Internal Medicine: DONE.

28th October'09@2020

Here I am,after a 3 hours of nap(yeah,i know it's pretty long but my internal rotation is over today!)..all rejunevated,sipping a glass of apple juice and munching my diwali cookies for dinner.;)

Internal medicine this semester was split into two periods-one right after my infectious paediatrics,for 8 days and will be continuing again in december for another 5 days,just before my last cycle for the sem,haematology..and we don;t know who will be taking us because Dr.Ksenia said it wouldn;t be her.Actually i prefer for a change different Dr. each semester.I have been under Dr.Ksenia,Dr.Yulia,Dr.'Nicole Kidman,Dr.Pavlovna..so actually I'm eyeing and really really hoping for Dr.Tatyana for my next semester.Really wish can be under her for the next 5 days for Endocrinology topic.Besides her,I won;t mind if I get Dr.Andrevna or maybe Dr.Panova?Let's cross my fingers for the best..after all it all depends on you no matter how excellent the mentors are.

But,this internal medicine was kind of relaxing for me!Okay I know you must be thinking I'm crazy here for even saying that..well it was seriously because the only topic which I learned in detail would be pulmonary embolism..the rest of the topics were repetition,but with Dr.Ksenia she won;t make life easier but at the same time you will feel a pinch of stress during Q&A session.Just like today,she managed to kinda'screw all of us' on our last day of tutorial class with her.

She returned our case report with comment "I'm not satisfied"..duh! As for me I think,we could've done better if we had written the whole complete case report rather than just writing about arterial hypertension when the patient ACTUALLY got admitted to the hospital due to hyperglycemic attack.So the chief complaints would be?Like I had said,sometimes long and complex process can make the job loads more simpler.Just like my previous patient,he had Diabetes Mellitus Type II(which was the reason for his admittance to the hospital),Arterial Hypertension(type?) and Chronic gastritis.So I had to only write on Arterial Hypertension!Moreover,according to the patient both his arterial hypertension and diabetes mellitus were discovered at the same time,6 years ago.Now,tell me which one lead to another?But one thing,it wasn;t secondary arterial hypertension according to her.*my turn off mood*.

Apart for the case reports issue,normally she would ask us back on the previous materials,and will give points based on how we had answered.Today,I prepared for Cor Pulmonale(right sided heart failure) and Myocarditis(inflammation of the heart's myocardium).She turned the table and here we go,Syahrul,Filzah,Jeff and I were asked on Chronic Bronchitis which was our today's class' topic..ermm,managed somehow but wasn;t excellent.This woman,unpredictable-la...

In spite of all that,we even made a very short case report in an hour time on patient's with chronic bronchitis.My patient,58 years old,a policeman by profession with moderate severity(concluded that after my clarking).He is a chronic smoker for the past 40 year with about 15 cigarettes/day.I'm sure he has complication of Cor Pulmonale but he said the doctor in charge didn;t mention anything about it and I,Abdalla and Zakiah were wondering whether we should omit the complications..moreover we couldn;t be 100% sure because there wasn;t Chest X-ray in his case report.But I did check his ECG and I'm pretty sure I saw few abnormalities,deep S-wave in V1-V6,sinus bradycardia,but there was no right axis deviation indicating right heart involvement.In addition to that,pulmonary function test wan't performed on him on his current admission.I suppose it was done way too earlier when he had his first attack 20 years ago.He too has Arterial Hypertension.

After collecting all the informations needed,the last 1 hour of our tutorial class was discussed on our last patients for the sem,all together 3 patients.Atleast,that part of class went smoothly and finally she gave us her smile,we said 'thank you' and left her,greatfully indeed!

So for now,I'm done with internal..and tomorrow at 8.15am,I will be off for my new rotation,Psychiatry.I'm looking forward for the cycle because I desperately need to know more about people,atleast selected ones which are making my life less cheerful now.Hopefully,towards the end of the rotation,I will be able to read people's minds BETTER than ever.

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