We discussed a 8 years old child with nausea, weight loss and pruritis. Differential diagnosis was Chronic liver disease with portal hypertension secondary to — possible aetiology.
Learning points:

• Group the aetiological causes into broad categories
• Infective, Drugs, Metabolic, Autoimmune, Cardiac etc
• Similarly arrange thought process to discuss investigations
• Very fine details are not required – can / should seen advice from Specialist Hepatic unit.

Another point we discussed was – the next Examination date is not certain and may be delayed. I would like you all to continue with your preparations and lose ground on the time you have worked so hard.

To avoid a gap and you dropping from the sessions – I have offered to add 2 sessions to 4 session subscription i.e. 6 instead of 4, till a date for the examination is published by RCPCH.

It is hard to pick up after a break and make up lost ground.

Do continue to practice and send me suggestions on how to improve your learning experience.

Anil Garg