Thank you for participating in the session today. We concluded the Extended Clinical Session from last Thursday.
Next week we will start our Winter Course. Communication – to start with.

3 month old with unexplained rib fractures and skull fracture is seen in A&E with his mother c/o crying and poor feeding for 48 hours. I role played a candidate and Dr N role played the mother. In the first 6 minutes we covered general presentation concerns, birth history and specifics relating to the ‘trauma’ findings on Universal cues. No history is perfect but do watch and let me know what you make of it. Dr Aloke was the examiner for Clinical examination and discussion.
We had updates on recent examination.
Learning points:

• Have a note pad and pen to write down cues signs, main history points
• You have to be VERY SPECIFIC in questions during examination
• Ask for weight & growth – and then say you will plot them
• You will not get useful ‘dependent cue’ with ‘vague’ question.
• Be VERY systematic in the examination
• With examiner – summary with + & – ve findings and a simple Differential diagnosis
• Management – wait for examiner’s questions.
• Do not be biased on diagnosis – work out a differential. There always is a differential
• Use Universal cues to guide your focused history

If there are any comments or points you wish to add please visit www.mrcpchonline.org

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Anil Garg