Chemotherapy and supportive pharmacology — formative viva

A MedVellum formative branching structured oral on chemotherapy and supportive pharmacology in children, following a child on a doxorubicin and cisplatin regimen through dexrazoxane cardioprotection, the antiemetic ladder, febrile neutropenia prophylaxis and management, and the non-negotiable vincristine-intravenous-only route rule. It is not an official board format.

branching clinical structured oral6 min readVerification in progress

Prompt

An eight-year-old child on a doxorubicin and cisplatin regimen for a solid tumour moves through the supportive pharmacology plan. The examiner releases information in stages. The candidate must state the dexrazoxane cardioprotection decision and mechanism, the antiemetic ladder for cisplatin, the colony-stimulating factor prophylaxis, and the vincristine-intravenous-only route rule with its prevention system.

Branching cross-examination

Name: Chemotherapy and supportive pharmacology — formative viva
Creator: MedVellum
Published: 2026-07-17

This is a MedVellum formative viva. It is not an official RACP, MRCPCH, ABP, ACGME or RCPSC station, mark scheme, duration or pass standard. Release each update only after the candidate states the mechanism, the dose principle, and the safeguard. [1] [4]

Candidate brief

You are the paediatric registrar in an oncology shared-care clinic. Speak as you would when building a supportive pharmacology plan around a child on doxorubicin and cisplatin. State the toxicity, the matched antidote, and the surveillance at each step. This is one continuous case. Each escalation branch leads to the next update. [1]

Paediatrics Fellowship Pro

You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References6Show ledger

[1]Lipshultz SE; Rifai N; Dalton VM; Levy DE; Silverman LB; Lipsitz SR The effect of dexrazoxane on myocardial injury in doxorubicin-treated children with acute lymphoblastic leukemia The New England journal of medicine, 2004.PMID 15247354
[2]Dupuis LL; Sung L; Molassiotis A; Orsey AD; Tissing W; van de Wetering M 2016 updated MASCC/ESMO consensus recommendations: Prevention of acute chemotherapy-induced nausea and vomiting in children Supportive care in cancer, 2017.PMID 27565788
[3]Kang HJ; Loftus S; Taylor A; DiCristina C; Green S; Zwaan CM Aprepitant for the prevention of chemotherapy-induced nausea and vomiting in children: a randomised, double-blind, phase 3 trial The Lancet. Oncology, 2015.PMID 25770814
[4]Smith TJ; Khatcheressian J; Lyman GH; Ozer H; Armitage JO; Balducci L 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline Journal of clinical oncology, 2006.PMID 16682719
[5]Mouridsen HT; Langer SW; Buter J; Eidtmann H; Rosti G; de Wit M Treatment of anthracycline extravasation with Savene (dexrazoxane): results from two prospective clinical multicentre studies Annals of oncology, 2007.PMID 17185744
[6]DeVine A; Landier W; Hudson MM; Constine LS; Bhatia S; Armenian SH The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers: A Review JAMA oncology, 2025.PMID 39976936