Dear All

Thank you those who were able to attend and make our double session successful.

In RRR we discussed:

• Failure to Thrive in 6 month old: possible aetiology
• Enuresis: Aetiology and basic management
• Hydrocephalus: causes and management

In our first session we concluded and discussed How to of unexplained Injury to 2.5 year old carried over from last session. Video clip of AG & Anne was viewed and points discussed. There was discussion on a scenario of Brain Death. Video scenario was of a 6 month old presenting with vomiting for 24 hours, there was evidence of a repaired meningomyelocele and a Ventriculo-Peritoneal  shunt. Dr A toot the hot seat with Dr A and Dr J contributing to the history, examination and discussion. In the second session after a short break the Video clip was of a 6 month old presenting with Failure To Thrive, Clinical signs of a bright infant – tachypnoea, sub and suprasternal recession, Nasogastric tube, hepatomegaly. Dr U took the hotseat. She identified the signs and had a good discussion.

The Learning points are:

• Read the information provided very carefully.
• Watch the Video carefully 
• focus on different aspects when reviewing.
• Formulate differential diagnosis of 3 by this time.
• Do NOT go in with only One diagnosis
• Ask History questions to support or refute a diagnosis.
• Examine – focused again with above aim for diagnosis
• Most likely diagnosis should be first. 
• Avoid rare causes you have not seen yourself.
• Keep it simple.
• Do not just list investigations
• Investigation with explanation of what you are expecting
• Discuss / inform your consultant.

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

Anil Garg