Ward day and...tremor??

We have hospital day on Fridays starting this semester. The cool thing is, I'm psoted at Bradford Royal Infirmary - a hospital, therefore, there's a lot of patients. Sadly, we get to see only one or 2 patients per day (it's usually only for 1.5 hours) - 9am til 10.30. It has been 3 weeks a.k.a 3 Fridays. Had to take cardiac history for the first two. And, last Friday, we manage to do cardiac examination. And I was the first to do it! I can't remember what I was supposed to do. (Haa.. another point, please don't expect to have teaching in the morning. You should have revised it the night before, after attending last week's lecture)

Luckily, I remembered that we start the examination by taking the patients hands.. look and feel - is it nice and warm? Any bruises, tenderness, redness, scars etc? Then look at fingers - splinter haemorrhages, tar stain, Osler's nodes, and another thing that I can't remember right now. Look at the joints for signs or arthritis... soem spot (maybe due to old age). Then do the pulse checking - pressure, rate, regular/irregular, radio-radial delay, collapsing pulse(only cardiologists do this, according to my consultant who is an anaesthetist).

Then we moved to face. Again, look and see. Any redness around the cheeks (it's suppose to be a sign of something, but can't remember what..) Eyes - anaemia, xanthal -something2-, white ring around sclera (owh..I gorgot this one as well), jaundice, (you can check your cranial nerves while you're at it as well!) Then the tongue - central cyanosis, thrush, ulcers, salivation (dehydration).. what else??

Owh, another thing, then you move on to checking the JVP - not suppose to see it on normal person. And my first patient was normal ;)

Huhu...and, as you noticed, it's a hell lot of stuffs! And this is just the beginning. My friend continued with the chest area - oberservation, palpation and auscultation. [We'll need to do all this in 6 minutes by next year..]

Whoa!! Cool! Now I feel like a doctor - putting stethoscope on.. hihi.. and the patient was happy to see us with our 'toys' - colourful.. hihi..

We heard a swooshing sound up in his aorta. According to my consultant, it's either aortic stenosis or aortic sclerosis. It's common for old people to have aortic sclerosis... but if it's stenosis, there may be some problem to anaesthetize him later (he's due for an operation in 6-8 weeks!). Did him a favour didn't we? [and we thought we were stupid not able to hear the LUB DUB sound..(or is it Rabb Rabb sound?)]

Hmm...happy.

Understood my ECG after 3 cardiologists explained it to me.

Manage to do cardiac examination though if it was an OSCE, I would have failed.

And critical appraisal.

Now - need to solat subuh as this gadget called RubyMerah has taken my fingers away from me for the past hour.

Solat, ma'thurat...BREAKFAST :D