We discussed our video scenario showing a six month old infant with evidence of operated meningo-myelocele and VP shunt. The story wars of child of child being unwell for 24 hours with vomiting. The findings were picked up by all however in history of common because the vomiting in a child i.e. viral infection was not thought of as part of the differential. More serious conditions were well picked.

We had a discussion on ventriculo-peritoneal shunt and its functioning. How to examine the shunt to check for blockage and if suspected what next investigation would be appropriate.

The learning points were:

• Think of the differential diagnosis while watching the video.
• Generally 2 to 3 courses. 
• Ask the relevant questions as part of history to differentiate your diagnoses
• Only think of specific examinations that will help your differential.
• Watch the video carefully and watch it till the end.

Please add a comment or anything that I may have missed.