My scribbles

Thursday, April 10, 2008

currently in rheumatology ward

Dr K is immitating me.. no.. hes undeniably always like to tease me
i think hes a weirdo
you know, a kind of doctor who laugh out loud after inflicting pain to the patient
enjoys making other people grimacing in horror
thats dr K

otherwise Dr Kuan is quite a nice specialist
he nearly put me into tears when he 'scolded' me for forgetting to review Chan renal profile
he said he didnt scold me
he just want me to observe carefully this patient
eventho everytime i answer his q he'll say it wrong - and tell me nicely that the answer is wrong

i'm a bit confused of rheumato treatment and the way patient presents
- joint pain, scalydactyly, systemic sclerosis, abdominal pain, persitent vomtiing
its a kinda mixing together
all symptoms come in a jumble
i mean, how can u differentiate persistent vomiting from an active/ flare of SLE from a GIT infection?

check the C3/C4/ ESr/ CRp level?

k , thats to monitor active SLE ..

and what else did i learnt?

dermatomyositis...
hurm , complex, but its quite direct..
proximal muscle weakness, shawl sign skin appearence, raising LDH / CK
need to get EMG appt and muscle biopsy ( tro fibrilation of the affected muscle)

hey, quite a good environemtn to learn rheumato
especially if im going with a to tganu

ganu kite

drfatiha

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