Phys Vivas · dermatological
Malignant Skin Lesions — Viva Defence
DCE viva defence for Malignant Skin Lesions.
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Study tools
Target exams
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]
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