Dear All
Thank you for participating in the session today.In RRR we discussed:

• VECTRAL association and it’s relevance / importance
• 7 year old with Headache and nausea. 

It is important to keep common conditions on top of your list vs more rare. Common cause I have seen is Migraine but most serious to rule out is a Space Occupying Lesion. Benin Intracranial Hypertension – should not be a first diagnosis as differential.
In Development station we first saw a boy of 3.5 yrs with concerns regarding inability to common daily tasks like his brother. The video of fine motor assessment was seen. Good points noted. Then Dr S and Dr A were in the hotseat to verbalize the same / similar examination.
Learning points:

• Observe the whole child – do NOT miss obvious association / signs
• Hand preference vs inability to use the other hand freely.
• Verbalizing is harder and there are not commonly practised.
• Use SIMPLE commands – important for child to understand
• Practice, Practice, Practice
• In summarizing – ‘I could not get him to do xyz on this occasion’.

Vist www.mrcpchonline.org to add your comment or anything I may have missed.
Anil Garg