Thursday, July 11, 2013

Post Mortem Exam : Day 1


ENT

  • We were given two cases.
  • Took the case for 15 minutes each.
  • Did all the tests necessary before taking the help of translator for history taking.
  • I did forgot to do few vital tasks.
  • It was so haphazard and unsystematic at all.
  • The case presentation was okay. Although i gave a different provisional diagnosis from others. The examiner says its ok, provided that i've given a solid strong reason for my opinion.
  • The viva..hurm, i don't know what to say.
  • Instruments? No need to say much. Just take what ever that i know and describe it. St Clair Thompson adenoid curette with guard was the one i chose without any thinking. Actually i chose that because i finished presenting a case related to it. He gave the the marks in front of me. i could care less. Pufft.
  • So, i wrote provisional diagnosis as Hypertrophied Rhinitis with Sinusitis and Total perforation of the tympanic membrane of atticoantral type.
  • I argued and gave reasons as why i did so, but unfortunately the diagnosis i gave was not perfect.
  • It should be adenoiditis with sinusitis which usually present over early childhood and persisit for long time as causes nasal obstruction.
  • The second case could be subtotal perforation( i can't really make out the annulus or margin, hence total perforation) because of the continuous discharge of the ear. I deduced it based on the fact that the patient had foul smelling discharge and total perforation with no ossicles left in the middle ear cavity.

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