Dear All

Thank you for participating in the session today.

A number of our members have completed Clinical exam in last two weeks and in the previous two sessions we had feedback. Exams were very well organised, Examiners were friendly but difficult to gauge their response, cases were straight forward. We had discussed almost all the topics in the last 3 months. Rapid Random Review and Hotseat are very helpful in preparing for the exam. Very reassuring.

In RRR we discussed:

• Kawasaki disease
• Haemolytic Uraemic Syndrome
• Paracetamol Overdose

Communication scenario was speaking with a 14 year old admitted 2 hours ago with Paracetamol overdose needing treatment who is refusing to engage with doctors. Dr T was in the hotseat, AG role played and with Dr S & Dr F with the examiner hats. Dr T handled the scenario well and was able to engage with the ‘Teenage’ Role player and move on with discussion of options for treatment and other management points.

The Learning points are:

• Teenagers are ‘difficult’ to engage – need to be patient
• Social circumstances and medical management are equally important
• Do not ignore social issues in management in over all plan
• You need not give great details of medical management – outline is usually enough
• Start with open questions and find point of concurrence
• Summarize at 6 minutes
• Be correct in information you provide
• n-acetyl cystine infusion does not reduce Paracetamol level

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

Anil Garg