clinical school is like a day-long pbl session.

patient has a history of steroid-resistant nephrotic syndrome. he was treated with cyclosporin but for some reason that i didn’t write down in my notebook, he stopped treatment.

learning issues: side effects of cyclosporin cyclophosphamide cyclosporin. indications? how is steroid-resistant nephrotic syndrome managed? causes? note: revise complications of nephrotic syndrome.

patient with 3-day history of fever and sore throat. currently has copious amount of purulent discharge from right ear.

learning issues: features of otitis media. age group?

patient with growth retardation.

learning issues: causes???? what is asd with tr? tricuspid regurgitation? how does murmur in asd sound like? metabolic disorders causing growth restriction. congenital hypothyroidism. incidence? symptoms? treatment? complications? note: revise immunisation schedule and practice presenting. cxr – kerley b lines only at base? fluid in transverse fissure – significance. hyperinflation of chest = >6 ribs anteriorly, >8 ribs posteriorly. in adults?

patient with down’s syndrome.

learning issues: chromosomal disorders. trisomy 21, 18? describe appearance of down’s syndrome. what are epicanthal folds? how to screen? pathophysiology?

patient with cough and runny nose for 5 days. no fever. associated with wheeze.

learning issues: differentials – aeba, pneumonia, viral bronchiolitis, croup, pertussis. how to tell pneumonia and bronchiolitis apart? additional aspects of history? associated with runny nose? tachypnoea and intercostal/subcostal/sternal recession are specific for lower respiratory tract infections.

…and then i come home, stare at all the learning issues, stare at my books…and realise that there is no way i’d be able to cover everything before my exam tomorrow.


i love medicine. i love medicine. i love medicine. that’s right, keep telling myself that. i love medicine. i love medicine. i love medicine. i love medicine. i love medicine. i love medicine…


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