OSCE Ophthalmology

Assalamualaikum... Again, i really want to use the fb for this so that there will be discussion, and again, the internet is too, too stingy!!! So i just do what i can...For your information, ada jawapan pada setiap gambar ne, tapi font de berwarna putih, so if nak tengok, kena select, baru nampak...hehe...

Acute angle closure glaucoma

AION

hypopyon from anterior uveitis

anterior uveitis

central retinal artery occlusion

 AV nipping

 Blepharitis

Chalazion

 Corneal Ulcer

Corneal edema (and hypopyon n bla..bla...bla..)

corneal ulcer

foregin body

corneal ulcer

CRVO

Dacryoadenitis

Darcocystitis

Diabetic Retinopathy

Episcleritis

Glaucoma

Glaucoma

Hyphema

Hypopyon, 

keratitis

cataracts

\

Normal la...haha

Orbital cellulitis

cataracts

Ptryegium

retinal detachment

Subconjunctival heamorhhage

SPK

Ulcerative keratitis

Uveitis lagi

vitreous hemorrhage la,,,pe lagi

untuk gambar diabetic retinopathy dan hypertensive retinopathy yg lebih best, sila ke link berikut

http://usa.nidek.com/products/afc

Defense Mechanism

Assalamualaikum

Honestly, i want to put this in my facebook. But the internet is too stingy to me tonight, so i just let it be. This is the notes i use for my study group when i explained on defense mechanism. I really like this topic, hope this will help:

Psychological Defenses

Defense mechanisms are automatic psychological processes that protect an individual from anxiety and the awareness of internal or external threats or stressors. People are often unaware of these processes as they operate (although others may be painfully aware of them!). Defense mechanisms can be classified into groups or levels that indicate how they affect an individual's functioning.

High Adaptive Level: Defense mechanisms in this group result in optimal adaptation to stress. The defenses usually maximize feelings of well being and do not interfere with the conscious awareness of feelings, ideas, and their consequences.

• Affiliation involves dealing with stressors by turning to others for help or support. This involves sharing problems with others but not trying to make someone else responsible for them.
• Altruism involves dealing with stressors by dedicating yourself to meeting the needs of others. The individual receives satisfaction vicariously or from the response of others.
• Anticipation involves dealing with stressors by anticipating the consequences and feelings associated with possible future events and considering realistic solutions.
• Humor involves dealing with stress by emphasizing the amusing or ironic aspects of the situation.
• Self-Assertion involves dealing with stress by expressing your feelings and thoughts directly in a way that is not aggressive, coercive, or manipulative.
• Self-Observation involves dealing with stress by reflecting on your own thoughts, feelings, motivation, and behavior, and then responding appropriately.
• Sublimation involves dealing with stress by channeling potentially disruptive feelings or impulses into socially acceptable behavior (e.g., playing rugby to channel angry impulses).
• Suppression involves dealing with stress by intentionally avoiding thinking about disturbing problems, wishes, feelings, or experiences.

Mental Inhibition Level: Defense mechanisms in this group keep potentially threatening ideas, feelings, memories, wishes, or fears out of awareness. Diminished awareness can affect the person's ability to relate to others.

• Displacement involves dealing with stress by transferring strong feelings about on situation onto another (usually less threatening) substitute situation.-->Displacement involves taking out our frustrations, feelings and impulses on people or objects that are less threatening. Displaced aggression is a common example of this defense mechanism. Rather than express our anger in ways that could lead to negative consequences (like arguing with our boss), we instead express our anger towards a person or object that poses no threat (such as our spouses, children or pets).
• Dissociation involves dealing with stress by breaking off part of memory, consciousness, or perception of self or the environment to avoid a problem situation (e.g., amnesia).
• Intellectualization involves dealing with stress by excessively using abstract thinking and generalizations to avoid or minimize unpleasant feelings. React in a cold way, focus on intellectual aspect only
• Reaction Formation involves dealing with stress by substituting behavior, thoughts, or feelings that are the exact opposite of your own unacceptable thoughts or feelings (which the person is usually not aware of).-->treating someone you strongly dislike in an excessively friendly manner in order to hide your true feelings. Why do people behave this way? According to Freud, they are using reaction formation as a defense mechanism to hide their true feelings by behaving in the exact opposite manner
• Repression involves dealing with stress by removing disturbing wishes, thoughts, or experiences from conscious awareness. The person may still be aware of the feelings associated with the repressed issue, but will not know where the feelings come from.-->Repression acts to keep information out of conscious awareness. However, these memories don't just disappear; they continue to influence our behavior. For example, a person who has repressed memories of abuse suffered as a child may later have difficulty forming relationships.
• Undoing involves dealing with stress by using words or behaviors designed to negate or make amends symbolically for unacceptable thoughts, feelings, or actions. (taubat?)

Disavowal Level: Defense mechanisms in this category try to keep unpleasant or unacceptable stressors, impulses, ideas, feelings, or responsibilities out of awareness.

• Denial involves dealing with stress by refusing to acknowledge some painful aspect of reality or experience that is apparent to others.
• Projection involves dealing with stress by falsely attributing your own unacceptable feelings, impulses, or thoughts to another person.-->a strong dislike for someone, you might instead believe that he or she does not like you. Projection works by allowing the expression of the desire or impulse, but in a way that the ego cannot recognize, therefore reducing anxiety.
• Rationalization involves dealing with stress by concealing the true motivations for a thought, action, or feeling by using elaborate, reassuring, and self-serving (but incorrect) explanations.

Action Level: This level is characterized by defenses that deal with internal or external stressors by action or withdrawal.

• Acting Out involves dealing with stress by using action rather than reflection or feeling. Defensive acting out is often associated with "bad behavior" when there are underlying emotional conflicts. Acting out' means literally means acting out the desires that are forbidden by the Super ego and yet desired by the Id. We thus cope with the pressure to do what we believe is wrong by giving in to the desire
• Help-Rejecting Complaining involves dealing with stress by complaining and making repeated requests for help that disguise hidden feelings of hostility toward others, which is then expressed by rejecting the suggestions, advice, or help that others offer. The complaints may involve physical or psychological symptoms or life problems.
• Passive Aggression involves dealing with stress by indirectly and unassertively expressing aggression toward others. The person displays an outward superficial cooperativeness that masks the underlying resistance, resentment, and hostility. This defense may be adaptive in situations where direct and assertive communication is punished (e.g., abusive relationships)

Defense Mechanisms of Distortions

Distortions in regards to defense mechanisms are broken down into three separate levels; minor, major and dysregulation. Minor image-distorting level is characterized by distortions in the image of self, body, or others that may be used to maintain self-esteem. Examples include:

• Devaluation: attributing exaggerated negative qualities to self or others.
• Idealization: attributing exaggerated positive qualities to self or others.
• Omnipotence: acting as if self is possessed with special powers or abilities and is superior to others.

Major image-distorting level is characterized by gross distortion or misattribution of the image of self or others. Examples of this level include:

• Autistic fantasy: excessive daydreaming as a substitute for human relationships, more effective action, or problem solving.
• Projective identification: falsely attributing to another the feelings, thoughts or impulses of self; differing from simple projection by the fact that the individual doesn’t fully disavow what is projected; rather misattributes them as justifiable reactions to the other person. Frequently the individual induces those very feelings in others that were believed to be there, making it difficult to untangle the situation.
• Splitting of self-image or image of others: compartmentalizing opposite affect states and failing to integrate the positive and negative qualities of self or others into cohesive images. Self and object images ten to alternate between polar opposites.

The more severe level of distortion, defensive dysregulation, is characterized by a failure of defensive regulation in individuals’ reactions to stressors, which lead to a pronounced break with objective reality. Examples of this level include:

• Delusional projection: attributing non reality-based thoughts, emotions and impulses to others.
• Psychotic denial: gross impairment in reality testing.
• Psychotic distortion: gross impairment in perceiving reality differently than others

This is not exhaustive of the multitude of defense mechanisms that individuals use to communicate. Interactions can be complex and though an understanding of defense mechanisms is helpful; when impaired, it is wise to leave it to professionals to conduct in depth analysis of another’s words or actions.

In addition these are some funny exercise...But of course, these are my opinions, not real answers.:D

okay what defense mechanism is this? Easy one right, this is displacement. Then again, i might be wrong.

If u ask me, i'll say this is idealization (attributing exaggerated positive qualities to self or others)

Im not sure exactly, but this one seems like rationalization... Or we could say its projection too...

(rationalization:dealing with stress by concealing the true motivations for a thought, action, or feeling by using elaborate, reassuring, and self-serving (but incorrect) explanations)

well, this one is not really a defense mechanism, more like disorganized behaviour

With that, i end my post with some pictures on Freud Model Personality, the Id, Ego and Superego

Holistik Approach dalam hidup

Semoga Allah permudahkan urusan hamba-hambaNya yang menuntut ilmu hanya kerna mancari redhaNya, menjadi hambaNya yang akan memimpin manusia seluruhnya ke jalanNya yang lurus. Sungguh, siapalah kita dan apa sangatlah usaha kita study 2 minggu ni... Kalau sudah ditakdirkan lulus, maka 2 hari study day pun boleh lulus,kalau dah ditakdirkan gagal, sebulan study month pun tak dapat membantu. Usahalah, Allah memandang pada usaha kita, maka usahalah dengan ikhlas, mengikut batasannya, tetap menjalankan ibadah dengan lebih tekun dan mempertingkatkan amal. Bukankah usaha itu sendiri harusnya holistik (ingat PPD je holistik?). Jadi mengapa surau perlu kosong? Mengapa mathurat perlu keseorangan? Mengapa perlu subuh begitu sunyi? Dimana holistik approach kita sebagai hamba Allah. Study, study jugak, tapi janganlah kita merasakan seperti seluruh nyawa kita bergantung pada study, di tempat lain, bumi Mesir, saudara seislam kita sedang berjuang untuk menegakkan islam, takkanlah disebabkan study kita jadi tak endah pada mereka? Dimana holistik approach kita sebagai manusia itu sendiri? Exam terlalu 'memakan' kita sampaikan kita jadi lupa tujuan utama hidup kita, untuk menyembah Pencipta kita, Allah s.w.t.

Ada yang menyangkal dan mengatakan bahawa study itu sendiri adalah salah satu bentuk penyembahan kepada Allah. Yeke? Habis tu kalau dah melewat-lewatkan solat, tidur lewat sampai bangun pagi tak sempat subuh, tinggalkan bacaan Quran, dan sebagainya, sembah Allah yang macamana tu? Astaghfirullah.... Ya Allah tunjukkanlah kami kepada jalanMu yang lurus, moga kami tidak termasuk dalam golongan orang-orang yang rugi...


Akhir kata, kembalilah kepada fitrah kita sebagai manusia, kita bukanlah robot yang dicipta khas untuk pass exam, tapi bakal doktor yang harusnya punya sifat kemanusiaan. Jadi lah manusia!MANUSIA, dan jadilah manusia yang tidak putus beramal soleh. Usahalah seholistik mungkin untuk mencapai kejayaan dunia, moga kejayaan akhirat itu pasti.

Complicated ME

Sometimes i wonder about the things i can do
what about all those chances i miss?
the time when opportunities stood in front of me
but then i step back, face down in misery

why do i do the things i do?
why don't i do the things i should do?
why do i restrict myself from doing it?
what make me strong?
and what makes me weak?
what makes me consistent?
what makes me gives up?

these are questions running through my thoughts
whenever there is a storm in my heart
whether its a feeling i have for life or just for a moment
it becomes significant since its MINE

i wonder wonder and wonder again...

can i blame others for my mistakes?
should i blame them for not being supportive?
am i the only who feels like this?
or does everybody also feels the same?

i wonder what runs through your minds
when you decide something and i decide the other
when i thought of something but you thought of the other
sometimes i feel so alien
other time i just thought that i am lonely

can anyone understand this being called "me"?
her heart have dark places that even she haven't discover
at the same time the bright places is a dangerous glare
her range of emotions is near bipolar
she is clueless of most of the things,even the closest one to her

am i to be blame?
are they to be blame?
who are to be blame?
it this is a test?
should i still be questioning?
am i wrong?
can i undo it?

i'm not saying i hate myself
not even near to saying i wanted to be someone else
even if God were to give me an exchange
i would want to stay the same
not to be anyone else

its just that there are these questions
its rhetorical, no need for your answer
the questions i ask Allah
i ask and ask....
and i will keep asking....
because only Allah understands...
this complicated being called ME
and only Allah can answer these questions

so leave me in my own "beautiful mind"
whether you can accept it or not
whether its pathological or not
somehow somewhere
i play a role in this world
even how small it is....
i do believe it
that in a way
i am special
if i'm not...
i wouldn't...
be here...
today....

My Artwork the 2nd

I have to say that I enjoy making posters for Palestin issues, and even the last time, it came out quite good

I came up with an idea to do a countdown... This is Ramadhan special

Of course we have iftar, always have n always will...

Ah-ha... this is d first KBM-Special poster... don't forget to check out the "story" behind this poster...

go to link: http://keindahanbersamamu-ppukm.blogspot.com/2010/11/lepaskan-diri-dari-penjara-dosa.html

this was made for Fahmi's entry, his very first entry.. Go to Link:

http://keindahanbersamamu-ppukm.blogspot.com/2010/10/gara-gara-hiburan.html

I really like the book : Super Health... Its very medic n scientific! I hope to do more posters like these

I really like this poster.... :D

Go to link: http://keindahanbersamamu-ppukm.blogspot.com/2010/11/ziarah-sahabat-nursing.html

Ha-ha... this is a special father's day poster i guess... This is d first time i have my family member as a model for my poster... Me dad~~~ but there's a sad n touching story to be shared here... Go to link:

http://keindahanbersamamu-ppukm.blogspot.com/2009/06/cerita-tentang-ayah-bukan-sekadar_22.html

and the award for the most popular post goes to~~~Prof Har's talk!!Yeay! congrats to prof har... I guess she have quite an influence :D... Go to link:

http://keindahanbersamamu-ppukm.blogspot.com/2010/11/perkongsianour-role-in-sex-related.html

and the 2nd most popular post goes tooooo.... DERU!!Oh yeah! im so happy for DERU!!

go to link: http://keindahanbersamamu-ppukm.blogspot.com/2010/11/post-deru.html

kisah raja n ikan: 

http://keindahanbersamamu-ppukm.blogspot.com/2010/11/kisah-raja-dan-ikan.html

we have a monthly "ta'lim by ustaz emran.. there will be a third one, n yes, still on shahadah.. shahadatain is very very important people....

more Surau's program...

this poster was made after i met a psychiatric patient who have suicidal ideation... she make me think a lot that i came up with this:

http://doctorimanrozali.blogspot.com/2010/12/what-makes-you-live-life.html

this one is on Hijrah : http://zatelimanrozali.blogspot.com/2010/12/mari-berhijrah.html

this is a perkongsian on PERINTIS's forum: http://keindahanbersamamu-ppukm.blogspot.com/2010/12/pada-7-disember-2010-bersamaan-1.html

this is actually an artwork i made specially for the book PERSIAP is making, the inter-language book?

i think that was it.. huhu...