11 of us are required to repeat 6 months
1 of us need to repeat 1 year straight.
星期六, 4月 23, 2005
星期四, 4月 21, 2005
The results are out.
The results are out....faster than expected
First of all, I have passed. But there is no joy in passing. I dont know why, maybe that is because some of my very good friends had failed and had to repeat the year? Maybe I have to hide my emotion in front of my friends who has failed? I dont know.
This examination is my greatest hurdle in life. The overwhelming stress, the sleepless nights, the fear, the rumours and the speculation. People tends to show their true self when under extreme stress, and I have learnt about my friends alot better during this exam period, much more than I wanted to know.
I feel so tired, exhausted, maybe I have used up all my adrenaline, maybe i hated the exam too much. Maybe I am going to miss my friends very much. I wish to thank all my friends who stood by me and whipped me into studying.
Joshua, thank you
Samma, Thank you
Peter, thank you
Franklin, thank you
Choi Wan, Thank you
Loretta, Thank you
For the group 6 classmates who has been with me, thank you.
overall,
9 of us have failed (unfairly) for 6 months
19 have failed and got a pull up viva vorce
wish them best of luck..may the force be with you
First of all, I have passed. But there is no joy in passing. I dont know why, maybe that is because some of my very good friends had failed and had to repeat the year? Maybe I have to hide my emotion in front of my friends who has failed? I dont know.
This examination is my greatest hurdle in life. The overwhelming stress, the sleepless nights, the fear, the rumours and the speculation. People tends to show their true self when under extreme stress, and I have learnt about my friends alot better during this exam period, much more than I wanted to know.
I feel so tired, exhausted, maybe I have used up all my adrenaline, maybe i hated the exam too much. Maybe I am going to miss my friends very much. I wish to thank all my friends who stood by me and whipped me into studying.
Joshua, thank you
Samma, Thank you
Peter, thank you
Franklin, thank you
Choi Wan, Thank you
Loretta, Thank you
For the group 6 classmates who has been with me, thank you.
overall,
9 of us have failed (unfairly) for 6 months
19 have failed and got a pull up viva vorce
wish them best of luck..may the force be with you
Final MB done!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Just finished my surgical OSCE. it was crazy, 26 stations.....(but the worse was in med one anatomy practical 150 stations).....anyway. standard things came out.
BTW confirmed 16 pple failed medical written and 10 pple failed medical OSCE (not me)...those 10 are straight fail cases, and have to repeat 6 months of medicine. Shit, I think all of them deserve a second chance. It is just unacceptable.
Here are some of the OSCE station I got today
1)Catheterise a bladder in less than 5 minutes.
2)Setup a CVP and take a measurement
3)Local anaesthetise a piece of PORK skin for a ecisional biopsy
4)Examine fake breasts worn by an old man
5)Examine 5 more fake breast lying on a table and write the diagnosis
6)Examine the gait and do trendenlenberg test on a lady
7)Do a nerological exam of the lower limbs and a straight leg raising test on an old lady
8)X-ray of monteggia fracture
9)X-ray of hip fracture
10)X-ray of pneumothorax
11)CT/x-ray of Malignat small bowel obstruction with liver and lung met
12)Clerk a history of low back pain
13)Clerk a history of claudication
14)Break bad news (in english) to the son of someone with inoperable gastric CA
15)Make long distant call to an old lady's son. The old lady has Seborraeic dermatosis.
16)Examine someone with derranged thyroid function
17)Manage someone with a high fever day 3 after hip replacement (intepret temperature and fluid chart), likely to be transfusion reaction
18)Fill up a form to request imaging for a young lady with cystic neck mass (you can choose MRI, CT, Ultrasound, and Angiogram), She had private Ultrasound and she is also wearing braces.
19)assess the GCS of a RTA sufferer and manage accordingly.
BTW confirmed 16 pple failed medical written and 10 pple failed medical OSCE (not me)...those 10 are straight fail cases, and have to repeat 6 months of medicine. Shit, I think all of them deserve a second chance. It is just unacceptable.
Here are some of the OSCE station I got today
1)Catheterise a bladder in less than 5 minutes.
2)Setup a CVP and take a measurement
3)Local anaesthetise a piece of PORK skin for a ecisional biopsy
4)Examine fake breasts worn by an old man
5)Examine 5 more fake breast lying on a table and write the diagnosis
6)Examine the gait and do trendenlenberg test on a lady
7)Do a nerological exam of the lower limbs and a straight leg raising test on an old lady
8)X-ray of monteggia fracture
9)X-ray of hip fracture
10)X-ray of pneumothorax
11)CT/x-ray of Malignat small bowel obstruction with liver and lung met
12)Clerk a history of low back pain
13)Clerk a history of claudication
14)Break bad news (in english) to the son of someone with inoperable gastric CA
15)Make long distant call to an old lady's son. The old lady has Seborraeic dermatosis.
16)Examine someone with derranged thyroid function
17)Manage someone with a high fever day 3 after hip replacement (intepret temperature and fluid chart), likely to be transfusion reaction
18)Fill up a form to request imaging for a young lady with cystic neck mass (you can choose MRI, CT, Ultrasound, and Angiogram), She had private Ultrasound and she is also wearing braces.
19)assess the GCS of a RTA sufferer and manage accordingly.
Surgical OSCE!!!
In 3 hours' time, I am going to take my final MB surgical OSCE. No one knows what is going to come out. Hopefully we will all pass...
星期三, 4月 20, 2005
Medicine OSCE Done!!!!
I have just finished the Medical OSCE....
Here are the cases that I've got
1)Charcot-marie-tooth disease in a middle age gentlemen
2)Left lobe ?fibrosis in a frigety middle age lady with scoliosis
3)Proliferative DM retinopathy
4)Transplanted Kideny in a cushignoid lady with bilateral ballotable polycystic kidney
5)Aortic valve replacement with a mid-sternotomy scar
6)Hyperpigmented gums with history of tiredness (addison?)
7)Young man with 1 yr history of malasis and lymphadenopathy...and intermittent fever...everything else is negative!!! wasted 10mins....father had TB.but not significant contact.
that is all... I think I can pass.....hopefully
Here are the cases that I've got
1)Charcot-marie-tooth disease in a middle age gentlemen
2)Left lobe ?fibrosis in a frigety middle age lady with scoliosis
3)Proliferative DM retinopathy
4)Transplanted Kideny in a cushignoid lady with bilateral ballotable polycystic kidney
5)Aortic valve replacement with a mid-sternotomy scar
6)Hyperpigmented gums with history of tiredness (addison?)
7)Young man with 1 yr history of malasis and lymphadenopathy...and intermittent fever...everything else is negative!!! wasted 10mins....father had TB.but not significant contact.
that is all... I think I can pass.....hopefully
Medicine OSCE.!!!
Well, tommorrow is the dreadful Medicine OSCE, I alway think medicine is my weakest spot. The OSCE is also a sudden-death game without any second chance, there is no supplementary exam to redeem myself if I should fail this OSCE....
I have no mood to study. I have ironed my white coat and my pants....I think that is the best preparation I can do today.
I have no mood to study. I have ironed my white coat and my pants....I think that is the best preparation I can do today.
星期五, 4月 15, 2005
Stressed in a high mortality exam
There have been rumours saying that 16/157 of us failed at the medical written exam. Shit! that is more than 10% and that is only the written, there are still OSCE...it is a nightmare.
Some of the ways that we can fail the questions
1)failure to diagnose ITP in a lady with low platelet (20/157 made this mistake)
2)failure to diagnose contrast nephropahty and cholesteral emboli in a man with acute renal failure after cardiac catherisation (120/157 made this mistake)
3)failure to treat the underlying mechanical and neurological causes of dysphagia in a patient with aspiration pneumonia (30/157 made this mistake)
There are more but I cannot remember what the source said
Some of the ways that we can fail the questions
1)failure to diagnose ITP in a lady with low platelet (20/157 made this mistake)
2)failure to diagnose contrast nephropahty and cholesteral emboli in a man with acute renal failure after cardiac catherisation (120/157 made this mistake)
3)failure to treat the underlying mechanical and neurological causes of dysphagia in a patient with aspiration pneumonia (30/157 made this mistake)
There are more but I cannot remember what the source said
星期二, 4月 12, 2005
Final MB Surgical Written + Medicine MCQ done....!!!
Wow..finally... all the written papers are done. The medicine MCQ is harder than expected. The Surgical Written is just simply stupid. I think the faculty is trying to ask us stupid questions so that the guys from the new curriculum can out perform us next year, justifying their change in the curriculum.
So..once again.. before I forget...
1) clinical scenario of a breast lump (5cm with ipsilateral mobile axillary lymph node)
ask about the TNM staging
ask about the doubling time of the cancer and the time before it was diagnosed
about the false positive rate of FNAC
The patient is sad and depressed, despite a supportive family and social worker, name 3 ways to approach this problem.
the 3 factors for prognosis
2 drugs for chemotherapy
What are the chacnce of a oestrogen receptor +ve cancer responding to hormonal therapy
develop PATHOLOGICAL fracture neck of femur, what is the principle of treatment
Mx of metastatic disease
2) Young man, dying, no hope, on ventilator, TPN, vasopressor, eventually will die,…very gray. SMO and Consultants want to step down the treatment (in other words, let him die.)
a. What source of info will you seek (other than the medical team) before you make any adjustment to the management plan. And how would you do it?
b. If source 1 is not available, what other sources are there?
c. If the relatives agree, is there any way to proof their opinion legally? (or something to that effect?)
d. What are the priorities in steping down the treatment?
e. What are the 3 moral principles in making these decisions?
f. How can you make use of the 3 pricinples in the making of these decisions?
g. What if the family does not agree with you? What investigation, and legal actions that you can take to manage this patient?
3) fill in the table comparing neurological and vascular claudication
given a table for peripheral pulses
what is the bedside Ix for PVD at OPD?
Name 2 Ix for PVD
Patient also has unhealed foot ulcer
Mx
4) Some one with jaundice.. I forget
5) I forget
6) 2 studies… both are crappy… one on chances of cancer after total hip replacement, another compares somnoplasty to oral devices on reducing snoring… both no good
So..once again.. before I forget...
1) clinical scenario of a breast lump (5cm with ipsilateral mobile axillary lymph node)
ask about the TNM staging
ask about the doubling time of the cancer and the time before it was diagnosed
about the false positive rate of FNAC
The patient is sad and depressed, despite a supportive family and social worker, name 3 ways to approach this problem.
the 3 factors for prognosis
2 drugs for chemotherapy
What are the chacnce of a oestrogen receptor +ve cancer responding to hormonal therapy
develop PATHOLOGICAL fracture neck of femur, what is the principle of treatment
Mx of metastatic disease
2) Young man, dying, no hope, on ventilator, TPN, vasopressor, eventually will die,…very gray. SMO and Consultants want to step down the treatment (in other words, let him die.)
a. What source of info will you seek (other than the medical team) before you make any adjustment to the management plan. And how would you do it?
b. If source 1 is not available, what other sources are there?
c. If the relatives agree, is there any way to proof their opinion legally? (or something to that effect?)
d. What are the priorities in steping down the treatment?
e. What are the 3 moral principles in making these decisions?
f. How can you make use of the 3 pricinples in the making of these decisions?
g. What if the family does not agree with you? What investigation, and legal actions that you can take to manage this patient?
3) fill in the table comparing neurological and vascular claudication
given a table for peripheral pulses
what is the bedside Ix for PVD at OPD?
Name 2 Ix for PVD
Patient also has unhealed foot ulcer
Mx
4) Some one with jaundice.. I forget
5) I forget
6) 2 studies… both are crappy… one on chances of cancer after total hip replacement, another compares somnoplasty to oral devices on reducing snoring… both no good
星期一, 4月 11, 2005
Final MB Medical Written + Surgical MCQ done....!!!
Ths buses that are supposed to pick us up from PWH to CU main campus is 30 mins late and we started the exam 30 mins late. The surgical MCQ is crazy......200 questions....4 hours...fell asleep for the last 30 mins...luckily i have finished the paper by then
Before I forget...
Medicine (each question 15 min)
1)X-ray showing subphrenic gas, old lady with history of joint pain, taking colchicine, diclofenac, panadol....coffee ground and abdominal pain
-what is the abnormality on the x-ray (2)
-Would you do OGD to investigate the coffee ground? why? (3)
-How would you manage her? (5)
2)35 Male rejected from blood donation, 75kg and 1.4m height. ALT 2 times normal. Fasting glucose 12. anti-HBsAg+, anti-HC+, IgGanti-HAV+.
-What are the 3 possible causes of his deranged LFT?
-How would you investigate?
-How would you manage?
3)Yound man with TB symtoms, X-ray and Smear positive
-What are the anti-TB drugs that you would use?
-If on day 5 his ALT got up to 2X baseline, what would you do?
-If on day 7 his ALT got up to 4X normal, what would you do?
4)Outline the management of Aspiration pneumonia in elderly patients with dysphagia
5)35yo male with 6 months hx of Htn. on indapamide and metoprolol. Come in with weakness and K=2.1 Found to have throitoxicosis, not treatment yet.
-List 3 causes of his low K
-How would you investigate?
-How would you manage?
6)Yound lady with recent low mood, came in with stupor. Gotten some medication from GP 2 weeks ago for flu.
-What are the first line investigation you would do? Give reasons.
-How do you manage her?
7)Yound man with chronic diarrheo x 8mths, no blood no slime, weightloss 25 pounds. Frequent travel to china, denied drug and sexual exposure. Unknown colorectal surgery done some years ago. Now found to have skin tag at anus.
-List 2 commest diagnosis
-How would you investigate?
-How would you manage?
8)Yound lady with isolated platelet count of 67. Asymtomatic.
-What is the most likely diagnosis?
-How would you manage her?
-if she comes back at 6 months with epistaxis and bruising, Platelet count 12. How would you manange her?
9)Old man with sudden left sided weakness and slurring speech. DM and Htn 170/110
-How would you investigate?
-How do you manage him?
10)45 yo lawyer with sudden onset of great toe pain after meal. Hx of DM and HTN
-What is the most likely diagnosis?
-What are the significant differentials?
-How would you investigate and manage him?
11)55 yo man recent diagnosis of HTN, given diltiazem and metoprolol by GP. Came in unconciouses. Pulse 34/min. with complete heart block.
-What are the initial investigation?
-How would you manange?
-What are the pharmacodynamic cause of his heart block?
12)Middle age chronic heavy smoker with admitted with chest pain
-how would you quantify his risk factor?
-How would investigate and manage him?
Before I forget...
Medicine (each question 15 min)
1)X-ray showing subphrenic gas, old lady with history of joint pain, taking colchicine, diclofenac, panadol....coffee ground and abdominal pain
-what is the abnormality on the x-ray (2)
-Would you do OGD to investigate the coffee ground? why? (3)
-How would you manage her? (5)
2)35 Male rejected from blood donation, 75kg and 1.4m height. ALT 2 times normal. Fasting glucose 12. anti-HBsAg+, anti-HC+, IgGanti-HAV+.
-What are the 3 possible causes of his deranged LFT?
-How would you investigate?
-How would you manage?
3)Yound man with TB symtoms, X-ray and Smear positive
-What are the anti-TB drugs that you would use?
-If on day 5 his ALT got up to 2X baseline, what would you do?
-If on day 7 his ALT got up to 4X normal, what would you do?
4)Outline the management of Aspiration pneumonia in elderly patients with dysphagia
5)35yo male with 6 months hx of Htn. on indapamide and metoprolol. Come in with weakness and K=2.1 Found to have throitoxicosis, not treatment yet.
-List 3 causes of his low K
-How would you investigate?
-How would you manage?
6)Yound lady with recent low mood, came in with stupor. Gotten some medication from GP 2 weeks ago for flu.
-What are the first line investigation you would do? Give reasons.
-How do you manage her?
7)Yound man with chronic diarrheo x 8mths, no blood no slime, weightloss 25 pounds. Frequent travel to china, denied drug and sexual exposure. Unknown colorectal surgery done some years ago. Now found to have skin tag at anus.
-List 2 commest diagnosis
-How would you investigate?
-How would you manage?
8)Yound lady with isolated platelet count of 67. Asymtomatic.
-What is the most likely diagnosis?
-How would you manage her?
-if she comes back at 6 months with epistaxis and bruising, Platelet count 12. How would you manange her?
9)Old man with sudden left sided weakness and slurring speech. DM and Htn 170/110
-How would you investigate?
-How do you manage him?
10)45 yo lawyer with sudden onset of great toe pain after meal. Hx of DM and HTN
-What is the most likely diagnosis?
-What are the significant differentials?
-How would you investigate and manage him?
11)55 yo man recent diagnosis of HTN, given diltiazem and metoprolol by GP. Came in unconciouses. Pulse 34/min. with complete heart block.
-What are the initial investigation?
-How would you manange?
-What are the pharmacodynamic cause of his heart block?
12)Middle age chronic heavy smoker with admitted with chest pain
-how would you quantify his risk factor?
-How would investigate and manage him?
星期日, 4月 10, 2005
星期六, 4月 02, 2005
New exchange Student from Cambridge
Today I have met Aneil, he is a british born Indian, currently in fianl year medicine in cambridge. He is doing A&E in our hospital...
星期五, 4月 01, 2005
Last day of School
Today is my last day in OVS. and it is also the last day of offical teaching. Final MB is just around the corner....very stressed.
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