Oooh, been a long day. Started the morning off with trying desperately to contact the tutor for tomorrow afternoon's subspecialty teaching. The woman sounded so confused, and said she'd call me back in the afternoon. Lovely thing is, everyone's not in school!! No one to clerk! Once again, Li Qi saves the day. I'll check out what the case is about, she'll be clerking the patient tomorrow morning. Turned out to be weird. Aplastic anaemia but it was an incidental finding - the patient came in for chest pain and was severely anaemic (3.5g/dL !!)

Had tutorial with Dr. Hsu, and felt like an idiot. I was pouring out sweat like anything when he asked me to examine the patient's abdomen. It was dripping onto the patient and on his bed, and I was desperately trying to sponge it off. Pathetic sight, and very embarrassing. And I thought the abdominal mass was an enlarged spleen - oh come on! There was only a 1cm band of resonance under the costal margin, how was I to know? And we found out how very lousy the surgery posting at AH was. "How do you differentiate between a peritoneal and retro-peritoneal structure clinically?" ... No idea. "It could be a primary peritoneal cancer" ... What's that?

Then we saw a lady with rather severe skin eruptions of bullous pemphigoid. And EW proceeded to freak HS and I out by: 1) giving the correct diagnosis, and 2) spouting alien-sounding things like acanthosis nigricans. Went back to check Kumar & Clarke, OMG. The skin chapter's like the final chapter in that horrendous book, yes? Amazing reading speeds. I believe I'm still stuck at rheumatology or something. Last short case tutorial was on a lady with oedema of a single leg. What's when we started searching frantically for the word "Muroy's Syndrome". Prof Low would have murdered us for this, he talked about it at least twice. And HS went on the rampage, and started spouting long-forgotten parasite names ...

Went on a short case round in the afternoon. Saw:

1) Facial nerve palsy .. was it Bell's Palsy? Lovely lady though, she was an ex-teacher and adores students, including us.
2) Grade 3 familial clubbing - the patient astounded us by asking if we'd like to see his clubbing.
3) Oh yes. Picked up a murmur that was missed by the docs!! Exciting! =D HS and I think it's a ejection systolic, loudest at the lower left sternal border. And EW thought it was a pansystolic murmur loudest at the apex. Picked up end-inspiratory bi-basal fine lung crepitations, bilateral pedal odema extending to the top of the thighs, multiple enlarged cervical lymph nodes, multinodular goitre and hepatomegaly.
4) Stroke .. again!

Not too bad, saw loads today, but I dread the amount of reading-up I need to do to catch up with the emptyness in my head.