Breakthrough Cancer Pain AND Opioid Titration Viva

Long Case Viva Defence

Opening statement

"This patient presents with a problem best framed as Breakthrough Cancer Pain AND Opioid Titration. My priorities are to identify red flags, confirm the mechanism with purposeful investigations, start a sequenced management plan, and integrate multimorbidity and follow-up." ^{[1] [2]}

Examiner questions

Q1: "What makes this urgent?" ^[1]

"I look for threats to airway, perfusion, neurology, metabolism, infection or bleeding, and I escalate those before elective work-up." ^{[1] [2]}

Q2: "What is your first investigation package?" ^[2]

"I order tests that change management now, not a scattergun panel." ^{[1] [2]}

Q3: "Walk me through treatment." ^[1]

"Stabilise, treat the mechanism, prevent complications, and plan monitoring." ^{[1] [2] [3]}

Q4: "What is the classic trap?" ^[2]

"Treating a label without confirming the discriminating mechanism, or delaying escalation." ^{[1] [2]}