End posting 9th term Paediatrics

Arghhh...

This time i didn't do well. I was told to read more. This is not enough. Yeah, i didn't come prepared. Not 100% prepared.

I left my notes and books at home.I shouldn't do that next time.
Geram geram geram....
Geram sebab kes ni dah banyak kali aku present. Pastu, still tak confident nak jawab apa cikgu tanya.

I've repeated my answer soo many times and yet she didn't understand. Maybe i spoke too soft? Too slow?Mumbled? My accent? Okey, i admit it was my fault... *sigh*

My patient this time is super cooperative and playfull but i screw things up. I knew it was my fault...

There is no next time. Because next time it would be real. I hope i will be better next time.

Viva Questions

• What is nephrotic syndrome? Give proper definition.
• What is remission? What is relapse?
• Treatment for first time episode of nephrotic syndrome.
• Rx for relapse?
• Rx for remission
• Rx for steroid dependance?
• Method of assessing organomegaly in presence of ascites.
• Child draw a stick man. Give the age of the child.
• Development - motor,fine,social,personal of 7 year old.

Actually i realised that this kid had supraclavicular pulsations and elevated JVP of which i didn't say because it is too risky and way beyond my expertise. So, i stated only the OBVIOUS and most common findings in nephrotic syndrome.

He has fast breathing >30cycles/min, tense, distended abdomen, positive fluid thrill, positive shifting dullness. Just not confident enough to mention that the kid had signs of hydrothorax. No hydrocoele. There is puffiness of the eyes, abdomen distention and pedal edema of pitting type. No organomegaly. No hematuria. No fever. No artralgia. Nails have white bands, pale palm. He had history of hypertension and maybe that's why he had elevated JVP.(well it looks like it)...(-__-)" im not sure....

Next time, be sure.Be confident. You will get this right next time.

Aminn.