Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Gonadotrophin deficiency
• Encopresis
• Jittrey baby

The Video station – clip was of a 14 year old girl with rash on her abdomen. Dr N took the hotseat and identified most of the clinical cues. Dr T mentioned the cues that had been overlooked. Diagnosis was ‘obvious’ of Shingle with left dermatological spread. The rash did seem severe – erythema and papular. Management was covered adequately.

The Learning points are:

• Watch the video carefully – do not miss a frame.
• Keep the bigger picture in mind.
• Develop a differential diagnosis by the time you have finished watching the video.
• If diagnosis is ‘unrefusable’ then think of 3 causes!
• Formulate History questions to support or refute your DD.
• Examination – think broadly first. Common things common.
• Pain – should be alleviated first. We forget to tell.
• Jittrey babies are common DD of irritable baby with fits.

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

Anil Garg