Dear All

Thank you joining the session today.

In RRR we discussed:

• Munchausen by proxy
• Chronic Fatigue Syndrome
• Hearing loss in 6 yr old

The Video station had a 6 yrs old with generalized rash, flaccid blisters, eye and oral cavity involvement. Dr R & Dr D had the examiner hat while Dr A was in the hotseat. Clinical cues were all picked and differential was thought of. Specific history and examination points could be better elicited. Know important complications. Management is important – learn important initial 3-4 points. There will not be time for very detailed discussions.

Learning points are:

• Practice to formulate clear questions
• Be brief and to the point.
• Do not waste valuable time in explaining your rationale.
• Each word in the stem is chosen very carefully and has relevance.
• Examination: specific ‘test’ for: crepitation, bulging fontanelle, Nikolski’s sign etc
• Read VERY carefully.
• Develop a Differential diagnosis – ask related questions.
• Generalized rash – drug history: antibiotics, anticonvulsants.

Please visit www.mrcpchonline.org to add your comments of points I may have missed.

Anil Garg