I am in the middle of completing my last long case write up for Paeds when I decided to update this blog.Today I would like to show you some of the pictures that I have taken today.
Above is the classical rash in dengue fever.It is described as 'generalized erythematous rash with areas of hypopigmentation in between'.OR 'White islands in the sea of red'.This is due to plasma leakage.Smal,multiple non-blanching petechial rash can also be seen.Petechial rash on the other hand is due to small capillary burst.You'll get more petechial rash if Hess test is positive( which I did on this patient)
Above are what we called 'ecchymoses'.This 4 year old child came in today with multiple bruises over the upper on lower limbs as well as the trunk of 7 days duration.He has no history of trauma or fall.No lymphadenopathy or hepatomegaly.He had history of URTI about a month ago.Therefore he was diagnosed with Immune Thrombocytopenic Purpura(ITP) and not Acute Leukaemia coz Leukaemia must be one of the differentials.
We had another new Kawasaki's Diseases today.Admitted just before I went back from the hospital.We also had a patient with blisters and looks like its going to progress to Scalded skin syndrome.I'm going to take the pictures tomorrow.
I do feel sorry for the patients, but for the sake of studying we as medical student need to take pictures so that we can use it in our presentation later.Thats what I've been told by the specialist ' Take picture,take picture and include this in your case presentation later!You should be taking pictures and videos as long as you gain permission from your patients and that pics or videos will not degrade your patients later by circulating it around in Youtube!' I do feel a little bit awkward when taking pictures of the legs and bodies instead of the faces.
A group presented a TBL on Paediatric Emergency today.Lucky for us that Dr H the Paediatrician did not bebel us too much today.My subgroup will be having a bedside teaching by Dr Faizah tomorrow at 10 am.I'll be volunteering myself to present 2 cases tomorrow.Bioethics class with Dr Musa at 2.30pm.I'll be on-calling tomorrow night but before that I am going to Hospital Putrajaya to the Medical Ward.A colleague told me that they have a patient with Steven-Johnson syndrome.That is like super duper rare, 1 case in 1 million patients!