Phys Clinical Cases · general-medicine
Preoperative Medical Assessment AND Optimisation — DCE Clinical Case
DCE long-case and short-case station for Preoperative Medical Assessment AND Optimisation.
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Target exams
Preoperative Medical Assessment AND Optimisation — Clinical Case
DCE Long Case
Patient brief
Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Preoperative Medical Assessment AND Optimisation. [1]
Presenting complaint: Subacute or acute symptoms referable to Preoperative Medical Assessment AND Optimisation, with enough detail to force prioritisation. [1] [2]
Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]
Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]
Examination: Key positives and critical negatives for dangerous differentials. [1]
Investigations: A small set of results that change management. [1] [2]
Tasks
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- Provide safety-net and follow-up advice. [2]
Model discussion points
- Working diagnosis and acuity. [1]
- Differentials and discriminators. [2]
- Treatment sequence and monitoring. [1] [2] [3]
- Multimorbidity and communication. [2]
Short case
Focused examination or counselling station linked to Preoperative Medical Assessment AND Optimisation, with one interpretation task and one shared-decision point. [1] [2]
References
- [1]Nmezi J Anaesthetic Management of a Patient With Severe Bipolar Disorder: A Case Report Cureus, 2026.PMID 42368232
- [2]Krnojelac M, Andjelković L Surgical Resection of a Giant Hepatocellular Carcinoma in an 89-Year-Old Patient with Multiple Comorbidities: The Role of Frailty Assessment and Preoperative Optimisation-A Case Report and Literature Review Diagnostics (Basel), 2026.PMID 42351561
- [3]Charles AE, Castillo Suárez AA, Chhajed M, Jimenez Gallardo M, et al. Perioperative sleep optimisation and brain health in older adults (SLEEP-BOOST): protocol for a randomised controlled trial BMJ Open, 2026.PMID 42209013
- [4]Dreher D, Honnef G, Zoidl P, Auinger D, et al. Patient Blood Management: a systematic review of current international guidelines Br J Anaesth, 2026.PMID 42115060
- [5]Melgaard E, Westergaard LM, Olesen AS, Miger K, et al. Heart size on chest CT and its association with acute heart failure in the emergency department Dan Med J, 2026.PMID 42095314
- [6]Sørensen TB, Angaard LK, Axelsen DR, Lauridsen MC Preoperative imaging lowers the negative appendectomy rate in acute appendicitis Dan Med J, 2026.PMID 41978449
- [7]Doan HN, Chang MC Comparative Effectiveness of Unstable Versus Stable Resistance Training on Lower Limb Strength, Mobility, and Fear of Falling in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials Am J Phys Med Rehabil, 2026.PMID 42468010
- [8]Liu HW, Tsai TL Virtual Reality-assisted Physiotherapeutic Training for Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis Am J Phys Med Rehabil, 2026.PMID 42468005