Day 5 (10/7) – The Chest Clinic

10th JULY 2009 – FRIDAY

8.00 AM

  • I arrived at the hospital around 8 morning.
  • I went straight to the ward, reporting myself to Dr. W.
  • There was a patient with case of diabetes mellitus. Dr. W asked about the history taking of a patient with diabetes mellitus.
  • History taking of patient with diabetes mellitus is characterized by 3 main complaints – 3P
    • Polydipsia (thirst)
    • Polyuria
    • Polyphagia
  • Other complaints are also significant, for example weight loss and blurred vision may suggest nephropathy or retinopathy.
  • The diagnosis of diabetes is established when
    • Random glucose sample is >11.1 mmol/l
    • Fasting blood glucose is >7 mmol/l
    • Oral Glucose Tolerance Test (OGTT) 2 hours >11.1 mmol/l

10.30 AM

  • After I finished the ward round I went straight to the chest clinic (respiratory clinic), accompanying Dr. W.
  • Chest clinic is a special clinic targeting those with complaints of respiratory system diseases. Common cases in which are treated there – Pneumonia and TB.
    • Community Acquired Pneumonia (CAP)
      • I was given the chance to look at the xray of a patient with CAP. The xray shows right-sided shadow at the level of 4th/5th intercostal spaces.
      • The same patient also complained of coughing with white sputum, and pain at the right side of the chest.
      • The patient was then scheduled for sputum analysis.
    • Tuberculosis (TB)
      • Then, there was a patient with tuberculosis.
      • He was a male asian teenagers, with history of smoking since age of 14.
      • He developed cough since 2-3 months ago, with white-yellowish sputum. He also suffered from weight loss.
      • From the xray, I could see the distinguished border of a circle at the upper lobe of left lung, indicating the presence of a cavity caused by the disease.
      • According to Dr. W, upper lobe involvement is more common in asian patient of tuberculosis.
      • I also learned about the drugs used for treating tuberculosis. The drugs are:
  • Name of Drugs                         mg/kg (daily)           max dose (daily)
  • Streptomycin                                     15                      1000
  • Isoniazid                                             5                        300
  • Rifampicin                                         10                        600
  • Pyrazinamide                                     25                      1500
  • Ethambutol                                        25                      1200
  • I ended my day in the hospital at 1 PM. I was then allowed to be free.

5 thoughts on “Day 5 (10/7) – The Chest Clinic

  1. is TB so common in Malaysia? Is DOTS therapy followed there? i mean directly observed the patient swallowing the tablets in front of the health care worker? Im quite curious since India sangat gigih buat program ni..its sooo rampant here..

    I dunno the incidence rate, but since the clinic is directed specifically for those with respiratory problems, TB is quite common. Other diseases such as CAP, asthma.

    Yeah, i think they follow DOTS too. The younger patient, he was quite reluctant as he was asked to come every week to get the prescriptions.

  2. This looks cool so far, what’s up people?
    If there’s anyone else here, let me know.
    Oh, and yes I’m a real person LOL.

    Peace,

  3. Good morning

    I will buy new mini pc and was thinking what anti virus software to acquire?
    Thanks!

    Antivirus? I’ve u’re a beginner user, I would recommend free antivirus such as Avira Personal or Avast Home Edition. =)

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