This blog is so quiet nowadays..Let me cheer it up a bit with my experience during the last medical EOP with Prof Amin, k.

When I knew that my examiner is Prof Amin before the EOP started that morning, I could feel the rush of blood to my head.. stimulating my sympathetic system to release adrenaline. I was so nervous. But, during that tachycardic and tachypneic state, Aida said to me..."Takpe miya, takde ape2.." and almost immediately i remembered what Hadhanah said to me few months ago, that the one who controls everything including Prof Amin mood this morning is Allah swt..I took a deep breath and gained a lot of strength. Hisham brought me bad news when he finished the EOP which was the time Prof Amin allocated for PE is 5 minutes (i practiced with Dr Tengku in bedside for 8 minutes). Another 5 minutes for presentation and discussion..Means i need to speed up.
So, as Ekin leave with tears on her face as the second candidate, i entered as third candidate. As i entered, i could see how 'tercacak' Prof Amin's hair was. Omg. But Aida's and Hadhanah' s words were still in my heart, thus I greeted him good morning and tried to smile. He asked for my name and asked me a killer first ever question.. "So, you think you can do this well?" Omg. Spontaneously i answered.." I will try my best, Prof..."

So the examination started with the cardiac case as the first case. The command was " Do the general examination and proceed with pericordium examination"..After a very complicated PE, finally the diagnosis was > AS, MR, AF in failure with CCF and background of CABG.
The important points that i learned in that particular case were..

1) "The eyes cannot see what the brain does not know"..This is Prof Amin's quote dedicated to me. Hehe.

2)In patient who has sternotomy scar, always..i repeat..always look for scar at the lower limb (the scar of great saphenous vein conduit for CABG). Other conduit that can be use for CABG are internal thoracic artery and radial artery.

3) Treat patients as a whole.

4) Know how to manage patient with multiple diagnoses, dont forget the Frusemide dosage!

The second case was abdominal case. The command was "Examine the general examination and proceed with appropriate system"..The patient was cachexic, has pallor, hyperkeratotic lesions at the antecubital fossa, ascites (on inspection) and onicholysis. So i proceed with abdominal examination to find that he actually have fluid thrill, dull traube space and a vague mass at the umbilical region. The differentials of anemia was discussed. But the most unforgetable question was "What is the stain and culture media for fungal?" when we were discussing about the probable causes of onycholysis. Omg. I am so 'tak ingat' the year two stuff!!! What i learned from this case were:

1) always examine the throat and tonsils when you examine the mouth..and please use tongue depresser so that he'll be happy.

2) be gentle on distended abdomen.

3) treat patient as a whole (once again)

After both cases finished, i asked Prof Amin on how can i improve, so he advised:

1) treat patient as a whole (again!)

2) be spontaneous in answering question

3) speed up in PE so that you have time for discussion

4) dont look like you're thinking what will you do next during PE, it should be like a reflex to u.

5) finally, u need to work a lot more for finals..

So, friends, i think with this i concluded that i have not achieving his target for finals, not even a little. But one thing that is certain that is...It is Allah swt who will determines it all. Our job is to do our best, doa and tawakal. ALL THE BEST TO ALL, the finals is 78 days from today...