Phys Written Answers · dermatological
Malignant Skin Lesions — Written Clinical Reasoning
DCE-style written reasoning for Malignant Skin Lesions.
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Target exams
FRACP DCEMRCP Part 2
Prompt
DCE-style written reasoning for Malignant Skin Lesions.
SAQ 1 — Integrated plan (12 marks)
Prompt: Provide a prioritised problem list and management sequence for this presentation. [1] [2]
Model Answer
1. Frame and red flags (3 marks) [1]
State the working diagnosis/syndrome, acuity, and what would force emergency treatment now. [1] [2]
2. Discriminating assessment (3 marks) [2]
List the key history, examination and investigations that separate dangerous differentials from benign mimics. [1] [2]
3. Treatment sequence (4 marks) [1] [3]
Immediate stabilisation, disease-specific therapy, monitoring, and complications prevention. [1] [2] [3]
4. Follow-up and communication (2 marks) [2]
Disposition, safety-net advice, and who owns follow-up. [1] [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