Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Kawasaki disease
• Multifactorial inheritance
• Diabetes in children: long term aims of management

The Clinical station was of a 8 years old boy admitted 24 hours previously with respiratory distress. There was evidence of MDI use with spacer and audio clip of wheeze and rhonchi. Task was to examine his respiratory system. Dr R took the hotseat with Dr F and Dr S had the examiner hats. Dr R, remained clam and made a very good attempt of describing respiratory system examination. All major clinical signs were identified. There was over run on time and also there degree of back and forth’ in the procedure. Examiners picked out things that could be done different. Summary to examiner should be like that of a postgraduate trainee.

The Learning points are:

• Remain calm and do not be scared.
• Examination needs to be structured
• It needs to be fluent – as if you done it a 100s of time.
• General physical examination is a MUST – 30 secs – Observe.
• Start from periphery and move centrally.
• Examine both sides for Apex beat.
• Succent presentation to examiner – diagnosis first – if confident
• Marks are for Discussion also so do not waste time.
• Refresh BTS or NICE guidelines for Asthma management.
• Practice – Practice – Practice systemic examinations.

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

Anil Garg