Friday 4 September 2009

viva voce for ENT posting

Today is our viva voce for Ear, Nose, Throat posting.
I was taken by Prof Raman.
I guess it took me around 10-15 minutes to answer his questions. you can be faster if u r good.
I didn't study very well for this posting. As my other friends used their weekend to study ENTs, i went to Langkawi for fun. But with no regrets:)
The whole 2 weeks were very hectic.1 written long case and 3 written short cases to be submitted, 1 long case and 3 short cases to be presented to "Prof" or "Lecturers" or "4th year master student".
Basically i only manage to present to 3rd year master student. Don't bother whether they wanna pass my log book or not. Just tried my best to sign all the impossible task. The department is in the shortage of human resources to teach us. It was impossible for everyone to present to prof. Anyway,I learned some useful clinical skills, such as using otoscope, do anterior rhinoscopy, etc. Most of the time was just observing. Observe how syringing(wash out the ear wax) was done, how Dr sucked out the huge ear wax via suction... But my history taking was near to zero.Need to polish myself. It's not the matter of history taking, it's about the gist and how u tie up everything.

Ok, the viva voce questions were:
1. Indications of tracheostomy-upper airway obstruction, protection of bronchial tree, broncheolavage,reduces dead space, easier access to operation.blah blah...
2. Management of epistaxis
3. A 40 year old man comes to u with right hearing loss. Take the history.(everything is normal) (sudden onset, no otalgia, otorrhea, itchiness, vertigo, tinnitus, fever,no ototoxic drug taken,no family history,occupation...)
Findings of ENT all normal. What further tests u wanna do?(Rinne and Weber test).The results were bilateral Rinne positive and Weber's test lateralised to the opposite site. Interprete.(sensorineural hearing lose of right ear) What investigation?(CT scan of head).(Diagnosis: acoustic neuroma)
4. Prof Amin: Haemotympanum

Maybe not that precise. Just to give u a picture of how it was conducted.
*i learned that perforated eardrum can be regenerated~because the epithelium can proliferate. So, my perforated eardrum is healed.
And actually we don't have to use cotton bud to dig our ears as the wax will migrate out naturally.
Wax isn't dirty, they can even moisture ur ear canal and serves as antiseptic purpose~


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