PDIHM Goodie Bag

Just got the PDIHM goodie bag from Azman. Let's see what's so goodie goodie inside this goodie bag. The paper bag is light so I guess there's not much of goodies inside. What do you expect? Registration fee for the marathon was just RM20.



First off, my number:
Read: A1121. Sounds like "Want Want To Run". Photographers, take note - aim your cameras at this number ok.

The receipt of payment and the reporting slip. Azman said there would be a lucky draw. Wonder what the grand prize is.

RM100 voucher for Brooks running shoe only redeemable at PD Sportsland, Port Dickson.

PDIHM 2007 T-shirt. Don't think I'm gonna wear this for the run. The material sure cause skin chafing.

A Visit Malaysia 2007 notebook, Visit Malaysia 2007 key chain, and a Visit Malaysia 2007 ballpen. Who want these? I'm happy to give it out for free :-)

So that's all. Gonna sweat some muscles tomorrow. Which is actually just 15 hours from now. Gonna do some carbo-loading! Watch this space for the results tomorrow!

Post SAQ Exam (Int. Med)

Just finished my 1-hour SAQ paper for the Internal Medicine posting. There are 6 questions all together, and here's my contribution to the infamous "IMU Past Year Questions" archive.

Question 1
A man came in with right-sided pan-systolic murmur, fever, breathless. Multiple venous puncture scar on arm hinting on IVDU. Chest X-ray showed multiple cavitating lesions. Diagnosis is right-sided infective endocarditis, involving the tricuspid valve with septic embolisation resulting in pneumonia. I find the question "Describe the chest X-ray findings" a bit confusing. Is it asking for the cause of the pneumonia, or is it asking for other possible causes besides pneumonia?

Question 2
Middle aged Indian man came in with jaundice, epigastric discomfort, ascites, oedema. Causes of hepatitis? Viral, drug-induced, alcohol, biliary diseases. A LFT is provided, increased ALT. Two probable diagnosis? And give eight physical signs of liver disease.

Question 3
Patient came in confused, dizzy, vomited. Bilateral leg oedema. A BUSE result was given, showing hyponatraemia. What is the cause of confusion and vomitting? Answer: Hyponatraemia. Pathophysiology? Cerebral oedema. How would you manage the electrolyte imbalance (3 steps)? Answer: fluid restriction, diuretics, treat underlying cause, etc.

Question 4
A male executive came in to check his BP. It was raised la. Smokes ciggies for 15 yrs 10 sticks per day. Height 1.75cm, weight 90kg. His dad had DM and died of CVA at age 60. Give 4 investigations for his general well-being (again non-specific, tibai anything also correct I guess). What are the risk factors for development of CVA/CVD in this patient (give 3)? What are the side effects of hydrochlorothiazide he was given (give 3 also)?

Question 5
Old lady, collapsed at home. Another BUSE result given (normal range not given!). History of DM for 10yrs on Metformin. Random blood glucose on admission = Read: 60mmol/L! Diagnosis clinched - Hyperosmolar Non-ketotic coma (HONK)! Pathophysiology? Four other investigations you would perform on her? Management.

Question 6
Esha's question. Female came in with right-sided hemiparesis, history of two abortions, joints swollen and painful, with characteristic facial rash. Diagnosis - Systemic Lupus Erythematosus. Give four complications associated with the underlying disease (again, what is this question asking for?? I wrote the other manifestations of SLE). A syndrome commonly associated with SLE? Anti-phospholipid syndrome. How would you investigate her.

That's it guys. Overall, quite an easy paper la, since I never study that much also can answer >60%. If study more than average sure score kao kao one. Chiao, gonna makan. Can't go back KL coz Sunday got marathon!

Half Marathon!

Yes, I'm running! I'm joining Chee Yoong, Azman, and Fahmi to the PD International Half Marathon 2007 (PDIHM'07) this Sunday for my virginal marathon outing. My personal best was completing 5 laps of Seremban Lake Garden (outer perimeter) in 56 minutes. That's just a little more than 10km in total. But this is a half-marathon, there are 21km to cover in less than 2½hrs to get the qualifying medal (I paid RM20 for the registration so don't expect me to come back empty-handed without putting up a good fight!).

It's too late to practise now. Worse part is, I don't even have a proper pair of running shoes for the 21km run. I'm gonna use my old Reebok with it's flat sole. I have a pair of Timberland trekking boots, and a pair of brand-new NikeAir. But neither are good for the run unless I'm hankering for some ugly-looking blisters on my soles. Wish me luck guys! If Azman and Kenny Sia can do it, I sure can! Gonna do some stretching now...

PDIHM'07 registration form. I'm IN!
What does the PDIHM 2007's goodie bag looks like? Click here to find out!

UAV Gym @ Seremban 2

I'm transferring my Fitness First (FF) membership to my sister come April, so I'm officially a non-FF member by the end of this week. Visited FF less than 5 times for the past 2 months. It's time to let go. So guys, stop asking me for free entrance to FF, I'm saving those underwater tickets for myself. Keke... So now where to flex muscle? IMU's gym is hopeless. And this is when UAV comes to picture...

Felix, Quek and I joined this gym in Seremban 2 called UAV (God knows what that stands for!) early this month. I think Soo Seng will be joining us too next month, provided he can bear to not Dota for 2 hours every alternate day.

UAV is located along the double-storey shop houses obliquely opposite the famous steamboat place in Seremban 2 near Jusco. To be more specific, it is just opposite the Petronas petrol station.

Why UAV when there's Family Gym just along Jalan Rasah (above Public Bank)? For poor med students like us, it all boils down to $$$. UAV charges RM30 per month for student membership under the age of 24.

As you can see, the gym is fairly well equipped. But this is by no means FF, California Fitness, Celebrity Fitness, or the craps alike. The only other amenity besides the free weights and machines, is the toilet for you to do your private business. Don't expect free drinks, sauna, hot shower, swimming pool, and tight-fitting sexy chicks (the last item is NOT an amenity).

We started to get along quite well with the "Arnold Schwarzeneggar from India" (actually his real name is Rahman, a mamak, fondly referred as India Arnold), the curator of UAV. He's the fat tough guy wearing a blue singlet in the above pic.

Okay, now the pics of hunky medical students working out! Slurrps! Ladies and gentlemen, presenting you guys "Felix the Cat" and "Quek the Quack Dr" :

Quek flexing his biceps. See the coarse tremor? That's just 10kg Quek!

Felix building his imaginary "wings".

Another shot of Felix making his chicken wings.

Second set, still 10kg.

Third set, still 10kg. Like dat how to grow biceps?

I dunno what exercise that was. Can anybody guess?

Post Long Case Exam (Int. Med)

My patient for the long case was an elderly Malay man in his 80's, having a massive right-sided pleural effusion (that's water in the lung) due to lung cancer. I had more than ample time to clerk him and perform a complete physical examination before Dr. J came in.

Dr. J seated me at the nurses counter and I started to present my history and clinical findings. I did ok I guess, although it was interrupted by phone calls for Dr. J. Clinical specialist mah! And here comes the first blunder of the day...

Dr. J: So what's your diagnosis?
Me: (damn confident) Lung cancer!
Dr. J: *frown* You can diagnose lung cancer clinically meh?
Me: ... ... ... (confidence decreasing at a rapid rate)
Dr. J: Ok, nemind, come let's examine the patient.

And then Dr. J greeted the patient and asked whether I had examine him justnow. And I proceeded to examine him. And here comes the second blunder/stupid mistake... I auscultated his chest before doing a percussion. I was silently hoping he didn't see that as he was busy flipping the case notes. Well... he did...

When I was done with my physical exam...
Dr. J: Shouldn't auscultation come after percussion?...
Me: (damn, he saw it...)
Dr. J: Ok, nemind, come...
We went back to the nurses' counter to look at some chest radiographs.


Dr. J: So tell me, what do you see on the chest x-rays?
Me: There's an air-fluid level on the right lung signifying a pleural effusion, and the left lung is hyperinflated.
Dr. J: Meniscus sign! Air-fluid level suggests lung abscess. What else do you see?
Me: Err... err... upper lobe diversions here and there, a patch of heterogenous opacification here, err... no cardiomegaly (dunno what else to say edy)...
Dr. J: Ya ok, why do you think the left lung is hyperinflated?
Me: It may be due to lung collapse due to pleural effusion (simply shoot).
Dr. J: You mean it's a compensatory hyperinflation (trying to help me with the answer he wants).
Me: Yes yes, compensatory...
Dr. J: If it's not compensatory, what else could it be due to, the hyperinflated left lung?
Me: COPD (chronic obstructive pulmonary disease) due to him being a chronic smoker?
Dr. J: Yeeeeessss... that's right... he smokes like nobody's business. Now tell me, what do you think has caused the pleural effusion?
Me: Lung cancer... lung carcinoma... (gulp!)
Dr. J: Can you be more specific on the lung cancer?
Me: Bronchogenic carcinoma (gulped again!).
Dr. J: Which type of lung cancer do you think he has?
Me: Small cell carcinoma, coz he presented acutely 2 months ago and has progressively worsen ever since.
Dr. J: But I thought his cough started last year?
Me: (Ugghh!) Ermm, in that case, I would say it's a non-small cell ca.
Dr. J: Yesssss... it's a non-small cell ca. What type of histology would you expect in the biopsy?
Me: Adenocarcinoma.
Dr. J: Why?
Me: Coz it's commoner in smokers.
Dr. J: Other than that?
Me: ... ...
Dr. J: Adenocarcinoma affects glands, and where are glands foung in the lung? In the alveoli. Right... and thus adenocarcinoma affects lung periphery. As opposed to squamous cell carcinoma. It affects bronchus more, thus more centrally located or known as bronchogenic carcinoma...
Me: (wah, he sibeh good! If I examiner I sure pass him.)
Dr. J: Ok, this patient has multiple admissions for the last 2 months for pleural effusion. What is your first line management?
Me: To drain his pleural fluid by doing a thoracocentesis.
Dr. J: Ok, if the patient kept coming back for the same problem, what's your long term management?
Me: Put an indwelling drainage tube...
Dr. J: You mean to put a chest tube lah...
Me: Yeh yeh, chest tube... chest tube...
Dr. J: Other than chest tube?
Me: .............................................
Dr. J: Have you heard of chemical pleurodesis?
Me: (Shake head...)
Dr. J: It is done to fuse the parietal and visceral pleura so that no fluid can accumulate inside the pleural space.
Dr. J: Ok, you did OK, although there's some blunders here and there.

This is how Dr. J looked like after taking me for my long case exam:

Sigh... "A" is out of question (Dr. J: muahaha! "A"? HAHAHA!). Hope the result won't turn out too bad... gotta buck up! Gambateh!!!

p/s: Read Dr. J's take on IMU exam bloopers here. Do read it! Got comment by Dr. LKY on ethical issues! Haha! On more IMU bloopers by Dr. J, click here and here.

Software Malfunction!

Arghhh... am having my Internal Medicine long case exam tomorrow (yes, it's a Sunday, can you believe it?!). And I spent the whole day fixing some software malfunction coz I screwed some registries while optimising my laptop the other day. Managed to finally and successfully install and run ZoneAlarm Security Suite v7.0 and Webroot SpySweeper v5.3. Noticed some changes in the new ZoneAlarm program interface, as the previously ZoneLabs is now owned by Check Point Software Technologies Ltd. It uses the Kaspersky antivirus engine too (touted the world's fastest antivirus update engine)! Damn... I can't believe I still have time to blog this. Hope my examiner Dr. J would be extra good mood tomorrow. Fingers crossed...

Portable Powwah!

I thought I'd better get a new portable HDD, seen as though my laptop has only 3 to 4Gb of free space, and with a 2Gb memory stick in my Sony T50 camera, that won't last long! So I managed to get a 80Gb Hitachi 2.5" portable harddrive and an ultra-tiny 2Gb pendrive (might as well!) last weekend. Both items were bought from the new IT wing on 4th Floor of Sunway Pyramid.

Let's start with the harddickdisk first. Me and Rachel went straight to the shop in which her cousin bought his harddrive several weeks ago. Not due to it's particularly cheap pricing, but the friendliness of the guys over there. Here's how my drive looks like, plus the external aluminum casing but sans the leather pouch:

The harddisk is by Hitachi; I wanted a Western Digital one but they're out of stock. On why I preferred Western Digital over Hitachi, it's all because the former sounded much cooler. I've no idea which perform better or of better quality though! Here's a pic of the drive with the included fake leather pouch:

Now the pricing. For 40Gb Western Digital 2.5" disks, it's RM180. RM200 would give you a 60Gb disk, while 80Gb ones are priced at RM240 (all prices are inclusive of a low-grade cheapo casing). I chose a better hardcore aluminum casing (by Zynet), and the package totalled RM258. I heard a 3.5" 200Gb Western Digital SATA drive (8MB Cache) can be bought for about the same price is it? The sales person fixed everything for us (we bought one each), so I had only a few seconds of glimpse of the actual harddrive before it's slotted into it's aluminum coffin. I remembered from the harddrive package that the drive was made in Thailand, though.

Managed to clear up some 20+Gb of junks from my laptop to the new drive. Transfer rate was adequately fast not too slow (how do I compare? Tiu!). Here's a size comparison between my new drive and my good 'ol Sony Clié TH55 PDA with casing:

Ok, enough of the drive already. Now the tiny pendrive/carddrive/flashdisk/fuckdick: it's mine for a mere RM55, and comes with a plastic casing and lanyard.

Works fantastically well, and I guess you could lose it as fantastically well too! Makes me think if they could make a pendrive so small, why the others are still making (proverbial/relatively) humongous + voluptuous pendrives? Welcome to the newest edition to the gadget family.

Sony Ericsson W880i

Sony Ericsson is releasing a new Walkman Phone in Malaysia soon! Never had I anticipated a handphone that is worth to be anticipated since the last Nokia 8210. The new SE880i is of the "slim candybar" genre. I'm gonna get it! Fuck brand loyalty!!

Read the comprehensive review available at Mobile-review.com.

[Updated 23.04.07]
Looks like there are loads of problem with a phone this thin. The most significant problem from the reviewers is that it turns itself off every now and then. Must be the battery connectors or sumthin. Plus, it lacks radio, flash, and the sound on the loudspeaker sucks. Not to mention the soft vibration alert. Read reviewer's comments here. Contemplating the yet to release K810i.

Superbikers Killed

Two members from the Kedah-based StarBikers club, Mohd Mumtaz (the club's president) and Mohd Shahrirman, were killed at Kilometre 119 of the North-South Expressway (near Bertam) last Saturday.

The news had it that Mumtaz, who was on a Yamaha R1, rear-butted a container lorry and lost control of his 1,000cc machine. That sent him screeching against traffic and to the shoulder of the other side of the highway, and man and machine burst into flames.
The remains of the barbequed Yamaha R1.

Shahrirman who was on a Honda CBR400 on the other hand, was either travelling too fast or too close to Mumtaz, collided with the latter. The Honda travelled a further 100 metres from the spot where Shahrirman fell. Both died on the spot, while the lorry driver continued to drive happily towards Butterworth.

The Honda CBR400 with it's broken arse.

Moral of the story:
Speeding kills, but it's always safe to speed on a container lorry!
Ride safe guys, and no doing 110km/h on a 100cc scooter ever again, no matter how your inconsiderate mate challenge you! And my deepest condolences go to the families of the deceased bikers. R.I.P.

Source: SpitFireBikers.com and msportbike.com.

Scoot To Melaka

Exactly one week has passed since I rode my Orange Beast down to the historical city town of Melaka with two friends (Ah Fat and Mania). It was a one-day-trip biking adventure which started from Seremban. The journey to and fro covered some 150kms of arse-numbing ride.

We left Seremban at 9.00am sharp, headed towards Melaka via the North-South highway at 90km/h (I was leading since my Orange Beast was the weakest bike). Very soon, the manic Mania decided to overtake me with his old Suzuki RG Sports. So much for group riding/biking adventure! Ptui, lick my rectal juice! We reached Melaka Town around 12pm (we stopped for quite a while before Alor Gajah coz it was drizzling).

We headed straight to this Kedai Kopi Chung Wah for it's chicken lice rice balls. It was my first try on those rice balls served with chicken meat. The rice balls were cold and oily, the chicken nothing fantastic. So much for the hype!

Then we started to walk around the "historical area" and look-see look-see the old pre-war buildings that I had not seen since I was a seven-year-old kid. I remembered sitting on a buffalo-cart with my sister the last time we were in Melaka.

But the buffalo carts are replaced with trishaws installed with high-capacity boom boxes blasting a variety of "dangdut" songs. I dunno about the foreigners, but I found the loud "noises" very annoying under the hot Malaysian sun.

After tired of walking around the hill (I honestly do not know the name of the hill, haha!), we headed to Jonker Street for food! And we stumbled upon this Baba & Nyonya-style kopitiam.

I ordered a bowl of durian-flavoured "Eight Pleasure Chendol" and a bowl of "Baba Seafood Laksa":

The food was gooooooodd... especially the Baba Seafood Laksa. Will definitely go back again for more laksa. We then headed home. The Orange Beast was forced to churned out some 110km/h of brute speed coz Mania decided to leave me all alone on the North-South highway. No more biking with Mania until I get a litre-plus mean machine! Ah Fat! Ipoh next!