Phys Vivas · oncological
Pain Management IN Cancer AND Chronic Disease — Viva Defence
DCE viva defence for Pain Management IN Cancer AND Chronic Disease.
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Pain Management IN Cancer AND Chronic Disease Viva
Long Case Viva Defence
Opening statement
"This patient presents with a problem best framed as Pain Management IN Cancer AND Chronic Disease. 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]Wiffen PJ, McQuay HJ Oral morphine for cancer pain Cochrane Database Syst Rev, 2007.PMID 17943804
- [2]Wiffen PJ, Wee B, Derry S, et al. Opioids for cancer pain - an overview of Cochrane reviews Cochrane Database Syst Rev, 2017.PMID 28683172
- [3]Coluzzi PH, Schwartzberg L, Conroy JD, et al. Breakthrough cancer pain: a randomized trial comparing oral transmucosal fentanyl citrate (OTFC) and morphine sulfate immediate release (MSIR) Pain, 2001.PMID 11240084