Dear All

Thank you for your participation in the session today.

In RRR we discussed:

• Indications for admission following h/o head injury
• Thyrotoxicosis
• Seizure of 20-30 min without regaining consciousness

The Video clip was of a 4 month old infant with rash on the face with golden crust and involvement of eyelids and right hand. Dr A was on the hotseat with Dr J and Dr P taking the examiner hats. Dr A made a good attempt and picked up the clinical signs depicted. Differential Diagnosis was not quite in keeping with ‘Common things common’. Some rare diagnosis were mentioned. Infected ‘eczema’ in a young infant is most likely due to Cow’s Milk Protein allergy in UK. Family history and other relevant questions can be asked. Management again – mention the most important intervention first. Examiners made very relevant observations and rest of the group contributed. Cow’s milk protein intolerance is not a common problem in India but it needs to kept at near the top of the list.

Learning points are:

• Acute management has to be mentioned first i.e. abort seizure!
• Stabilize
• Differential diagnosis – Common is Common
• If you have NOT seen the ‘condition’ most unlikely needs to be included
• History and examination need to be based on your DD
• Management – broad principle and key important first.

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

Anil Garg