Phys Vivas · general-medicine
Preoperative Medical Assessment AND Optimisation — Viva Defence
DCE viva defence for Preoperative Medical Assessment AND Optimisation.
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Target exams
Preoperative Medical Assessment AND Optimisation Viva
Long Case Viva Defence
Opening statement
"This patient presents with a problem best framed as Preoperative Medical Assessment AND Optimisation. 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]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