Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Precocious puberty
• Cyanosis in a newborn
• Asthma – Outpatient management at discharge

The Video station was of a clip of a 2 day old baby in a headbox having features suggestive of on going convulsion – facial twitching, lip smacking, tonic clonic movement of left arm. Dr T took the hotseat. We did not have any specific examiner hats today.

We probed initial diagnosis after viewing the video clip by all members and unanimous impression was that the baby is having a fit. If the diagnosis cannot have a Differential diagnosis then we need to look at the causes of that diagnosis. Dr T made a good list with top three differential. We then proceeded to history questions followed by specific examination finding to check for. Discussion was ‘What will you do next?” followed by few other management questions.

The Learning points are:

• Watch the Video very carefully
• Concentrate on different aspect when reviewing
• Develop 3 differentials to discuss
• Common things first – if you have not seen it – unlikely to be relevant
• Support with your finding you ‘final’ diagnosis
• Discuss management of ‘child / condition seen in Video
• Acute condition needs to be controlled first
• In OP management plan – write out a Treatment Plan
• Written plan is relevant to all Chronic conditions

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

Anil Garg