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4. Iqlima Idris salam..

candidate no 6 jadi no 9 pulakkk examiner:RKR,Dr chandra,Dr


philip and and Mr Hashim yg baekkkk Mdm P,57 years old,with DM for 2 years and
asthma for 17 years ago presented to hospital 2 weeks ago due worsening of
shortness of breath and productive cough and fever.Diagnosis:poorly controlled
asthma.Mase present history ade jugakkk dr interupt..why patient stop working...yg
ni betul2 lupe tanye.. Q:this patient got reduce effort tolerance,do you think it's
related to her asthma or new condition? M:asthma,since she has no pnd,orthopnea
and leg swelling Q:What do you think about her asthma control? M:poorly controlled
because 3 attacks within a week...but relieved with inhaler Q:do you check BP and
fundus..TAKKKKK SEMPATTTT...kene ngan rkr! Q:please examine the respiratory:no
findings Q:please examine the fundus...perform la....adoi fundus die bgi kecik sgt....i
punye tertinggal kat luar...mr hashim nak gi amekkk..but rkr said:no need!!!! Q:DM
what do you to check: M:RP,ECG,Urine FEME,check the leg,fungal infection Q:How
do you mange asthma? M:divide in acute setting....bla..bla Q:tell me step of
managing asthma? M:bla..bla.. Q:what is leukotriene inhibitor?
M:bronchodilator??????kene bom lagi ngan rkr... Q:tell me the pathophysiology of
asthma???
PROFESSIONAL EXAM 2013 6TH BATCH DAY 3
CLINICAL EXAMS
M:bl..bla...last2 dpr jugakkk leukotrine tu reduce hypersensitivity....abessss

salam, candidate number 4-->10 long case (dr hanip-HKL, dr onny, dr ravi, dr foo)
madam paniah 57 years old malay lady non smoker with b/ground hx of asthma for
17 yrs and DM for 2 years came to hosp 2 weeks ago following episode of worsening
shortness of breath a/w cough and fever for 2 weeks. dx: AEBA (kite ckp die
secondary to pneumonia - sbb die ada sx of chest infx) diorg terima. what else do
you want to tell us in hx? rupa2nya diorg nk tau pasal past obstetric hx.. adoihh dah
la x tnya patient. ingat xde kaitan dgn asthma. last2 diorg suro tnya masa bawak g
kt patient. lepas tu byk tnya pasal history - precipitating factors and medication that
the patient's had, rescue nebulizer. inhaler technique. suro demonstrate, ix, what
type of medications. DM - die tnya side effect of metformin - weight loss, how would
u monitor - BSP, ix for DM.

LONG CASE: Medicine Asthma


Examiner: dr. wan haniza, prof anne, dr ravi, dr faisal peads

habibah, 59y/o housewife, with poor control asthma 10y, dm n hpt for 5y good
control n on med. multiple admission dt asthma. last admission 6/4/12 wit cough
and sob for 3 days prior.
trigger fx - smoke, pet, carpet and dust (all triggers fx of asthma)

history die mm...g sume asthma pnye cite

quest (leader: dr. wan)


1. what relevants hx for dis pt? - so ckp la sume yg bkaitan ngn asthma dr HOPI till
SOCIAL
2. dx and ddx
3. p kat pt - examine pt's back, wats ur finding? - polyphonic rhonci involve both
lungs
4. hows d rhonci occur? dt partial obst of lower resp tract
5. where do u thin the obst can b? - sy jwb bronchi and bronchioles..huhu
6. agknye cm salah kot, so next quest ask bout anatomy of the lungs..from
bronchus to the alveoli, how many lobes and cbg2 bronchioles stiap lobes sume
lah..
7. dah cite sume tu, ask back how polyphonic ronchi tu bley occurs - ans- involve
multiples bronchioles..die angguk..hohoho
8. diskas kat blik lak - investigation and management acute and long term
9. last quest from prof anne - how do u want to check the severity of asthma after
acute mx

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