We discussed a seven day old baby who was sent in by the midwife for poor feeding.

The clinical signs were: central cyanosis, peripheral shutdown, normal respiration with no evidence of distress and CXR showing pulmonary plethora. The signs were picked up and appropriate history was asked for an examination findings confirmed.

There was some discussion on the management regarding being prepared for known side-effects of common medications.

Learning points:

• Examiners are ‘looking for’ patient safety first and a registrar who is ‘safe’.
• Inform Consultant first before discussing outside your ‘unit’ if situation permits else tell them as soon after.
• CXR – describe in a systematic manner. Less likely to miss important findings.
• Differential diagnosis: Respiratory or Cardiac – then it is easier.

Add your comment or anything I may have missed.

One of the participants mentioned was informed that next diet clinical exam in UK will be all online. I have no way of knowing but  keep checking RCPCH website for updates. If So – it will be like we have been practicing.

Anil Garg