Mirthless Laughter

*Collapses onto bed*

Yes, I passed ... phew!! Although it was pretty horrid, and I didn't perform as well as I think I could have. Here's the breakdown of cases:

Long case - 6 days continuous fever relieved by antipyretics also with chills and rigors, 2 days vomitting without coffee-grounds or blood, non-projectile, with semi-digested food. NOTHING on examination except petechiae. Yes, it's viraemia. I started suggesting gastro-enteritis, food poisoning (obviously a wrong differential) and acute hepatitis.

Short case #1 - AV fistula, thinned eyebrows and slight Cushingoid appearance, shifting dullness, mass in suprapubic region and right iliac fossa. It's a renal transplant case, although I suggested the mass may have been a bladder and got whacked for that. And no, no urine for me to smell. Didn't dare to mention the mass actually, and got whacked too. Cos if you make up a sign that's not there, you get 0 for the section. See .. sometimes it's good to risk it eh.

Short case #2, aka my nemesis - a totally non-responsive patient on whom I had to perform a motor examination of the lower limbs. Erm .. how in the world am I supposed to ask the patient to push on my hand to test for power when she can't even respond to command??! OK, that's exactly what my tester asked me, and I was so stumped. Also with right below-knee amputation, no reflexes on the left, normal reflexes on right, wasting on left. Could not do Babinski's sign .. the patient started shrieking every time I placed my tendon tapper on her!

And yes, I was so flustered, I started dripping like mad on 2 patients. He asked me for diagnosis of short case #2, and I was silent. Till this day, I have no idea what she has. Then he said it's an unusual case and asked me not to worry.

Prof. Lee's a really nice guy, regardless of comments I've heard. He's really, really nice. Passed both of us and told us not to lose any sleep over this (erm ..too late!), and pointed out our mistakes nicely. And he didn't ask anything on investigation and management. Pure year 3 standard!!

Phew, phew, phew. Now for a well-deserved break, then it's back to MCQs.