. So there it goes.. 5 hours of trying to fix the laptop with me trying to convince him that he will never be able to fix it. u see ,obviously, the keyboard was manufacture wrongly! ( trust me,u do not want to know what exactly the problem of that freaking keyboard, because it's way too complicated to be explained n to be understand )

the time is ticking n the day is getting dark, and it's now the time for the store to be closed.. tapi tak siap2 jugak betulkan..da reinstall windows,software n all pastu fomat n re install again, what's more??huh.

well,thank god that finally he surrenders n give me a new laptop.

Lepas ni, if anyone wants to buy a Laptop kat Suk Komputer, i suggest, fikirla dua kali, it's better if u can buy it from somewhere else.somemore,kalau nk beli laptop, make sure u bring someone y mmg tahu pasal computer with u.

Tq ALLAH, i know i can never thank YOU enough.
Thanks, Aza, Nik, Nani, Fairuz n Tkay for being caring n understanding.

oh! one of my dreams comes true , baru sedar.