Phys Vivas · general-medicine
END OF Life Decision Making — Viva Defence
DCE viva defence for END OF Life Decision Making.
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Target exams
END OF Life Decision Making Viva
Long Case Viva Defence
Opening statement
"This patient presents with a problem best framed as END OF Life Decision Making. 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]
Short case
Counsel the patient on the plan, risks and warning symptoms in plain language. [1] [2]
References
- [1]Bolton P, White BP, Huppert J, Dadich A Assisted Dying Makes Us Think Differently About Care Health Expect, 2026.PMID 42460812
- [2]Bergen K, Bouwmans P, van Oevelen M, Avesani CM, et al. Deciding between conservative kidney management and dialysis in older people with kidney failure: a narrative review Clin Kidney J, 2026.PMID 42459744
- [3]Hoftiezer L, Hof MHP, van Lingen RA, Hukkelhoven CWPM, et al. Beyond cut-offs: gestational age-specific perinatal mortality across the birthweight-for-gestational-age continuum-a population-based cross-sectional study Eur J Pediatr, 2026.PMID 42458127
- [4]Aljohar A, Williamson MD, Mitchell RA, Roston TM, et al. Arrhythmogenic Right Ventricular Cardiomyopathy in Athletes: The Importance of Shared Decision-Making and an Individualized Approach JACC Case Rep, 2026.PMID 42460947
- [5]Genoud A, Portugal I, Murith N, Deux JF, et al. Coronary Artery Anomalies Revisited: Description of the Types, Pathophysiology and Treatment Options Based on Latest Guidelines J Clin Med, 2026.PMID 42452422
- [6]Shah V, Constantin K, Taddio A, McMurtry CM, et al. A Systematic Review and Meta-Analysis of the Effectiveness of Physical Interventions Administered Orally for Infants for Reducing Distress During Vaccine Injections Clin J Pain, 2026.PMID 42444178
- [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