HOW TO USE THIS BOOK

Instead of a how-to-do, this book is a what-to-do for medical students clinical practice particularly during elective posting. Users of this book are encouraged to seek guidance from doctors and nurses during their elective postings on how and when to perform or observe the cases and procedures listed in this book. This book is divided into ten alphabetically arranged departments in most local hospitals; namely: 1. Department of Accident & Emergency (A&E) 2. Department of Medicine 3. Department of Neurology 4. Department of Obstetrics & Gynaecology (O&G) 5. Department of Ophthalmology 6. Department of Otorhinolaryngology (ENT) 7. Department of Orthopaedics 8. Department of Paediatrics 9. Department of Psychiatry 10. Department of Surgery. Note that postings for housemanship are Department of A&E, Department of Medicine, Department of O&G, Department of Orthopaedics, Department of Paediatrics and Department of Surgery. Thus these six are the commonly pursued departments during elective postings. Each department in this book is further organized into: 1. Diseases and presentations (signs and symptoms) commonly encountered 2. Cases clerked 3. Essential procedures and operations DISEASES AND PRESENTATIONS We try to arrange the diseases and presentations listed in each department by order of importance and commonness in an average Malaysian hospital. The DATE column is for the user to document the date and the COMMENT column is for jotting down important key points on the diseases. Empty rows are included for the user to include unmentioned but encountered diseases and presentations. With the space limitation in this book, we highly recommend each user to carry along a separate notebook for noting down the management of each cases and everything else.

HOW TO USE THIS BOOK

CASES CLERKED Among the important skills for a medical student are history-taking and case-presenting. These are essential to build up your clinical sense and self-esteem as a doctor-to-be. Courage is the most important of all the virtues, because without courage you can't practice any other virtue consistently. -Maya Angelou The CASES CLERKED table is for the user to summarize the patients he/she had clerked during the elective posting. The R/N column is to document the nurse assigned to that patient. We highly recommend each user to be proactive and step forward to present the cases to any doctors in the department. ESSENTIALS PROCEDURES For the ease of the user, we try to arrange the procedures by order of importance and commonly performed by the medical student himself. Procedures listed later on are usually observed or assisted as a doctor performs it on a patient. The STATUS column is divided into two columns. The smaller is to jot whether the procedure was performed (P), assisted (A) or observed (O) by the user. The bigger column on the right is for documenting the date. Three rows are allocated to encourage the user to perform each procedure as many times as he can. Feel free to practice performing the procedures beyond the number of rows allocated. Lastly, set your intentions straight and we wish you all the best and enjoy your elective postings. The Editors

CHAPTER 1: DEPARTMENT OF ACCIDENT AND EMERGENCY

ATTACHMENT LOGBOOK

DISEASES
NO DISEASE DATE
30/7/12

COMMENT
Elevated ST segment

CARDIOVASCULAR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Myocardial infarction Acute coronary syndrome / unstable angina Hypertensive crisis (emergency and urgency) Heart failure / CCF Ischemic stroke Intracranial bleed Epilepsy Asthma Pneumothorax COAD Pneumonia Acute gastritis Appendicitis Upper GI bleed Gastroenteritis UTI Pyelonephritis Renal stone Orchitis Inguinal hernia

NEUROLOGY

RESPIRATORY

GASTROINTESTINAL

GENITOURINARY

DEPARTMENT OF ACCIDENT & EMERGENCY

DISEASES
NO DISEASE DATE COMMENT

OBSTETRICS & GYNAECOLOGY 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Ectopic pregnancy Threatened miscarriage Dengue fever Anaemia Uncontrolled DM/DKA
Food poisoning 21/7/12 Severe dehydration

OTHERS

ATTACHMENT LOGBOOK

PRESENTATIONS
NO PRESENTATION DATE COMMENT

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

Fever Headache / dizziness Chest pain Epigastric pain SOB Diarrhoea / vomiting Pedal oedema PV bleed Haematemesis Haemoptysis Maleana Wheezing Dysuria / frequency / urinary hesitancy Cough Syncope / fainted Palpitation Ascites Back pain Body weakness Jaundice Pallor

DEPARTMENT OF ACCIDENT & EMERGENCY

CASES CLERKED
NO NAME
Zaiem Irsyad

R/N
Sr. Atiqah

DATE ADMITTED
26/7/12

DIAGNOSIS
Femur fracture

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

ATTACHMENT LOGBOOK

ESSENTIAL PROCEDURES
P A O NO PROCEDURE STATUS
O A P 22/7/12 23/7/12 25/7/12

STATUS Performed Assisted Observed

COMMENT
Need to practice 8 times or more. Ganbatte !

Setting IV line

Taking blood sample Basic toilet & suture Wound dressing

Looking and controlling source of bleeding Blood glucose test

CPR

Perform 12-lead ECG ECG interpretations AED and defibrillation on manikin

10

DEPARTMENT OF ACCIDENT & EMERGENCY

ESSENTIAL PROCEDURES
NO PROCEDURE STATUS COMMENT

11

Setting nebulizer for asthma bay Cervical collar application Immobilization

12

13

14

Endotracheal intubation and ambubagging

Ryles / Nasogastric tube insertion and removal

15

16

FAST

17

Gastric lavage

18

Per rectum

19

20

21

Urinary bladder catheterization (male and female) Central venous line insertion, monitoring CVP CMR

22

Back slab

ATTACHMENT LOGBOOK

ESSENTIAL PROCEDURES
NO PROCEDURE STATUS COMMENT

23

Eye irrigation and staining Foreign body removal (eye/nose)

Lumbar puncture O 28/7/12 Observe the CSF 'opening' pressure

24

25

26

27

28

29

30

31

32

33

34

DEPARTMENT OF ACCIDENT & EMERGENCY

NOTES

10

ATTACHMENT LOGBOOK

NOTES