housemanship: assessments

Well, I had passed all the assessments in Paediatrics a week before raya. There are a total of 5 assessments in Paediatrics.

1. Off Tag
Need to pass within 2 weeks of tagging. There are NICU and Ward topics. I remember I worked 9 days straight because I wanted to get a day off on Saturday so that I can see Shahrin but turned out MCO started luls. This 9 days of working really burnt me out, I hardly had time to study, eventually I made it. I sacrificed my precious sleep time, I burn the midnight oil. Paeds is a new thing to me. It is totally different from previous posting, I'm dealing with fragile one now, no silly mistakes allowed here.

2. MO Assessment
This one is usually after 5 weeks in Paeds. For NICU, I were asked regarding Severe Neonatal Jaundice secondary to Presumed Sepsis.
Day 3 of life, born term 40 weeks with birth weight of 3.5 kg, current weight 3 kg, came with yellowish discoloration of skin with TSB of 420. Looked lethargic, generalized hypotonia and inconsolable crying.
For Ward topics I were asked regarding Moderate AEBA secondary to Bronchopneumonia complicated with Left Pleural Effusion with underlying newly diagnosed Severe Persistent Bronchial Asthma. The second question was Right Cerebral Abscess with Metabolic Acidosis and Hypokalemia (causing the fitting episode). It was a case based discussion. My MO gave me the situation from the initial presentation and question me my next plans.

3. Neonatal Resuscitation Program (theory & practical)
I started my rotation in NICU. So of course when labour room calls for baby flat or standby, I need to go. This NRP thingy prepares us for things like this, step-by-step algorithm on how to deal with newborn, term and premature. I managed to finish the 300 pages book of NRP during 1 week quarantine in Pagoh. Thank goodness for the free time. During practical session, the MO will give us the situation and assess on how we manage the baby mannequin.

I get the question of 29 weeker, with weight 1 kg, born flat. And I forgot about the plastic wrap and the baby didnt survive. I nearly failed the assessment. Fortunately, the MO gave me another chance and I made it.

4. Theory
Just answer the questions lah, MCQ, subjectives and some calculations.

5. Specialist assessment
The scariest of all obviously. Cant believe I nailed it ha-ha. There were 2 parts mini cex and also case based discussions. For 10 minutes mini cex: abdominal system. I were asked regarding causes of finger clubbing, causes of hepatomegaly, causes of bilateral pitting edema, causes of hypoalbuminaemia, the pathophysiology of edema in nephrotic syndrome and congestive cardiac failure.

As for case based discussion, I were given the situation in which I were a MO in district hospital dealing with prem baby born flat. My specialist is a very detail one. She asked regarding anatomy of self inflating bags, she wants to hear every detail event in resuscitating the baby like how we connect the suction catheter to suction apparatus, how we make sure that the bag is functioning well, how we dilute the adrenaline and more. Same goes to the next questions of status asthmaticus, severe AEBA, she even asked me how to dilute magnesium sulphate. Luckily, I managed to catch a pharmacist prior and she taught me how.

Nevertheless, I had passed all the assessments. May Allah ease the rest of my days in paeds. 1 month more inshallah. Next posting shall be O&G ^^,

Till then,
:)