Dear All

Thank you for joining the session today.

In RRR we discussed:

• ITP
• Cystic Fibrosis
• Diabetes Insipidius

The Video station depcited a 2 day old with obvious conculsion – eyes flickering, mouth twitching, left arm jerking, right arm flaccid, lying immobile. Baby in headbox. Dr P took the hotseat whle Dr A U& Dr P got the examiner hats. Dr P picked up most of the clues in the clip and had the diagnosis and knew the managemnt. Some clues were picked up by others ie headbox and ‘immobile’ right arm. There are alwayspoints we can learn.

The Learning points are:

• Start working on differential diagnosis from initial information and have it ready by the time you have finished seeing the video.
• Do NOT see the same bit, you have noticed’ on the video on review
• Focus of different part of the screen – there can be other clues.
• History questions need to help you with your Differential diagnosis.
• Be precise and exact with your words for the information you are seeking
• Do not ask unnecessary questions
• Listen carefully to information being given
• If not sure – better to Clarify than going down the wrong path!!
• If a child is fitting – no point checking for the tone – waste of a question.
• Read up ALL the emergeincies, Hypos & Hypers, Status…
• Know the first few managment options well – know current guidelines.
• Be ready to back up your answers if required

We then also discussed the change to differential diagnosis if the video was of a baby 28 days old.

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

Anil Garg