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Phys Vivasdermatological

Phys Vivas · dermatological

Malignant Skin Lesions — Viva Defence

DCE viva defence for Malignant Skin Lesions.

1 min readVerification in progress

Target exams

FRACP DCEMRCP PACES
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Study tools

Target exams

FRACP DCEMRCP PACES
Prompt
DCE viva defence for Malignant Skin Lesions.

Malignant Skin Lesions Viva

Long Case Viva Defence

Opening statement

"This patient presents with a problem best framed as Malignant Skin Lesions. 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]

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References3ShowHide
  1. [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. [2]Robert C, Schachter J, Long GV, et al. Pembrolizumab versus Ipilimumab in Advanced Melanoma. N Engl J Med, 2015.PMID 25891173
  3. [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
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