Thursday, April 28, 2011

end of E N D

Assalamua'laikum and salam sejahtera,

Syukur, E&D(Examination and Diagnosis module) exam already finished and my group present with other Dr, not previous Dr. I am very relieve, cause they said previous Dr quite 'tegas'. huhuhu...Anyway, these are among the selected memorable scenes during my E&D examination:

1)
Me : the temporomandibular joint(TMJ) is palpable but no clicking and no tenderness upon palpation
Dr : no clicking? are sure?
Me : err..yes, I think there's no clicking...
Dr : try to palpate the left side, what type of clicking do you think it is?
rushing to put on my gloves, then palpate...
Dr : where did you palpate? here is the ear, this is the antrum, anterior to this is the TMJ.
(Dr ajar lagi macam mana nak cari exact location of TMJ, by theory and practical)
then I palpate, but...
Dr : can you appreciate it? there is some clicking in the left side.
Me : I think it is the same with the right side...
Dr : eh!? here...
I palpate again but the result is the same...
Dr : ok, takpe lah..you can proceed...

2)
Me : no bleeding on probing of gingiva, the interdental papilla is sharp, no calculus, no inflammation of gigngiva...
Dr : no bleeding on probing?
then I was in shock when my patient's (my friend) gingiva is bleeding!
Dr : are you sure the interdental papilla is sharp? it is blunted right, look at here, and here also...
Me : o...

3)
Dr : so what is the DFMX?
Me : the DFMX is ......
Dr : ok, so the TPR?
Me : T..P..R..????(huh!?apakah benda ini?TPR?sambil menunjukkan muka blur...)
Dr : adekan? TPR kat situ...
then I look back at the E&D form, oh!?it is there! but what is that so-called-TPR thing is!?4 weeks keep on reading the same thing repeatedly for this one session only, but yet I dunno what that thing is?huh!?habislah...
Dr : ade x?
Me : er..no (luckly my friend (my patient) already fill in that part for me just now...fuh)

4)
Me : for the investigation, I would like to do bitewing radiograph to asses for proximal caries and orthopantomography (OPG) to asses for her eruption status of her lower 8th tooth...err...her third molar...
Dr : OPG? do you really need to order for the OPG even the patient is asymptomatic?
Me : err...yes..
Dr : no, you dun have to ask for the OPG if the patient is asymptomatic...
Me : o...ok...
Dr : your diagnosis?
Me : dental caries on .....(because I already wrote it just now so I have no choice but to read it also even Dr already said just now it is not caries...just deep fissure only...)
Dr : dental caries? I already said just now, it is not caries right, just deep fissure only...

5)
Me : for the treatment planning, Oral hygiene instruction and diet counselling.
Dr : that is all?
Me : err...yes...
Dr : she had bleeding on probing of her gingiva, what do you called that?
Me : gingivatis...
Dr : what grade do you think it is? mild, moderate of severe?
Me : I think mild...(eh, apa aku ni?kenapa sebut mild, moderate la!!!ah...lantaklah....)
Dr : really?she got bleeding on probing.
Me : moderate gingivatis...(hohoho...)
Dr : so you don't want to do something about her gingivatis?
Me : she had no calculus...
Dr : yes, she had no calculus but she had gingvatis. what treatment plan do you intend to give to her?
Me : ............................senyap memanjang......................
setelah beberapa detik, Dr pun sambung...
Dr : oral prophylaxis...ok, other than that?
Me : review....
Dr : for how long? 
Me : 6 months...
Dr : hmm....
Me : thank you Dr....

that is all, after this have to cease blogging for a while...exam 1 month to go...

Wassalam.

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