Phys Vivas · dermatological
Drug Eruptions AND Severe Cutaneous Adverse Reactions — Viva Defence
DCE viva defence for Drug Eruptions AND Severe Cutaneous Adverse Reactions.
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Drug Eruptions AND Severe Cutaneous Adverse Reactions Viva
Long Case Viva Defence
Opening statement
"This patient presents with a problem best framed as Drug Eruptions AND Severe Cutaneous Adverse Reactions. 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]
References3ShowHide
- [1]Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, et al. Current Perspectives on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. Clin Rev Allergy Immunol, 2018.PMID 29188475
- [2]Bastuji-Garin S, Fouchard N, Bertocchi M, et al. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol, 2000.PMID 10951229
- [3]Seminario-Vidal L, Kroshinsky D, Malachowski SJ, et al. Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome and toxic epidermal necrolysis. J Am Acad Dermatol, 2020.PMID 32151629