Dear All

Thank you for particpating in the session today.

In RRR we discussed:

• Iron Deficiney Anaemia: management
• Hearing loss in 6 year old
• Abdominal malignancy: Symptoms & signs

The Clinical Station was to examine the Lower Limbs and any other relavant examination in a 12 year old girl. She had features of Left hemipresis. Dr K took the hotseat and made the first attempt at the station. Dr K ran out of his 6 minutes. Dr A came to the hotseat next and completed the exam in a structured way though with a little guidance. Comments from all were relevant.

The Learning points are:

• Structured fluent examination is essential
• Inspection of surroundings and ‘child’ is next
• Get down to level of child & kneel to get your eyes at correct level
• 5 Ss are essential in a neurology station:
  • SHOES – give important clues
  • Spine
  • Scars
  • Shunt
  • Squint
• Observe the ‘Whole’ child and not just the legs
• Compare one side with the other
• When offered to ask question to get to aetiology
• “When did parents first concerned of problem?’
• This will guide to time where to explore for more details
• Keep questions – simple.

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

Anil Garg