CSU - Dr. KA

CSU with Dr. KA.

Dr. KA

very kind on one to one talk, doesn't expect you to know everything, answers questions generously.

some of the new things i noticed.

CVS - the neck need not be fully flexed to see the JVP. Hepatojugular reflex press on the ribs rather than the stomache.

- when commenting on heart sounds, extra sounds may include pleural rub and pericardial rub. to distinguish between pericardial and pleural rub, ask the patient to hold breath. if sound persist, it is pericardial.

- in BP station, there are marks allocated for explanation of the (seemingly obvious) procedure and permission taking. also warning for patient (might cause some tightness...)

assume the patient does not know anything.

Respi - when doing flapping tremor, ask patient to spread the hands fully, and close their eyes.

- upon percussing the left para-sternal border, deviate a little to the further left since the heart is there. percuss straight down along the mid-sternal line for the right.

- taking the respiratory rate is more important than pulse rate. comment on rhythm and rate too.

G.I. - there is this thing called general percussion, where you're supposed to percuss the 9 regions of the Abdomen before any percussion. very few knew the existance but according to Dr, it is in the marking scheme.

http://www.entusa.com/oral_photos.htm very useful for "mouth" station of CSU. things that can go wrong in your mouth