Phys · Written Answers

Written Answers

23 units across 9 domains — Written clinical-reasoning practice mapped to DCE long-case preparation.

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Physician Medicine Written Answers — Plate — physMedVellum Press

23Units

9Domains

general-medicine cardiovascular infectious respiratory renal rheumatological haematological gastrointestinal hepatic

Domain

general-medicine

Anaphylaxis — Written Clinical Reasoning

DCE written preparation: structured clinical reasoning for anaphylaxis scenarios — bee sting with airway compromise, and refractory anaphylaxis in a beta-blocked patient.

Open

Domain

cardiovascular

Anticoagulation and Antiplatelet Therapy — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for perioperative anticoagulation planning and for major gastrointestinal bleeding on a direct oral anticoagulant.

Open

Arrhythmias and Conduction Disease — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for arrhythmia scenarios — new AF with rapid ventricular response in sepsis, and syncope with bifascicular block.

Open

Cardiovascular Prevention and Rehabilitation — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for cardiovascular prevention scenarios — primary prevention assessment with a strong family history, and the post-MI secondary prevention bundle with statin intolerance.

Open

Domain

infectious

Bloodstream Infections and Infective Endocarditis — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for bloodstream infection scenarios — S. aureus bacteraemia in a dialysis catheter patient, and fever with a new murmur and an embolic phenomenon.

Open

CNS Infections — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for suspected bacterial meningitis and for encephalitis, including management sequencing, CT-before-LP criteria, and CSF interpretation.

Open

Tuberculosis — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for tuberculosis scenarios — reactivation risk in an anti-TNF candidate, and tuberculous meningitis with HIV co-infection.

Open

Viral Hepatitis — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for infectious-diseases viral hepatitis scenarios — HBV reactivation prophylaxis before chemotherapy, and the HCV test-and-cure pathway in a newly diagnosed patient.

Open

Domain

respiratory

Diffuse Alveolar Haemorrhage — Written Clinical Reasoning

DCE written preparation: structured reasoning for diffuse alveolar haemorrhage scenarios — diagnosis when haemoptysis is absent, and management of anti-GBM disease with pulmonary-renal syndrome.

Open

Lung Cancer — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for lung cancer scenarios — the growing solitary pulmonary nodule in a smoker, and SVC obstruction at first presentation.

Open

Respiratory Failure and Non-Invasive Ventilation — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for acute respiratory failure — the acidotic COPD exacerbation and the hypoxaemic pneumonia support decision.

Open

Respiratory Investigation — Written Clinical Reasoning

DCE written preparation: structured reasoning for respiratory investigation scenarios — interpreting three PFT panels (ILD vs obesity vs neuromuscular weakness) and working up a unilateral exudative pleural effusion.

Open

Solitary Pulmonary Nodule — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for solitary pulmonary nodule scenarios — the 9 mm solid nodule in a 60-year-old smoker, and the 12 mm part-solid nodule with a 7 mm solid component.

Open

Domain

renal

Electrolyte Disorders (Calcium, Magnesium, Phosphate) — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for divalent ion scenarios — severe hypercalcaemia with suppressed PTH in myeloma, and acute post-thyroidectomy hypocalcaemia.

Open

Hypertensive Nephrosclerosis and Renovascular Disease — Written Clinical Reasoning

DCE written preparation: structured reasoning for renovascular scenarios — the young woman with a bruit and the older vascular patient with a creatinine rise on ACE inhibition.

Open

Polycystic Kidney Disease (ADPKD) — Written Clinical Reasoning

DCE written preparation: structured reasoning for ADPKD scenarios — the new diagnosis in a young man with preserved GFR, and the tolvaptan decision in a woman with rapid progression.

Open

Renal Replacement Therapy — Written Clinical Reasoning

DCE long-case preparation for RRT: modality selection, IDEAL initiation, access planning, PD peritonitis, and conservative care as an active alternative.

Open

Tubulointerstitial Disease — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for acute interstitial nephritis — a PPI-induced creatinine drift with deprescribing and steroid reasoning, and checkpoint-inhibitor AKI with rechallenge reasoning.

Open

Domain

rheumatological

IgG4-Related Disease — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for a 62-year-old man with IgG4-related disease presenting as painless jaundice, bilateral submandibular gland enlargement and renal impairment — the one-disease-many-organs concept, the clinicopathological diagnosis (histopathology triad of dense lymphoplasmacytic infiltrate, storiform fibrosis and obliterative phlebitis with IgG4-positive plasma cells), the correct use and limits of serum IgG4, the exclusion of pancreatobiliary malignancy and Sjogren syndrome, the 2019 ACR and EULAR classification criteria and the 2020 revised comprehensive diagnostic criteria, and the treatment ladder of glucocorticoids first-line and rituximab for relapsing or multi-organ disease.

Open

Domain

haematological

Iron Deficiency — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for iron deficiency — the GI workup and management of a 68-year-old man with severe iron-deficiency anaemia, and functional iron deficiency in chronic kidney disease.

Open

Transfusion Medicine — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for transfusion scenarios — acute reaction discrimination and massive haemorrhage management on anticoagulation.

Open

Domain

gastrointestinal

Oesophageal Disorders — Written Clinical Reasoning

DCE-style written reasoning for oesophageal scenarios: progressive dysphagia with alarm features in an older smoker, and recurrent food bolus obstruction in a young atopic patient.

Open

Domain

hepatic

Viral Hepatitis — Written Clinical Reasoning

DCE long-case preparation: structured written reasoning for hepatitis B serology interpretation, the four phases of chronic HBV and treatment selection, HCV DAA therapy planning, and perinatal transmission prevention.

Open