Part of me…In words

As the title suggest, this shows what i had been doing over the past few days until i’m so busy that i could not free some time to write. Well, its very tiring to study things that i don’t really interested in. Despite the busy studying OH, i guess i’ve got back my passion in medicine. That’s good and worth celebrating. Haha!!!

I like going to the ward and studying about medicine. It’s cool. Maybe i have to spend extra long time in the ward in the coming 2 weeks to compensate back my laziness for the past 3 months. In UM, there are 2 medicine posting in 3rd year where each of them lasts 2 months (8 weeks). FOr my last posting, i am shy to admit that i was playing around all the time.

Today, i presented a case to my lecturer and it turns our to be FUNNY!!! I was describing about waht this patient was having in the morning prior to admission. THis history is particularly important for this patient because he was suspected to have hypoglycemic attack. And so, i presented: ” He had a slice of mango only before admission.” Then i dunno what’s wrong that the whole class became quiet. THen i said: ” It’s a type of FOOD!” This sentence just came popped from my mind and the next thing they do is LAUGH!!! MY god… THat’s very funny, i know that. and i did stress a few times that he had scrotal swelling oedema as well. Lecturer end up laughing at me again. Anyway, this is my first time seeing a scrotal oedema.

Good luck to myself tomorrow for the OH paper tomorrow. Gotta continue study again….

Friday, Yes another friday. THe reason why i like friday is because there will be two days on holiday following. But not for this time. Today is the last day for our lecturer to teach us and she had been with us for 3 weeks. 3 weeks is considerably short, but i dunno why that feeling just came out. Frankly, i know i am emotional. Haha. Anyway, looking forward to next week, with our new lecturer. She is the kind of lecturer who likes to talk abd lecture us about haematological diseases, not like others who ‘enjoy’ ask us to read ourself.

Today we discussed about TTP and plenty of ECG. What are the findings in pericarditis? Okay… THere are diffuse ST elevation which is concave (saddle shaped) and commonly associated with atrial flutter. This is because pericarditis causes irritation of the atrium leading to conduction abnormalities. If there are no other co-morbidities, the atrial flutter will resolve with pericarditis.

Thrombotic thrombocytopenic purpura (TTP). First thing to say is that it is a medical emergency. Seen in older patient as contrast to haemolytic Uraemic syndrome (HUS). Basically these 2 diseases has a quite similar presentation, so its better to compare to both of them.
Patho: Acquired presence of antibody that cross react with metalloprotease or absence of the protease which function to cleaves multimer of von Willebrand Factor, vWF. This causes vWF multimer to be activated causing platelet aggregation and fibrin deposition in small vessels. 2 consequences: 1. Fibrin deposition causing formation of fibrin mesh and microangiopathic hemolytic anaemia (MAHA) 2. Formation of mirothrombi due to activation of clotting cascade.
5 clinical Features: 1. MAHA 2. Neuro sequelae (TIA, Stroke, seizure) 3. Renal imparment 4. Fever 5. thrombocytopenia
Cause: assoc with drugs(clopidogrel), HIV, Autoimmune disease like SLE
Ix: PBF to look for schistiocytes, target cells, coag profile is normal, protease assay
Mx: plasmapheresis, cryoprep depleted FFP

well that’s it la about TTP. oh ya, HUS has a cause and its more common in paediatric age group with features of acute renal failure, thrombocytopenia, and MAHA. Cause is E. coli H0157. presenting with previous history of diarrhoeal disease.

I’m in Green box now, while writing this. I like to sing, but cant sing well, that’s why i just sing rarely in K. thats wat i wanna comment about Karaoke….

Coming weekend is time to concentrate in OH.

I’m glad that i’m beginning to recover now. Quite happy. I just came back from the ward and seen a young patient (20+) with tender hepatomegaly and the diagnosis came out to be Hepatocellular carcinoma. Its weird frankly. How can someone have that disease at a young age like him. This usually happen in someone with previous insult to the liver causing liver cirrhosis and may progress to HCC then. Alcoholism is one of the most common cause in this region and hepatitis B too. I doubt that diagnosis. Anyway just something to share. If anyone around you keep drinking a lot of alcohol everyday, its time to stop them, gradually.

Next week there will be another exam, Occupational Health. Wow… sound interesting right? with things like carpal tunnel syndrome, asbestosis, etc and the way to prevent occupational disease. Haha and 3 more weeks after this will be another end-of-posting exam. I may start a little bit late in doing revision, but i believe <ITS NEVER TOO LATE!!!> ~hopefully~~:-)

And another 8 weeks after the end of posting exam, will be the FINAL. That is scary.

Tonight’s plan is to study TTP and bleeding disorder, plus occupational health. Actually an idea popped up in my head suddenly, why not i summarise up what i studied here??? so that i can remember better… ok i’ll seriously think about that.

I forgot my username jusnow when i was trying to log in into this history of mine. Why am i back here now??? I dunno why, guess maybe there are things inside my heart that need to be voiced out.

Life’s cool and time is flying. What can i do about this then, to follow the step of everyone. So many things to do yet so little time is given.

Today our clinical group had a farewell party with lecturer and its a good experience.

This morning, at 6 in the morning, it began to rain and it was very cool. I fell in love with the weather and fell asleep for another one and a half hour and so, i’m left behind of my schedule. Maybe i’m used to left behind.

Many times, i felt that i’m alone without hooi min and perhaps i am really alone. No friends, nothing. Especially in gathering, any gathering, i felt i’m left behind. No one to blame, but only me myself to blame. I shall try harder to get into the crowd and join everyone… right?