Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Antenatal screening
• Obesity
• Cong Hypothyroidism

The Clinical station – we covered a Video Station scenario. 6 month old with Spina bifida & VP shunt presenting with vomiting for 24 hours. Dr A & Dr P had the examiner hat – Dr j took the hot seat and made a very good attempt. He identified the clinical signs present. History and examination dependent cues were important. In history & examination- What can be deducted by clinical exam to help support or refute diagnosis is the key.

Learning points:

• UTI, Gastroenteritis, Meningitis – common causes.
• Video station – concentrate on Acute problem
• Do not go into detailed past medical history
• Develop a differential diagnosis of 3 to work through
• DO NOT get stuck with ONLY one diagnosis
• Simple things first
• A complicated diagnosis may not be causative of presentation
• Targeted questions as opportunity to ask only 2-3
• Focus and be structured
• Antiemetics and NOT give routinely in UK practice
• Regular use only in association with Chemotherapy
• Antibiotics – do not delay after culture sample taken
• Involve your consultant

Visit www.mrcpchonline.org to add your comments or points I may have missed.

Anil Garg