Phys Clinical Cases · dermatological
Malignant Skin Lesions — DCE Clinical Case
DCE long-case and short-case station for Malignant Skin Lesions.
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Target exams
FRACP DCEMRCP PACES
Prompt
DCE long-case and short-case station for Malignant Skin Lesions.
Malignant Skin Lesions — Clinical Case
DCE Long Case
Patient brief
Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Malignant Skin Lesions. [1]
Presenting complaint: Subacute or acute symptoms referable to Malignant Skin Lesions, with enough detail to force prioritisation. [1] [2]
Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]
Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]
Examination: Key positives and critical negatives for dangerous differentials. [1]
Investigations: A small set of results that change management. [1] [2]
Tasks
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- Provide safety-net and follow-up advice. [2]
Model discussion points
- Working diagnosis and acuity. [1]
- Differentials and discriminators. [2]
- Treatment sequence and monitoring. [1] [2] [3]
- Multimorbidity and communication. [2]
References3ShowHide
- [1]Larkin J, Chiarion-Sileni V, Gonzalez R, et al. Combined Nivolumab and Ipilimumab or Monotherapy in Untreated Melanoma. N Engl J Med, 2015.PMID 26027431
- [2]Robert C, Schachter J, Long GV, et al. Pembrolizumab versus Ipilimumab in Advanced Melanoma. N Engl J Med, 2015.PMID 25891173
- [3]Faries MB, Thompson JF, Cochran AJ, et al. Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma. N Engl J Med, 2017.PMID 28591523