Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Preterm 30 wks – expected complicartions
• Precocious puberty
• Acute heamolytic anaemia

The Clinical station was examination of Respiratory system of a 8 years old with h/o increasing shortness of breath over past 3-4 days. Dr S took the hotseat while Dr A & Dr S wore the examiner hats. Dr S attempted the examination systematically but there were some points noted by the examiner: ward regarding pain, growth parameters, Clubbing, scars on chest wall.

The learning points are:

• Consider a differential even diagnosis seems obvious
• Ask of pain and reassure will stop if uncomfortable
• General examination is mandatory at ALL stations
• Systematic examination – Expose / ask
• Inspection – Palpation – Percussion – Auscultation
• It is fine to check for scars in General examination
• Growth parameters
• In summary – give your diagnosis then support with signs
• Asthma is a common diagnosis – easy hence need better ‘performance’
• Do NOT narrate your finds and keep your diagnosis for the end.
• 3-4 questions on management

We move to a Communication scenario next on popular demand.

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

Anil Garg