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| First oncall life (3/7 6pm to 4/7 8am)
18:05 9A E case: pleural effusion
18:30 9A E case: CAPD peritonitis (fail to see patient on time)
18:45 dinner time
18:55 9D E case: a very classical CVA
19:40 11C E case: CAP
19:50 9D E case: COPD exacerbation, not seen by me
20:30 11C HBs setting
21:00 11C Lab result screening: Hb <8, inform MO, scolded by MO for not doing proper P/E first
21:30 11C all P/E done, MO decided to transfuse with lasix cover (patient in CHF), start combo of consent, HB and T&S
22:15 9A Informed chills and rigors in a patient receving blood transfusion, temperature simialar as before, stop blood transfusion temporarily, add piriton 10mg and hydrocortisone 100mg cover. Retry transfusion 15min later
22:30 9A Informed increase pulse > 120, pulse go back to 80 when I see him, keep observe
22:40 9D Blood taking for CVA patient admitted before
23:15 9D Blood taking + ECG for COPD patient(1st ABG done: takes a very very long time)
23:45 11C Blood taking for CAP patient (2nd ABG done)
00:30 11C Finally have time to do the T&S for the anemic patient
00:45 9D Informed desat of COPD patient, increase dose of O2 as suggested by nurse
01:15 9D Lab result screening: ABG for COPD patient showed mild respiratory acidosis, mild CO2 retension. MO informed, suggest try tailor down the oxygen
02:00 4E Informed oncology patient receiving blood transfusion low grade fever <38C, stop transfusion temporarily, recheck temperature 30min later, continue transfusion if not fever
02:15 11C different kinds of minor homework
02:45 9A Informed decrease no PU for one day, decide to insert foley (not by me of coz)
03:00 9A Informed increase BP > 190/100, Adalat Retard 20mg stat prescribed by me
03:15 9A earned a soy bean milk for ‘super’, provided by a ‘sir’ in 9A
03:20 sleeping time
03:25 9D informed decrease GC for COPD patient, decrease oxygen to retain hypoxic drive for patient
04:00 9D Lab result screening: ABG showed type II respiratory acidosis for that COPD patient, nurse suggest calling MO. MO suggest CXR, ECG, ABG (3rd ABG done)
04:20 9D Lab result screening: Hb 11 to 7, P/E exam done this time: unremarkable, T&S time again, another MO called, tell me to do a full workup for Fe profile next time
05:00 9D different kinds of minor homework
05:15 4E Informed drip loosening for 2 patient, both are extremely difficult cases, take almost half an hour for one case, failed both case, MO called, suggest no need to set
06:00 11C post transfusion blood taken
06:15 4E some minor homework, informed itchiness and rash around drip site, patient seen, no itchiness and rash now, keep observe
06:30 9D informed desat, ABG taken suggested by nurse, (4th ABG taken)
07:15 breakfast time in canteen
07:35 11C E case: suspected swine flu
08:30 finish all the call stuff, another day starts (gets calls from 8C for anchoring CVP and 4A for HB and T&S for a renal patient immediately, and piles of homework in 9AB awaiting) | | |
| Weight loss
General malaize
Palpable LN (1 LN at each area) at at submental area, left submandibular area, left anterior chain, right suboccipital area, ?left medial axillary area, ?left supraclavicular area, left groin, right groin
大獲 | | |
| 英台，上虞祝氏女，偽為男裝遊學，與會稽梁山伯者同肄業。山伯，字處仁。祝先歸。二年，山伯訪之，方知其為女子，悵然如有所失。告其父母求聘，而祝已字馬氏子矣。山伯後為鄞令，病死，葬鄮城西。祝適馬氏，舟過墓所，風濤不能進。問知山伯墓，祝登號慟，地忽自裂陷，祝氏遂並埋焉。晉丞相謝安奏表其墓曰義婦塚。
張讀 <宣室志> | | |
| Med 5 = Pregnancy
Med 5 正式的medicine + surgery rotation時間是剛剛好是40個星期
接著,大家就會在考Final MB時把所有知識"泌"出來
唔知Maternal mortality係幾多呢? | | |
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