Ok, today’s exam was the SIMPLEST yet it was the one I floundered MOST!
Still feel so irritated at my ‘blank-out’ performance today that sigh, I have this irresistible urge to bang my head on the wall everytime I think of it…
Examiners were Dr Quak SH and another female doc (who has the look that BOSS likes! hahaha)
1st case - teenager with ?TR
The teen was very gan jiong, and I got super gan jiong when I saw him all tensing up and not relaxing… Was so ganjiong I think I must have had some sort of heart block, cuz I counted him as having only 48 beats per minute of pulse rate, and tremblingly told the examiner so. The female examiner had this extreme look of displeasure on her face and asked me what causes bradycardia?
I blank, then said ‘physiological… drugs like yr b-blockers… and um…. heart block’ Then she let me continue presenting… No collapsing, JVP can’t assess, palpable thrill over LSE, palpable P2, apex not displaced though. I heard a loud 4/6 PSM over LLSE without any radiation. Could also be heard elsewhere on praecordium but softer. No MDM at apex, no EDM at LSE, no bibasal creps, no hepatomegaly, no ankle oedema. Concluded as VSD of moderate severity.
Prof asked: What are your differentials?
THEN I JUST BLANKED OUT, I TOOK A DEEP BREATH BUT STILL WHITE-WHITE… THEN SEI LOR…. I JUST BLANKED OUT! WTH… Never done this in my THREE years of clinicals… Then Prof took pity on me (or maybe he thinks I got NO hope liao…) said, NEVERMIND and questioned me on why I was looking out for the EDM… So just said might be juxta-arterial (ie. btwn AV and PV) which prone to AR… so will have EDM, more severe got to repair, so must look out for. Said didn’t find in this place… Then the female examiner asked why MDM. I said, it’s probably due to flow murmur. And she mumbled, ‘STENOSIS’, and looked like someone put pickles under her nose. DIE. But then well, we’re talking abt the MDM of a VSD, not like MS rite?!?!?!? wa sei… is she from paeds or med?
Anyway… I think my fate almost sealed liaoo… They didn’t ask me much else…. er… die lor… Maybe I failed this case?
Then I heard fr the other person who did this case that when she finally got the differential of TR squeezed out, they visibly brightened up and quizzed her a bit on it… so maybe this was a TR after all. Sigh. I doubt I got enough marks to pass this one leh. :(
Case 2: DA
Examiners: cardio prof (the very nice one) fr KKH and A. Yeoh.
Haiz, so hard to establish rapport with the kid cuz she’s Malay and I don’t know what sort of Malay to speak to a kid! -_- Very cute gal though… Went thru the works… Almost forgot to give her pen and paper to scribble but Yeoh intervened… hengz! In the end, put her as 20 months. Kind of a feeling thing la… But I didn’t ask the examiners what her real age was. Later on checked with my partner, she said they told her the kid was 18m. I guess should be safe for this case, though I didn’t exactly shine doing it. :(
Dang. Had to end the exam on such a low note. :(
All the best to those doing tomorrow! I hope we all will PASS as a whole cohort and start work together!!!
