Post Exam-Osce Ortho

Semalam merupakan last day utk final exam 4th yr aku.Syoknya dah abes exam.Harap2 suma 4th yr lulus n bleh masuk final yr sesama.Amin.Sapa tgh bacakan tlg doakan sekali ok :)

Smlm exam OSCE kami start petang.aku pnya turn start at 3.15 p.m cmtu la.Suruh berkumpul pkl2.30.tp after briefing apa suma,last2 start lmbt 45 min.No big deal.X apa.

Ada 6 station sumanya.Xdak station rehat.Satu station plak 10 minit.Aku start dgn station PPD.Soklan dia lebih kurang cmni.

"Pn.Khadijah,a 40-year-old lady who had septicemia secondary to necrotising fasciitis undergone surgery for her right lower limb.However,during operation,she developed myocardial infarction and cardiorespiratory arrest.After resuscitation,her condition was stable.She was then transferred to ICU.You, as an assistant to a Medical Officer was there in OT room during the surgery.Your task is to inform her husband (En.Ahmad) about the event."

Haaa..lebih kurang cmtula.Soklan dia pnjang lg tp aku igt byk ni ja.So,aku pn masuk bg salam,suruh En.Ahmad duduk suma.And aku pun mula la berlakon.Bla bla bla..Last2 aku habis awal.Simulated Patient(SP) dah ckp Thank You.Xdak apa nak tnya suma.Aku pn then ckp TQ kat Dr yg assess PPD skill aku tu n kluar awal.

Pastu ada Dr len lalu time aku tggu hbis masa 10 min.Dr tu tnya,"Aik,mana student kat station ni (dlm bilik)?"

Aku pn angkat la tgn,seyes aku rasa lama tggu loceng first 10 minit bunyi.Aku ni kuar awal sgt ka? Haha..biarla.

Pastu unmanned station ada 3.Satu station ada 2 soklan.So kiranya ada 6 soklan paper.Lagi 2 stations adalah utk Physical Examination (PE).

Unmanned station masuk soklan apa ntah aku xsure yg first tu.Ada Dr ckp yg tu shoulder dislocation (tp nmpk pelik sket),ada yg kata Aneurysmal Bone Cyst .Haha..aku pn x tau.yg pasti aku tulis ja ada lytic lesion kat X-ray tu.Biarla.Ahhh...

Pastu ada soklan psl Salter-Harris classification for epiphyseal injury,Anterior Cruciate Ligament tear -yg ni ada video dia buat Lachmann,Anterior Drawer and Pivot Shift test.Pastu dia suruh name the tests,apa diagnosis and management.Next,ada pasal Rheumatoid Arthritis,Ankle Foot Orthosis and Pneumatic tourniquet tu.

PE plak masuk Carpal Tunnel Syndrome,kena examine hand.Patient tu ada median nerve injury.Pastu present suma.Dpt Prof Sharaff as examiner.

Pastu Prof tnya diagnosis,aku bg CTS.

Pastu soklan lg,"Why in median nerve injury,the sensation over the thenar eminence is intact? ".Aku jwbla coz thenar eminence's sensation is supplied by palmar cutaneous branch of Median Nerve.

Then,Prof tnya lg what is your management.
Aku jwb -The management can be divided into 2,conservative and operative.For conservative,we can give patient analgesics such as NSAIDs,corticosteroid injection,cock-up splint(lupa nk ckp physiotherapy).And for operative management,we can do carpal tunnel release.Harap2 betul la.Aku habis awal.Takut klu x complete examination.Pastu Prof p jalan2 tggu loceng bunyi.Hihi..

Next station utk PE dapat case En Daud ada low back pain after heavy weight lifting cmtu la.Pastu kena do neurological examination of lower limbs.Aku pun buat la suma start ngan gait smpi abis.Dia ada problem kat spine level L5/S1 sbb xleh extend big toe and plantarflex.Pastu abis buat suma,tggl part discussion.Dr tnya,what other examination you would like to perform to this patient.Aku jwbla,Per rectal examination (to look for anal tone,sensation-sbb kita nk localize spinal level yg ada problem tu),Straight Leg Raising(SLR) test.Pastu Dr ckp,ok,do SLR.Abis buat SLR,aku nk buat Sciatic Stretch Test yg kena dorsiflex kaki patient kat level yg dia x sakit tu.Tapi aku turunkan kaki patient,dia still sakit.Bowstring pn x bleh check sbb sakit.Aku explain la kat Dr.

Pastu Dr tnya diagnosis,jwpnnya ialah Herniated Nucleus Pulposus at the L5/S1 region.Haha..seb bek Dr angguk.Pastu abis awal gak ni.Pastu Dr tnya lagi,what other examination you would like to do? Aku pikir pnya pikir aku blank,then aku tnya blk Dr,"Investigation ke Dr?".Then Dr ckp," Examination".Pastu baru teringat,then aku jwb,"Oh,Schober's test".Pastu Dr angguk.Pastu abis la.Abis awal lagi.Risau la klu x perform complete examination.Tu la last station aku.Aku siap sembang ngan Steve after abis station tu.Pastu bunyila loceng penamat,kringggggggggggggg...


Yay,MERDEKA.Bleh happy2.

For a while.

Bcoz ada org cakap,result kuar Jumaat ni.

Waaaa...baru nk rileks,takut ni.Soklan susah la exam ni.Especially Paeds,teori payah gila(i told you in previous post dah).Tp mmg cmni pn kami,abis exam minggu ni,mggu depan dh dpt result.Yg ni la paling laju,abis exam Selasa,Jumaat dah dapat result.Wow,mmg EFFICIENT !!