Phys Vivas · pharmacological
Therapeutic Drug Monitoring — Viva Defence
DCE viva defence for Therapeutic Drug Monitoring.
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Therapeutic Drug Monitoring Viva
Long Case Viva Defence
Opening statement
"This patient presents with a problem best framed as Therapeutic Drug Monitoring. 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]Kang JS, Lee MH Overview of therapeutic drug monitoring. Korean J Intern Med, 2009.PMID 19270474
- [2]Rybak MJ, Le J, Lodise TP, Levine DP, et al. Therapeutic Monitoring of Vancomycin for Serious Methicillin-resistant Staphylococcus aureus Infections: A Revised Consensus Guideline and Review by the American Society of Health-system Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. Clin Infect Dis, 2020.PMID 32658968
- [3]Krishnan N, Perazella MA Diagnosis and Management of Acute and Chronic Lithium-Associated Nephrotoxicity. J Am Soc Nephrol, 2026.PMID 42247265