Thursday, March 5, 2009

Ear Nose & Throat


Tamat round Ear Nose & Throat (ENT) semalam dengan exam yang cukup ringkas. Saya fikir kurang dari 5 minit saya berada di klinik untuk disoal doktor.

Apabila dipanggil masuk ke dalam,berdebar juga rasanya. Masakan tidak berdebar, soalan apa yang bakal ditanya, dapat jawab ke, common case ke.. Sarat otak mengingatkan semula semua yang telah dipelajari.

Saya melangkah masuk ke bilik doktor. Seusai masuk, saya memberi salam dan duduk tanpa disuruh.(haha). Terus doktor bertanya.

"What is your name?"

"Nur Faezza Mohd Mohtar"
"Ok, supposed you are in the ER. A patient comes with epistaxis. What is the management?"

"(Yeah! Alhamdulillah, favourite question. Bismillah, ya Allah kau lancarkanlah..)"

"ABC, depends on severity of the bleeding. If it is severe, we prepare the blood for cross-match and 2 large pores canula."

"If it is mild, we ask the patient to compress or put pressure on the nasal cartilage. Wait until 10-15 minutes. If it persists, we took 2 pieces of cotton soaked in vasoconstrictor solution ie. epinephrine, we put at the side of bleeding. Wait until about 10 minutes."

"Then if it persists, we do the cauterization. Depends whether it is active or inactive bleeding. If active, we use electrical cautery. If inactive, we do chemical cautery using silver nitrate stick"
"What if the blood come from the mouth?"

"We ask the patient to spit the blood, not to swallow it." (He nodded)
"What about posterior pack?"

"Ya, we did it. But before that, we try to put anterior pack first, bilayer, bilaterally. If it persists, then we put the posterior anterior pack".

"How do you do the posterior pack?"

"Using Foleys catheter and ballon, we insert to the nose, inject normal saline or air until we feel the resistance"

"How much CC of normal saline you want to put?"

"Erk.. (3 ke 30 cc ha?? lupaa.. confuse..) 3 cc (adeh..)?"

"Even in children we inject more than 10 cc.."

"Err, sorry. We use 30 cc."

"Ok, 25-30 cc."

"(thanks God..:))"

"Ok you may go now"

"(Erk, am btemzah? (are you joking doctor?) I feel like did not finish yet! Haha beranilah nak cakap dengan doktor serius ni macam tu.)

"Err..Finish? Thank you doctor. Allah yu3tikal 3afiah."
Saya pun melangkah keluar. Kebingungan sedikit, tertanya-tanya. "Betul ke dah habis? Kenapa tak kena ambil history? Kenapa tak kena buat ENT exam?"

Di luar klinik, saya lihat rakan lain yang sedang di'test' oleh doktor lain sibuk mengambil history dan melakukan ENT exam di hadapan doktor. Mereka yang telah masuk dahulu masih berada di dalam, saya yang terkemudian dipanggil telah pun keluar.

Kawan lain punyalah hebat di'access' oleh doktor lain, ditanya bermacam-macam, management of chronic sinusitis lah, positive finding perforation tympanic membrane and diagnosisnya. Untung juga dapat dengan doktor yang seorang ini.

Alhamdulillah bersyukur juga kerana exam saya begitu ringan dan ringkas. Markah juga saya harapkan agar cemerlang.

I kept the 'Elephant notes' or so called 'nota gajah' by Tiq and Kel (the twin) and put it on the rack.



Elephant notes : Main reference for ENT selain notes yang disalin dalam seminar. It is called 'elephant' because there is a pic of elephants on the front page doing the ENT exam. How cute~~ ^-^)

As usual, i'll spend my lovely leisure weekend with 'non-stop meetings' here and there..

::Let's prepare for the next 2 week's : Neurology week is coming!~~::

5 comments:

  1. salam..

    fez, kte kt lab com ucd, daedalus building..smbil tggu bank kt sblh ni bukak, baik surf internet wat kali terakhir di ucd (adeh, sedih nya bunyi..huhu~)..alhmdulillah, dh abis pn exam utk ENT..seronok nya dgr betapa sng nya faeza lalui exam smlm..kalu Allah nk permudahkan, mcm2 cara Allah bole buat..kdg2 tu, ada org tu study stu topic je mlm be4 exam..last2 topic tu je keluar..subhanallah..betapa rezki kte yang Allah nk bg ni kdg2 x terpikir dek akal manusia normal yang waras..=D K la, jam dh menunjukkan 1005 am, nk pi jmpa pegawai bank yang hensem2..hihi~ wassalam..

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  2. selamat ber'meeting' ler ek.
    hahahahaha....

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  3. ENT adalah perkara favourite yg disebut oleh adik kt kalo buat karangan...cikgu dia bg ape2 tajuk pun..tetap ade istilah ENT, HUKM, tracheostomy etc...(wah...rindu pulak kat adik..nasib baik esok balik kg..hoho~)

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  4. odah,
    alhamdulillah 3ala kulli hal. haih cik sikah, betulkan lah niat nak gi bank tu. karang tersadung kaki. :p

    kher,
    oo,mentang2 dapat mc.. good luck exam.

    ain,
    ada pernah terbaca pasal cte adik ain tu. byk experience die eh.

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  5. soklan epistaxis jekkkkk??????wah22222

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