{\rtf1\ansi\ansicpg1252\uc1 \deff0\deflang1033\deflangfe1033{\fonttbl{\f0\froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\f30\froman\fcharset238\fprq2 Times New Roman CE;}{\f31\froman\fcharset204\fprq2 Times New Roman Cyr;}
{\f33\froman\fcharset161\fprq2 Times New Roman Greek;}{\f34\froman\fcharset162\fprq2 Times New Roman Tur;}{\f35\froman\fcharset177\fprq2 Times New Roman (Hebrew);}{\f36\froman\fcharset178\fprq2 Times New Roman (Arabic);}
{\f37\froman\fcharset186\fprq2 Times New Roman Baltic;}}{\colortbl;\red0\green0\blue0;\red0\green0\blue255;\red0\green255\blue255;\red0\green255\blue0;\red255\green0\blue255;\red255\green0\blue0;\red255\green255\blue0;\red255\green255\blue255;
\red0\green0\blue128;\red0\green128\blue128;\red0\green128\blue0;\red128\green0\blue128;\red128\green0\blue0;\red128\green128\blue0;\red128\green128\blue128;\red192\green192\blue192;}{\stylesheet{
\ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 \snext0 Normal;}{\*\cs10 \additive Default Paragraph Font;}{\*\cs15 \additive \b \sbasedon10 Strong;}{
\s16\ql \li0\ri0\sb100\sa100\sbauto1\saauto1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 \sbasedon0 \snext16 Normal (Web);}}{\info{\title Dear All}{\author Mayford House}
{\operator chris}{\creatim\yr2007\mo9\dy3\hr18\min50}{\revtim\yr2007\mo9\dy3\hr18\min50}{\version2}{\edmins0}{\nofpages1}{\nofwords0}{\nofchars0}{\*\company Mayford House}{\nofcharsws0}{\vern8229}}\paperw11906\paperh16838 
\widowctrl\ftnbj\aenddoc\noxlattoyen\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\hyphcaps0\formshade\horzdoc\dgmargin\dghspace180\dgvspace180\dghorigin1800\dgvorigin1440\dghshow1\dgvshow1
\jexpand\viewkind1\viewscale85\pgbrdrhead\pgbrdrfoot\splytwnine\ftnlytwnine\htmautsp\nolnhtadjtbl\useltbaln\alntblind\lytcalctblwd\lyttblrtgr\lnbrkrule \fet0\sectd \linex0\headery708\footery708\colsx708\endnhere\sectlinegrid360\sectdefaultcl {\*\pnseclvl1
\pnucrm\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl2\pnucltr\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang{\pntxta )}}{\*\pnseclvl5
\pndec\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl8\pnlcltr\pnstart1\pnindent720\pnhang
{\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}\pard\plain \s16\ql \li0\ri0\sb100\sa100\sbauto1\saauto1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 
\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\cs15 
\par Dear All
\par Nick Collier has kindly put forward a case based on a real patient for the PBL session 13th Sept,\~ please can we all do some preparation for the session, try to treat it as a long essay question and think widely around knowledge skills and\~
attitudes as well as Dr and patient behaviour. You will get some time on the day for EBM searching, but not alot so do some reading around the evidence before the session and it will make it much easier for you.}{\b 
\par }{\cs15 Have fun and see you on 13th Sept}{\b 
\par }{\cs15 Peter Green}{\b 
\par }\pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\cs15 
\par 
\par A 74 year old man with several years history of gradually progressive}{\b \line }{\cs15 exertional dyspnoea, chronic cough and sputum and with recent onset of ankle}{\b \line }{\cs15 oedema walks into your surgery. You are busy and running a bit late but}
{\b \line }{\cs15 notice he has not been to the surgery for anything for\~ several years,he is}{\b \line }{\cs15 on no medication and has no recorded significant history. What do you do now}{\b \line }{\cs15 and what issues might arise in the future?}{\b 

\par }}