417# Paediatrics: End

The last posting for semester 7 has officially ended. The next coming bomb will be the end of semester final exam, 2 weeks more to go. And I still haven't start to do anything yet now.

I'm quite surprised that I was more hardworking for this posting than the previous 2 postings. Of course we don't have a choice when we were in obstetrics posting - everyone has to be hardworking.

I managed to get myself clerk one case per day in average. I didn't do that when I was in psychiatry and orthopaedic postings though.

Playing with paediatric patients were fun but not all children will play with strangers. Especially those who aged 9 months and above where they already developed stranger anxiety. But anyway there were still a lot of them who don't reject strangers.

This stranger anxiety thing really gave me a problem. I didn't face this during my daily clerking, but the very first time I had this was during my end of posting exam.

So my professor gave me a patient to clerk for my exam. The informant was the mother and during history talking the 14 months old girl was sleeping comfortably. There was not much of problem during the history taking, but the problem arise during the physical examination.

The patient presented with fever and cough with only 1 episode of wheeze. There was history of contact with her cousin and elder brother who had similar symptoms. So I was thinking of viral pneumonia or upper respiratory tract infection.

Physical examination without auscultation is a crime in this case. But unfortunately the patient cries when I ran a general inspection on her. Her mother told me that she is afraid of strangers and cries very easily.

Failing to do physical examination because of crying patient is not an acceptable excuse. We were told to visit the patient again after the patient stop crying.

Ok, I did. And guess what, I only had 30 minutes left for my exam and how am I supposed to "go back to the patient afterwards"?

Therefore I did nothing for 20 minutes and only got to check her pulse and auscultate her when she fell asleep again.

My examiner was not interested in the history taking which I covered well. He seemed to be more interested in physical examination which I didn't get to cover. In the end of the day I got a borderline pass for this exam.

Sien ah.

Whatever it is, that doesn't matter already now. What matter most is the next coming final exam. I feel so unprepared for it right now.

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