Rheumatological Investigation Autoantibodies Imaging Synovial Fluid Viva

Long Case Viva Defence

Opening statement

"This patient presents with a problem best framed as Rheumatological Investigation Autoantibodies Imaging Synovial Fluid. My priorities are to identify red flags, confirm the mechanism with purposeful investigations, start a sequenced management plan, and integrate multimorbidity and follow-up."

Examiner questions

Q1: "What makes this urgent?"

"I look for threats to airway, perfusion, neurology, metabolism, infection or bleeding, and I escalate those before elective work-up."

Q2: "What is your first investigation package?"

"I order tests that change management now, not a scattergun panel."

Q3: "Walk me through treatment."

"Stabilise, treat the mechanism, prevent complications, and plan monitoring."

Q4: "What is the classic trap?"

"Treating a label without confirming the discriminating mechanism, or delaying escalation."