it is funny girls cant deny it
Medicine Shortcase Exam
well ytd i had an exam with Dr. LP Tan and KT Chua and i have no reason to be afraid as both of them are so nice and loved by students.
Well i was the last to be examined and they asked me to do a CVS examination
Practically im very confident with the flow of my examinations as it acts like a good impression, by just showing some showmanship.
Well it went quite smooth until i saw the pulsation at the neck. well it can either be JVP pr carotid. Well i had to commit to carotid as although it has 2 pulsation, they were palpable, doesnt decrease with inspiration nor increase with abdominojugular reflex..
Then there was a murmur. out of every freaking common pansystolic murmur.. they gave me early diastolic murmur that was very soft. Well it has to be an AR...
when i was about to check the leg oedema, Dr. KT Chua stopped me and asked me " how would you like to finish the examination"
and i said by checking BP Temp and urine for hematuria..
then he said "no before that???"
there i was.. stood like an idiot trying to gather my thought. what he wanted was actually bibasal crept..
basically this was the moment that i know i screwed up. how the heck i supposed to know whether the patient is in failure or not..
so lessons of the day
1. always say what else i wanna do although he asked how im gonna end the examinations
2. i sux when the lecturer ask to present positive finding and relevant negative.. clearly in this case he wanted to know about AR.. causes of murmur.. whether he in failure or not and whether he developed IE or AF.
3. do more readings
4. examine more patients
BTW the diagnosis i should have mentioned would be
"This patient has a valvular heart disease , AR and the main etiology would be rheumatic heart disease. He doesnt have any evidence of IE and he is in failure"
yes yes i know im a failure
p/s: just got back from watching Prince of Persia in cineleisure and it was superb! well that should put aside the depression for now i guess..
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Remember
treatment of arrhythmia
ACUTE
1. cardioversion (electrical or phrmacological)
2. if cardioversion not possible, control ventricular rate with digoxin
LATER ON
treat the main cause
prevent thromboembolism with anticoagulant (aim for PT INR of 2-3)
Dawn of the new day
well ive been slacking quite alot past few months.. not strict with my diet and all.. now its time to redeem back all the sins..
well now im 79kg.. and aiming to get get to 68kg for good. or perhaps if i can make it to 65kg then ill be on top of the world..
here's the plan
breakfast : meal replacement 185kcal
lunch : chicken breast and vegetable 1 serving
dinner : meal replacement 185kcal
total per day 583kcal.
my BMR probably 1600kcal means im doing -1000kcal per say at least.
no freaking snacks
as for workout
everyday ill jog for 30mins. the distance quite arbitrary but ill try to improve everyday
as for gym
monday: chest
tuesday: leg
wednesday: back
thursday: shoulder
and repeat the sequence
4 diff machines or exercise
12 x 3 reps each
some cardio in between
will try 15x3 after 2 weeks and increase necessary weight as proceed
GO 65kg! W32 and nicely figured body.nite
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Conscience
Its been a very busy weekends as my little brothers were enrolled to PASUM.. and im officially babysitting them in UM.
Anyway.. i watched a good movie entitled "American History X" earlier. Its about Skinheads against Negros and stuff and one part of the movie got me thinking
did God hear my prayers?
did He respond to it?
perhaps ive been asking alot of wrong questions.
before i even ask for help perhaps i should ask myself
"has anything you done made yourself feel better?" :)
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Randomness #7
brownies banana boat @hartamas. not bad.. love the combination of hot brownies and icy cold vanilla ice cream
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Randomness #5
my sister used to tell me how this blog sounded like it belongs to my little brother, i know why because i rarely put picture of me
well he's "happy" rite? haha
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Catchy
"do not lie, steal, cheat and drink... if we must lie, lie in the arms of the one we love, steal her heart, cheat death.. and drink for the moments that take your breath away"
Mama
though i may not turned out as the perfect child
though i may not be as smart and gifted
though i may not be as beautiful as u always be
though i may not be as tricky and manipulative
though i will never be as caring and responsible as you are..
im happy that im part of you and although u dont really give a damn about mother's day, take it as one of our way of giving back...
love u mama
p/s: make sure those kembar make full use of the virgin olive oil and cook u something good! haha
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Toys
well well... Lamborghini Reventon Roadster , tell me who in the hell would not want this.. with this all u need is the helmet and G-Suit. Look at the trailer and tell me how cocky does it sounds like?
Owning this would be impossible unless suddenly there are few billions in my bank account out of the blue. I surfed lowyat.net the other day and spotted this picture. The owner is a Singaporean. 1 in 700,000,000 and one of the owner is in Singapore?? WTH!!!
Lamborghini Reventon Roadster
Xdapat the car. Buat wallpaper cukup bahagia dah~
Charice - "Pyramid" Featuring Iyaz
Well the other day i went to buy a baked lamb for mama from San Francisco Pizza and heard this song, tagged it using Shazam and it showed Charice - Pyramid. So i googled it up and listened to it in youtube. Such a great voice from this petite young girl.
Part of the lyrics caught my attention without even having to go through hassle to googling it up
Stones, heavy like the love you've shown (shown)
Solid as the ground we've known (known)
And I just wanna carry on
We took it from the bottom up (no no no)
And even in a desert storm (yeah)
Sturdy as a rock we hold (oh)
Wishing every moment froze
Now I just wanna let you know
Earthquakes can't shake us
Cyclones can't break us
Hurricanes can't take away our love
Pyramid, we built this on a solid rock
It feels just like it's heaven's touch
Together at the top (at the top baby), like a pyramid
And even when the wind is blowing
We'll never fall just keep on going
Forever we will stay, like a pyramid
Solid as the ground we've known (known)
And I just wanna carry on
We took it from the bottom up (no no no)
And even in a desert storm (yeah)
Sturdy as a rock we hold (oh)
Wishing every moment froze
Now I just wanna let you know
Earthquakes can't shake us
Cyclones can't break us
Hurricanes can't take away our love
Pyramid, we built this on a solid rock
It feels just like it's heaven's touch
Together at the top (at the top baby), like a pyramid
And even when the wind is blowing
We'll never fall just keep on going
Forever we will stay, like a pyramid
Randomness #4
Curry Karage Gunkan @ Sushi King.
its like eating mamak's food in sushi king using chopstick. that doesnt add up nicely rite?
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Angel's Cry
The original version of this song featured in Mariah Carey's album entitled "Memoirs of an imperfect Angel" was without a doubt one of the most brilliant song, sung by her. Well a friend of mine recommended a remix version featuring Neyo. It was a love at the first sight!
Great combination of voiceLightning don't strike
The same place twice
When you and I said goodbye
I felt the angels cry
True love's a gift
We let it drift
In a storm
Every night
I feel the angels cry
Download
