Day 1
Case 1 (idiopathic transverse myelitis): 醫生讚我PE做得好(讚左兩、三次 kiki emoticon)，diagnosis我都估到demyelinating diseases，我知要睇ophthalmoplegia同optic neuritis(講埋MS有Lhermitte sign tongue emoticon )，雖然唔記得ophthalmoscope嘅sign，醫生抽書時仲有講話:"Good, I don't expect you to know that at your level"，所以ok啦
Case 2 (transplant kidney): inspection無限咁多scar，大獲。Report時候醫生話:"I saw you spent quite a lot of time on inspection, that's good."，唔知真心定安慰我，不過我最後都漏左一條大scar。Percussion liver大左，但又palpate唔到喎。最後醫生話:"I know this is a difficult case, but overall quite good ." 後來我知醫生expectation好高架，想我地discuss Cushingoid、immunosuppressant嘅side effects、urine dipstick、DM control，不過佢話我地冇人去到呢個level答呢d問題...其實我地成組都做得唔好 frown emoticon
拉上補下啦，我從佢語氣feel到佢唔會肥我嘅。起碼case 1我幾滿意。之後繼續努力!!!
Day 2
Case 1 (MR, TR, MS): MR好明顯啦。TR有d唔肯定，因為inspiration唔係太覺有大聲到，冇pulsatile liver，個giant V wave又唔肯定。MS完全聽唔到(不過其實成組都聽唔到，MR+MS真係好難聽)。唉，我都知自己耳仔係差d架喇，成日都聽唔到diastolic murmur，真係要繼續努力先得。 upset emoticon
Case 2 (bulbar palsy): 一知道要examine cranial nerves，真係有d驚訝囉，不嬲都諗著係resp嘛。一路到CN VIII都正常，好彩一打開個口，有野睇: Uvula deviated to the right, tongue deviated to the left，其實我覺得SCM都有d weak左嘅。"So what is the diagnosis?" "I would suspect bulbar palsy." "What are the causes?" 以為係resp，冇咩溫CN，唔記得左，所以淨係答到syringobulbia同foramen magnum syndrome，後尾先醒起Guillain Barre同motor neuron disease都得。最後debriefing，醫生話牌版話係isolated 12th nerve palsy架，不過佢見我地有一半人話有deviation of uvula，所以試左佢gag reflex，真係有事喎。呵呵，即係我地啱啦，仲叻過個neurological team，連佢地都pick up唔到，呵呵呵呵。(講笑啫，我估係個patient嚴重左，之前未有CN XI, X involvement啫。)
不過重點係，醫生一入黎就話我地pass哂lu!! Yay!! 四日大假，隨便約我玩啦，哈哈!! kiki emoticon
Case 2 (bulbar palsy): 一知道要examine cranial nerves，真係有d驚訝囉，不嬲都諗著係resp嘛。一路到CN VIII都正常，好彩一打開個口，有野睇: Uvula deviated to the right, tongue deviated to the left，其實我覺得SCM都有d weak左嘅。"So what is the diagnosis?" "I would suspect bulbar palsy." "What are the causes?" 以為係resp，冇咩溫CN，唔記得左，所以淨係答到syringobulbia同foramen magnum syndrome，後尾先醒起Guillain Barre同motor neuron disease都得。最後debriefing，醫生話牌版話係isolated 12th nerve palsy架，不過佢見我地有一半人話有deviation of uvula，所以試左佢gag reflex，真係有事喎。呵呵，即係我地啱啦，仲叻過個neurological team，連佢地都pick up唔到，呵呵呵呵。(講笑啫，我估係個patient嚴重左，之前未有CN XI, X involvement啫。)
不過重點係，醫生一入黎就話我地pass哂lu!! Yay!! 四日大假，隨便約我玩啦，哈哈!! kiki emoticon
(寫於2013年8月26日及28日)
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