Dear All

Thank you for attending the session today. I send learning to most of our alumini so to keep in touch and remind them Paediatrics is a life long learning journey and MRCPCH is not the end. Your contribution is always welcome to guide our current and future members.

In RRR we discussed:

• Acute Liver Failure: causes & Investigations
• Abdominal mass with hepatospleenomegaly
• Choanal atresia

The Video station depicted a 7 year old boy thought to be day dreaming by parents and a video they have brought showed periodic absences. Dr P was in the Hotseat and Dr T & Dr A wore the examiner hat. Dr P noted the clinical signs, history questions were appropriate and examination was also good. Discussion got a little confused due to Hotseat syndrome. There is always room for improvement.

The Learning points are:

• Phrase questions ‘succinctly and be precise’.
• ‘How long has he had these episodes and have they been increasing?’
• Seizures is a common topic hence read up carefully and in detail
• What advice to give parents.
• Activity restriction till ‘seizures’ are controlled – not 2 years
• Drugs / medication can be started without EEG in cases.
• Diagnosis is based on history & observations and not only on EEG
• EEG is often normal inbetween seizures
• EEG is abnormal in 1% individuals with no symptoms!!

General questions: In Clinical station – Should you describe your examination finding as you go along. Depends on your & exainers preference but my advice is Talk to the child explaining what you are going to do as you go along. This will keep the child engaged and examiner will also know what your are doing.

Practice to finish a systemic exaination in 5 minutes.

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

Anil Garg