Long Case: DM, ESRD, etc

assalam. ni hani punya. candidate no 1. examiner ky, dr yu,

indian male, 40+ yo, underlying dm for 20 yrs, complicated with esrd currently on
capd with eye complications, surgical cataract removal, currently presented with left
loin pain. he also has pricking pain at right and left hypothenar, chest pun ade
finding, chief complaint sob ngan orthopnea. ade saucerization scar kat blakang,
findings, right sided pleural effusion, shifting dullness +ve, ade esm murmur heard
over left sternal edge most prob innocent murmur. discussion around the topic.
more to back pain, pleural effusion.

mirul Hafifi
maaf lambat .LONG CASE
. candiate no 34 -> 39 , same case with Hani Ao.. pakcik ni sgtlah tired n ckp sgtlah
slow waktu clerking sbb dia dh cukup penat.. 47 years old indian gentleman with bx
hx of 20 years DM , 2 years HPT complicate with ESRD , previous history of cataract
with chief complain of worsening dyspnea during last admission on December
associated with cough , PND , othopnea , reduce affect
PROFESSIONAL EXAM 2013 6TH BATCH DAY 2
CLINICAL EXAMS
tolearance and profuse sweating. Currently complain of blurring of vision bilaterally ,
reduce urine output and significant loss of weight 15kg in 3 months. Seriusly sgt
xdpt tgkap ap2 pun ,
On examination , CVS , PSM Murmur best heard at mitral area , grade 3/6 radiated
to axilla , not accentuated by inspiration .
RESPI : trache mcm deviated and ad stony dullness kat lower zone bilaterally ,
reduce breath sound and vocal fremitus. ( ACTUALLY DATO raja ckp middle and
lower zone of left lung , also bibasal ) so memang xdpt appreciate sgt2 kat sini ..dh
GIT ; ad ascitis , positive shifting dullness , ad pertioneal dialyis with scar over left
lumbar region.
CNS ; ad loss of sensation at C6 and C7 ..tapi seriusly memang xsure
examiner : dr chandra , dato raja , dr philip and mr hashim
- saya sgt xdpt nak present main active complain pakcik ni ..sy present seprti di
atas and seperti biasa Dr chandra memang nak tau detail complication of diabetes
n hypertension patient ni HOPI bukan PMH ..So memang kena bising habis2 kat
history ( so u all cn guess lah ye )

>medicine: ntahhhhhhhhhhhhhh. Ade hepatosplenomegaly, ade tenckoff, ade

ascites. Dr izwan: what if I tell you that his kidney is large? polycystic??

medicine: renal transplant. --> patient with AV fistula, and scar. arahan suruh
examine abdo, then tanye what is the scar due to ? --> renal transplant.

Holla~~ Candidate no 12 jd 7. Long case dr ramzi,prof sazli yg best :D,dr see,dr

zubin,external pmpuan. Mr amran 60 y/o hx of dm n hpt 13 years,cholelithiasis 8
years,recently dx right renal failure last year,currently with no active
complaint,came d/t exam purpose. (Igtkn ni case medicine,upenye case
surgery.hua~~gallstone tu da la ak tnye gitu2 je)

1. Medicine: Please examine abdo. Patient introduce as Mr Kernel. Ada mass at RIF.
Most likely mcm renal transplant sbb ada scar.