Warning to the geeks

What does this 2 picture have in common?
What is the cause of this condition?

sigh, I pity the ones who read my blog

case 4 - Island of white in a sea of red

"You are not a Malaysian if you don't know this"





Clue: patient complained of fever that lasted 9 days, chills, headache, joint and muscle pain

sigh, I pity the ones who read my blog

question 1

A 72 year old retired army comes for re-checkup. He sustained an anterior wall MI 5 month ago. He is currently on aspirin, metoprolol and simvastatin. His current Bp is 135/80 mmHg. Serum lipid profile LDL is 93 mg/dl. What should be done next? why?

a. increase simvastatin dose
b. repeat lipid profile
c. add enalapril



sigh, I pity the ones who read my blog

It has arrived - the medical short case book

It was fast, I waited 1 day only. thank you Dr. lim. havent had the chance to read it yet





anyone interested to buy this book can contact dr. lim thien thien from penang hospital thienthienlim@gmail.com



sigh, I pity the ones who read my blog

case 3 - "I can't smoke anymore!"

So, I was lucky, because I had read this case before and when the specialist asked with a grin I answered. She replied "you can't even answer a simple question but this one you know?"

A 73 year old malay man, admitted with symptoms of an almost constant cough. He also complained of weakness in his right arm arm (actual word was "tangan saya lemah sampai nak merokok pun xboleh" - wth? haha). During examination, there are guttering of metacarpal of both hand. ptosis of right eyelid, Anisocoria(R-3mm L-4mm), pupil react to light.




note: this is not the actual pic, but it showws the condition

Name the condition of the pupil?
What is the diagnosis?


sigh, I pity the ones who read my blog

case 2 - simple Q

So, this one is a simple one.
Malay man 64 years old, random plasma glucose is 6.1 mmol/l

Is it normal?
what should you do?
what is the criteria for diabetes?


sigh, I pity the ones who read my blog

case 1 - a man with clubbing

So, I'll start sharing interesting cases I encountered in my attachment in medical department. Sorry for no photos but I will try to be as descriptive as possible.

Patient X, malay men 60 years old, admitted with progressive right sided weakness. He was not toxic, no sign of liver failure. He has gross clubbing of the fingers. Patient has a history of smoking.

So I'll ask the same question the specialist asked me.




what do you suspect the patient have? (keep in mind the clubbing)
what are the causes of clubbing?


sigh, I pity the ones who read my blog