Thank you for participating in the session today.
In RRR we discussed:
- Headache in 12 yr old – hypertension
- Cyanosed newborn – 4 hours old
- Recurrent infection – 4 yr old
The History station was of a 21 day old aby with weight loss and serum Na-113 mmol/l. Dr I was a good Role player as father of infant. Dr P took to the hotseat while Dr R & Dr K wore examiner hats – with feedback with observations and as per mark sheet. Dr P made a very good attempt at getting the history and discussing management. Examiners made very accurate observations and Learning points from the group are:
- Have a Differential diagnosis with scenario information.
- This will give structure to your history
- Structure to history taking is essential
- Empathy – demonstrate as appropriate
- Do not ask too many questions together – get answers too.
- Family history can be vitally important do not ignore.
- If a cue is offered – explore – do not just brush over.
- CURRENT ACUTE problem ALWAYS needs to be tackled first.
- Discuss with your consultant
- Consult tertiary intensive care teams – if required.
- In CAH – DD – Sepsis, meningitis, Feeding problems
- 17 Hydroxy progestrone is an important investigation – need not wait for results
- SEPSIS in neonatal period – always consider & Treat as omission can be fatal
- Check if .2%Saline 10% dextrose is still used – my memory is that it was discontinued due to problems with hyponatremia. 10% Dextrose NS is used.
Please visit www.mrcpchonline.org to add your comments or points I may have missed.