internal medicine in memory

fuuuhhhhhh~~~~ ALHAMDULILLAH! at last... i can finally say.. "osce is overr!! relex n enjoy!!" huhu.. but not for long.. surgery is expecting my arrival to open a new chapter in the book of medicine.. hence, making all those moments in the internal medicine as an unforgettable memories.. surely im gonna miss all those funs.. but yet hoping not to lose even a single knowledge gained!

and here comes the story behind the 'fun playful' osce:

first spot with Dr Perihan :: taking pulse
my comment: regular, 80 beats per minute, normal force & volume, no special character, unequal with slightly weak pulse on the left side, and the vessel wall is not felt. dorsalis pedis & posterior tibial are both felt. (and she went.. gud, gud) *happy2*
second task i was asked to palpate the carotid artery... ops2!! i've done it wrongly.. my hand was like dancing all over the patient's neck searching for the artery but failed! =.=" (thank god the doctor was kind to give me chance).
and the best part.. she gave me full marks! she even showed me my marks.. huhu thank u doctor for the full marks.. luv.u.doc! <3

second spot :: inspect the lower limb
the first thing i comment, there's LL edema. and the doctor goes, "okay. but u hv to inspect"
silly me, how do u know it's LL edema juz by inspection.. u shud palpate for that.. huhu
and here's another story.. after i'd finished commenting on my findings and while the doctor was busy giving marks, i noticed the patient was giving a non verbal signs telling me bout his amputated right leg.. the most important finding i shud comment on but didnt.. hahah! thank u my patient for ur help.. hope it'll improve my marks a bit ;)

third spot :: examine the thyroid
the first worse spot ever! first question from the doctor.. what is the item of examination? i answered, "inspection, palpation and auscultation." and then i started to examine the patient.. while giving the comment, the doctor asked, "how do u know it's the thyroid?" ... i answered, "by asking the patient to iblag (swallow)" ... and then the doctor asked sumtin (i can't remember wut) which made me went blurr *ting tong* and then he said, "u forget to mention about percussion" (gud hint there) but still im in blurness~~ only after the xm i noticed that he was asking me to percuss the upper part of the sternum to see if there's enlargement of the gland extending to the mediastinum.. argh~!! hate it! hate it! hate it!

fourth spot :: auscultate the mitral area
my comment: muffled S1, pansystolic murmur, radiating to the axilla. "what is ur possible diagnosis?" .. i answered, "mitral regurge" ...(doctor nod2)...  "what are the causes of systolic murmur?" actually, i didn't really get the question.. and so i juz stand there blankly staring at the doctor without answering.. i shud hv asked him to repeat the question!! and now im regreting for not answering it.. u knew, but u lost the chance to answer..huh!

fifth spot :: inspect the back
not much of a story to tell.. it went smoothly, but still worrying about the marks... nice doctor, giving points to comment on, but bad me for not mentioning all of them =(

sixth spot :: acromegalic patient, inspect the face, hand and feet
the first comment i gave, slight slanting of the forehead.. suddenly the doctor asked, "why all of u gave the same comment? there's no such a thing of slanting of the forehead.. from which medical book did u get this term?" errkkk! "i dunno doctor, but this is the knowledge we got during our preclinical year." "wut?" "yes, the doctor from our preclinical studies told us this" and the doctor when.. "hmm..." ....but actually it's true, the doctors of internal medicine never once told us this point.. it's juz us making use of previous knowledge clinically.. huhu... but still im confused~! why taught us points that not even exist?! 0_o

seventh spot :: papate the spleen
nice spot... with very direct question.. and altho my comment was not 100% completed but still the doctor gave me full marks!! yeay! alhamdulillah, thank u Dr amani~ :)

eighth spot :: inspect the abdomen
the first item to comment is the shape... but unfortunately i lost my words! there was quite a long silence with me doing some stupid movement of my hand hoping that the word im searching for will immediately pop-up into mind.. haha.. even the doctor assessing started to pray "a'uzubillah himinash syaithonirajimm".. huhu.. but alhamdulillah not for long after, i managed to find a suitible word to describe.. fuhh~ *relieved!*

ninth spot :: auscultate the chest
hate this spot! there's too many mistakes i've done.. after reading the task, i went... BLURRRR!!!
i juz stood beside the bed looking at the patient's chest but not knowing wut to do.. and then suddenly i started to palpate for his apex?! for wut??? it's not the heart u shud examine, it's the chest! haha.. after quite some time, i realized im doing the wrong examination.. i immediately started auscultating his upper, middle, and lower lung zones trying to hear for the breath sound, any wheezes or crepitations.. after i felt satisfied with my findings i went to the doctor who's face was s00ooo horror oke.. not even a little smile present.. after commenting on the breath sound and the wheezes, he asked.. "wut about the vocal resonance?" AAaa~!! i forgot about that part of examination..!! *frust2* quickly running back to the patient, and do the xm.. then went back to the doctor and said.. "increase".. haha.. actually i dunno if the answer was correct or not.. bcoz i lost my focus and cannot interpret wut i heard exactly... hmm, at that state forgetting a step in an examination do add up my nervousness!=.="

tenth and last spot of the day :: taking history of jaundice
when i looked at the assessor... Dr zed?! i was like.. im dead meat! i remembered the time he assessed me during the long case last time.. it was horror!! asking to auscultate the aortic area.. so not knowing wut i heard.. but this time, alhamdulillah.. his question was quite simple and i managed to answer it.. but still im worried of my marks coz i caught my eyes looking at the marks of my friends previously assessed by him.. not even a single person got full marks.. even worse sumone got not even half of the full marks! oho doctor, pilzz be generous to me.. plizz, plizz..

and at last... fuhh.. i managed to call it a day! =)
now, im looking forward for surgery.. those who had juz finished their surgery exams said the exams was so sO SO hard! uhuk3 takutnye! but insyaAllah i'll try my best... 
chaiyok2 my dear friendss.. let us together fight to be the best future doctors graduating from alex.. aminn~

~salam maal hijrah~