Dear All

Thank you for participating in the session today.

In Rapid Random Reviews we discussed:

• Haematuria in a 5 year old
• Nephrotic syndrome
• ADHD

Mini Mock Exam was Examination of a 5 year old who had features of short stature and some dysmorphic feature. Dr F too the hotseat, Dr R & Dr S had the examiner hats. Dr F had some clarifications on how to proceed when no specific systemic examination is mentioned. Start with General physical paying more attention to growth, facial features and anything else that is obvious e.g. gait or behaviour. Follow up on the cues to examine specifics e.g. auscultation for murmurs. Dr F made a very good attempt at picking up and describing the cues. Presentation was also smooth and succent. A differential diagnosis was offered as a specific diagnosis could not be worked out. Discussion was good. Examiners noted the smooth flow of the description of the process.

Learning points are:

• Systematic approach is a MUST
• Do not panic and lose your chain of thought
• Start with observation and then move closer to the child
• Examine other relevant system i.e. auscultate for murmur, check BP
• Put your findings together and have a differential diagnosis
• Give your reasons supporting your diagnosis
• If you cannot formulate a diagnosis – say it.
• You will get more marks for your systematic approach than blurting out a diagnosis
• Remain calm – remember you know it do not let your nerves disturb your thinking.

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

Anil Garg