Paediatrics short

pretty ok exam for me...

Case 1

i was sitting outside the room waiting for the bell to ring before i can go in. 2 examiners walked in from the pantry (think they sneaked out for a tea break even though they were not supposed to...). phew... no smiling tigers in that team... yay...

but as the door opened, i caught a glimpse of a lil boy sitting on a wheelchair... NOOO!!!! neuro?!?! aahhh... ok... wheelchair... cannot walk... what are the causes? ok... what's my neuro examination sequence... everything's floating in my head.. haha!

went in, was told to inspect the legs and then proceed from there. (deja vu... sounds like my med neuro short... sekali can't see anything n dunno what the heck is going on how to proceed?)

luckily quite ok la... severe wasting, pseudohypertrophy... so said to examine the legs neurologically.

Me: i would like to help the patient up onto the bed.
Prof: No need. examine from here.
$#$%! i've NEVER done a neuro exam on a patient on wheelchair lor!! so looked damn awkward. plus my neuro technique was already half plus six to begin with... haaii...

anyway, i tried my best to spend more time talking rather than examining. (which means i was kinda slipshod in examining too) it's like just test a bit of power here n there... then present my findings...

until we finally finished off with the legs... and...

Prof: what else would you like to examine to help you localize the lesion?
Me: examine the upper limbs... (praying in my heart: please please!!! dun say go ahead!! please!!)
Prof: go ahead!
Me: (heart sank)

when i finally finished... think left like 1 minute or less... so they quickly asked me diagnosis... so i just said Duchenne's Muscular Dystrophy... and the bell rang!

Case 2

this one was more straightforward... hepatospenomegaly and pallor... so main discussion was on thalassemia. strange thing was the examiners kept staring at me blankly... instead of asking questions profusely (i thought i'm the one who's most zai at giving blank looks?). most of the time, i had to just open my mouth and lead the discussion to where i want to go...

even when they do ask me questions, they're generally quite standard ones... can answer one... yay! told me to go even before the bell rang! think tt's a good sign la...

yippee... one more down. LAST ONE!! and i'm finally done with this whole exam business...