Tuesday, April 5, 2011

0sce medicine~

Assalamualaikum..

da abes exam arini..
tp l0m bebas spenuhnye sbb ader satu lagi paper ari jumaat
exam zT (hubungan etnik)

0sce medicine td byk k0t ak cuai..terkilan lak~huu

start lam k0l 10 am td
cam bese,5 minutes f0r each stati0n
ader 5 stesen medicine, 2 stesen PPD,5 stesen rest
byk sgt rest stati0n kali nih..penat menunggu~

1st stati0n:
cam bese laa,ak lbh suke memilih tuk rest dlu
tenangkan fikiran *cesss k0n0n

2nd stati0n:
PPD..kn tgk vide0 bkaitan percakapan se0rg d0ct0r ngan patient
dr ni ngah nk educate patient dia sal unc0ntr0lled diabetes
*5minit tuk tgk vide0..2,3 kali k0t ak ulang2 vide0 tuh*

3rd stati0n:
PPD stati0n gak
kn jwb s0klan bkaitan vide0 yg da tgk tuh
s0klan tnye sal maj0r mistake lam vide0 tuh
n h0w t0 impr0ve patient educati0n in this case

4th stati0n:
rest

5th stati0n:
ader gamba patient ngah tersenyum
dia ader sudden weakness left side 0f his face
s0klan tnye finding gamba tuh,diagn0sis n sympt0m yg patient may have
*ak rase ak salah k0t diagn0sis stati0n nih* O_o

6th stati0n:
ader gamba electr0cardi0gram (ECG)
patient dtg ngan chest pain
s0klan tny sal abn0rmality ECG tuh,diagn0sis n risk fact0r f0r that disease
0k k0t stesen nih..

7th stati0n:
rest

8th stati0n:
ader gamba patient jaundice (mata dia kuning giler)
patient nih l0rry driver,pr0misc0us,c0mplaint 0f lethargy,arthralgia (j0int pain)
0n examination patient ni ader liver tenderness
s0klan tny ape sign lam gamba tuh,p0ssible diagn0sis n investigati0n at this stage
*yg ni p0n ak ase salah jwpan ak~aaaaa*

9th stati0n:
rest

10th stati0n:
gamba inhaler tuk asthma
s0klan tnye ape name device tuh
state the medicati0n delivered by this device n indicati0n
pastu c0mplicati0n gune device nih
*stesen ni p0n ak xyakin sgt*

11th stati0n:
rest

12th stati0n:
patient dgn past hist0ry 0f partial gastrect0my f0r perf0rated gastric ulcer 10 years ago
dtg dgn pale..ape ntah lagi
lab finding hem0gl0bin dia rendah,mean cell v0lume (MCV) tinggi
s0klan tnye ape je abn0rmal finding dia,causes n investigati0n t0 c0nfirm diagn0sis

abessss

tawakal je laa
satu je ak mintak...xnk reseat!

p/s: tinggal exam zT je lagi satu ari jumaat nih..

9 comments:

Rai said...

apa maksud uncontrolled diabetes? adakah bermaksud pesakit menghidap penyakit diabetes yang tak boleh dikawal atau pesakit tu tak mengawal penyakitnya (tak kawal pemakanan etc)?

my aunt ada diabetes (sugar level 19) doktor advice her to take daily insulin injection. setau saya, most of the medicine for diabetic just utk mengawal bukan untuk mengubati (the patient will not totally free from diabetes by taking med) apa side affect from taking insulin in the long term? my husband's friend has taking insulin injection for a while, she's now diagnosed with hepatosirosis. and now taking medicine for liver. will this medicine has side affect as well?

i'm not againts cure by the drugs but kadang2 saya rasa doctors kena educate patient pasal changing their lifestyle because disease like diabetes, high blood pressure adalah penyakit yg disebabkan oleh unhealthy lifestyle. this cannot be cure by medicine. the patient also need to change their current lifestyle because depends on the drugs only will cause side affect in the long term.

but im not a medical practitioner. what your say on this?

Anonymous said...

Nak tlg jawab kan.

Bijak dah tu jawapan anda, uncontrolled diabetes tu adalah penghidap diabetes yang selalunya hospitalized because of high blood glucose with or without diabetic complications.

Blood sugar level yang normal adalah dlm lingkungan 4.5-5.5 mmol/l. So sugar level 19 is very high and doctor tersebut mengubah medication ur aunt most likely due to poor compliance to medication or ineffective. Banyak different drugs for diabetes and selalunya oral medications such as metformin are prescribed first. Faktor penukaran kepada insulin seperti pregnancy, insensitivity to medication etc.

Benar, ubatan ni cuma complementary and helps to control masalah high blood sugar levels tapi perlu untuk pesakit diabetes. Diabetes type 2 ni ade modifiable risk factors seperti permakanan, exercise etc. Dengan kawalan lifestyle, as long as boleh maintain normal blood sugar level dan insyaallah boleh dirawat penyakit diabetes ni. Educating the patient about changing the modifiable risk factors is one of the management in diabetes. Ketika berjumpa doctor (on check-up etc), clarify with them anything you need to know or wish to understand. Insyaallah semua persoalan akan terjawab.

As far as i know, insulin does not cause liver disease (hepatocirrhosis). Kemungkinan kawan puan ada penyakit lain juga? Insulin berfungsi dlm pengawalan kandungan gula dlm darah. So their side effects are related to hyperglycemia (high blood sugar)and hypoglycemia (low blood sugar). Seharusnya pemakai insulin akan diberi nasihat dlm pemakaian insulin,seperti kesan-kesannya dan cara penggunaan.

:) hopefully ni sedikit sebanyak membantu.

Rai said...

thanks a lot..sangat membantu.

but in most cases ramai org tua yg sentiasa tak lupa makan ubat, tapi sangat tidak mengamalkan kehidupan yang sihat. and i also heard that some of the doctors tak bagi patients ambil supplement vitamin tambahan due to makan ubat. for me, ianya sangat menyedihkan because as far as i know vitamin e helps to boost pengeluaran insulin, b complex helps to pecahkan gula dalam darah and both are needed for diabetic people. tapi bukan semua doktor la..

my husband's friend tu diabetes type 1. while my aunt diabetes type 2 and having high cholestrol and also hepatitis b at the same time.she's very lucky eh..hehe..

boleh tak kalau saya kata yg sebenarnya penggunaan insulin yang menyebabkan penyakit berangkai >> high blood pressure. kemudian doktor akan prescribe ubat utk high blood pressure and the patient may end up sakit buah pinggang sbb banyak sangat load. or rosak liver function..the worst they also get sakit jantung. hehe..

again..i don't mean to blame the medication prescribed by doctor semata-mata. because those medication is needed to control the disease but ramai org yg bergantung sangat pada drugs and get poison by the drugs they are taking.so the doctor should educate these people because most of them don't know what they should know or what they should ask.

banyak la keja doktor lepas ni.. hahaha..

Anonymous said...

Tentang supplement vitamin ni, ia hanya makanan tambahan, kiranya bukan wajib untuk sesorang itu mengambilnya. Ia boleh membantu tapi bukan mengubat penyakit seperti diabetes, even ambil sesetengah traditional medicine pun boleh diambil kira as supplement.

Doktor mungkin risau compliance pesakit tersebut, kerana bermasalah juga kalau hari-hari perlu ambil banyak-banyak tablet. Bukan semua orang suka ambil ubatan. Jadi, mereka lebih berpendapat biarlah pesakit itu memfokuskan kepada apa yang lebih diperlukan saja. Pengambilan supplement juga bergantung kepada status kewangan pesakit itu juga.

Insulin ni sebenarnya hormon semulajadi dlm badan kita. So penyakit diabetes ni terjadi samada disebabkan fungsi insulin berkurangan atau kuantitinya tidak cukup. Jadi bukanlah salah insulin itu sebenarnya, lebih kepada masalah kandungan gula dalam darah itu sendiri.

Kandungan gula, lemak dlm darah serta tekanan darah yg tinggi mmg suatu faktor-faktor yang berkait rapat. Kandungan gula dlm darah yang tinggi akan menghasilkan by-product and juga menyebabkan kerosakan pd salur darah. So dpt tekanan darah tinggi. Selain itu, bila kandungan gula dlm darah tinggi dan ia tidak digunakan, gula tersebut akan menjadi lemak dan seterusnya boleh mengakibatkan saluran darah tersumbat dan masalah jantung. Komplikasi kepada uncontrolled diabetes melibatkan byk organ termasuk buah pingang dan kalau ade pakej tekanan darah tinggi, pun boleh effect buah pinggang juga.

Apa-apa pn, saya berpendapat ubatan yang prescribed by doctor tu wajar dan penting to help cope with the disease but banyak faktor lain juga yang perlu dikawal. Yelah, mungkin doctor terlalu sibuk untuk go to the details with every patients kn. Sebab tu, banyakkan la membaca dr internet or newspaper and apa2 yang perlu clarification boleh diajukan. :)

Rai said...

i'm totally agree with you. vitamin supplementation (i refer to vitamin supplementation, not the traditional medication) adalah makanan tambahan which is it is individual decision whether they want to take it or not. it is long time ago..but believe me today, we have too many reason that makes vitamin supplementation is essential to keep our health to the optimum level. many people unable to maintain their health to the optimum level due to lack of nutrients and unhealthy lifestyle. i'm talking about lifestyle related disease such as diabetese, heart attack, high blood pressure etc..

and yes.insulin adalah sejenis hormon yang dihasilkan oleh badan. but due to unhealthy lifestyle, the body unable to produce enough insulin to cope with the sugar yang masuk.or, insulin level is normal but there are too many sugar. when either one of these situation happens, the sugar level will rise. as i said, prescription by the doctor is necessary to maintain the sugar level. but we must be aware that this is not permanent. to maintain the sugar level, patient need to continously taking the medications.

as u said earlier, taking insulin in the long term can caused high/low blood pressure.secara tak langsung menambah masalah yang sedia ada..why not, they taking their medication with vitamin supplementation such as vitamin e so that the body can naturally produce more insulin to control the sugar level.taking extra b complex can also reduce sugar level because it helps to pecahkan sugar menjadi tenaga so that sugar tu tak jadi lemak..it will slowly helps to reduce the sugar level to normal..and maybe after a period of time the insulin dosage can be reduce..for me, there are too many benefit of taking supplement.

bagi saya, org sakit mmg kena makan ubat. as prescribe by the doctor. but totally rely on the drugs is very dangerous.

Rai said...

btw tuan rumah senyap je..sori menyemak kat sini ya. :D

Anonymous said...

:)
In the end, everything depends on the person itself. Usaha la yang termampu, kemudian doa dan tawakal.

I wish it was easier to promote healthy lifestyle especially exercising obesity is a big issue in malaysia and a main cause to diabetes. It's all in the mind really, "hendak seribu daya, xnk seribu dalih"

Diabetes type 1 x bleh buat apa la because they are genetically incompetent to produce insulin but for most (diabetes type 2) are due to insulin resistance because of their thick central adipose layer! Losing weight is far more beneficial to their health yet people are quite reluctant to do so. :) I suppose exercising should be included in our daily routine like brushing our teeth and commenced as soon as we are able to walk.

Ramai juga pesakit ta mahu makan ubat then rely on traditional meds and bomohs. Later on, came in with complications of the disease. So much for 3 stages of prevention, out go the 1st. ;p

P/S: Owner ade exam tomorrow, i think. As written in her post.

Rai said...

kan..i'm a mothers of two sangat2 risau melihat perkembangan pemakanan rakyat malaysia. especially bila restoren makanan segera yang tumbuh cam cendawan lepas hujan. not only those food high in salt. berminyak berlemak bagai.also hope that lebih ramai org prefer to cook their own food than makan bungkus :D

but then, this issue not only happen in malaysia.most country have the same issue. obesity :D in todays world it just too hard to maintain healthy lifestyle and excersizing since most of us terlalu sibuk focus on carik duit dan lupa focus on our health..

actually i pun marah bila ada org opt to traditional medication rather than prescribed one. sebab for me most of the traditional medication have no clinical studies to prove them. so it is very the dangerous jugak.we don't know what is the side affect or even they cannot guarantee that it will work. but too bad because some people listen to the wrong advice.

kadang2 medical practitioner pun boleh bagi wrong advice (no offence) because i'm also breastfeeding my kids. some doctors advice me to give them formula instead of continue to give breastmilk when my children not following their weight chart. but i think that im lucky enough because even im not in medical field, i know a bit about some of the health issue. but how about for mothers yang tak tahu apa2 about the benefit of breastfeeding. so sad kan.

ooh..takpe la..maybe later tuan rumah boleh tambah apa yg patut :D thanks anonim.gained a lot of knowledge thru the discussion.

mahirah said...

nice c0nversati0n here..saye p0n bru 3rd year medical student~masih lagu kurang ilmu & pengalaman..

juz nk tmbh laa..mngenai diabetes nih..memang,patient's educati0n sangat sangat laa penting..sbb tu di peringkat kami ni da diajar mngenai nih..h0w t0 c0mmunicate with patient's,h0w t0 impr0ve patient's c0mpliance etc..c0z kal0 patient tu sndiri xpaham mngenai their 0wn disease,n0 use jgk kan kite suruh mkn ubt tu mkn ubt ni tp patient xik0t p0n...

yep,mcm puan rai ckp..lifestyle 0rg malaysia nih m0stly xmemuaskan~ramai yg 0bese tp tu laa..bkn sng nk educate pe0ple~tp as a d0ct0r we must try laa

and as an0nym0us ckp..kite hnye mmpu berusaha~let the rest kite tawakal to ALLAH bile da ushe..thanks an0nim f0r sharing ur kn0wledge~hee

p/s: d0akan result ku memuaskan ari slase nih..nk lulus! :)