Dear All

Thank you for participating in the session.

In RRR we discussed:

• Hyperthyroidism in 13 year old
• Acute Liver Failure
• Developmental Regression in 2 year old

The Clinical Station was to examine a young person with a neck swelling. Dr A took the hot seat and made a very good attempt at the examination and discussion. There were very good suggestions from examiners regarding thinking more broadly and conducting relevant ‘examinations’. Midline neck swelling is likely to be a ‘Thyroid swelling’ unless it is proved otherwise.

Learning points are:

• Have a differential diagnosis
• In Thyroid swelling – beside the neck findings – consider
• Voice changes
• Eye signs
• Muscle weakness – proximal myopathy
• Tremors
• Deep tendon Reflexes
• Systematic and orderly examination technique
• Ht & Wt centile are appropriate in all situations

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

Anil Garg