Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Chronic diarrhoea with Failure to Thrive
• Haemolytic Uraemic Syndrome (HUS)
• Necrotising Entro-Colitis (NEC)

The History was of a 12 year old presenting for annual review for her Tachycardia with breakthrough symptoms in past few months. Dr A took the Hotseat, Dr A was a very able Role Player as mother and in Double role of being Young person. Dr P was with Examiner hat and Dr Shishir was our host today – he was moderator. Dr A had a very good attempt but there were some gaps in the information gathered due to extensive information gathering in other areas costing him time. Some of the gaps in information was picked up others.

The Learning points are:

• Paraphrase the information provided to begin and build on it.
• Do not go very deep in establishing the given diagnosis
• Recent worsening – 3-6 months – need to explore
• “What do you do to feel better?” is a good question.
• More important to gather information regarding treatment
• Compliance. Other Drugs – recreational.
• Failure of treatment can be due besides not taking is ‘out growing’
• Drug level is a very good way to confirm compliance
• Other relevant conditions: Thyrotoxicosis, Anxiety etc
• Do not get into Communication Mode
• Acknowledge questions and Park as appropriate
• Be careful of your Language – ‘Kid’ is not appropriate for a child
• Do NOT forget the various other facets of history.
• Make a note of points to ask in the 4 minutes while reading information provided
• Do not beat around the bush and repeat same questions.

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

Anil Garg