1st Faculty of Medicine Charles University 1st Faculty of Medicine Charles University Department of Dermatology
03.10.2016

The list of questions

The list of questions
for dermatology and venereology examination


The NEW formulation of topics for Dermatology exam in Academic Year 2016-2017 (Version approved 27/09/2014 - download here).

  • Based on discussions with our students in previous academic year we have significantly reduced number of examined topics. The now remaining topics target only the most relevant diseases which a clinician is meeting in routine daily praxis not only in dermatology, but also in other various specialities of medicine.
  • We have also postulated for You following TEN KEY POINTS which should be presented at each topic (disease) by student during the exam. Demonstration of Your s ability to cover the topic according to this short guidelines will reassure examiner that You would be able to manage successfully all aspects of problem of Your future patient.

     

    1. Definition. (Be concise! Fit the disease in in major categories - e.g. inflammation; tumour, infection; inborn error etc.).

    2. Etiopathogenesis. (Make a short clear description of causes and consequences. This scheme will also allow You to identify the suitable treatment target, which You will need later).

    3. Clinical presentation. (Use our specific dermatologic terminology for description of the disease signs and symptoms. Describe primary or secondary lesions which allow You to recognize the disease.)

    4. Clinical course. (Here You should demonstrate Your ability to obtain, combine and analyse information from Your patient. History taking in dermatology sometimes resembles a thrilling detective story. The course of the disease also allows You to predict the most suitable time for biopsy, laboratory examination or therapeutic intervention).

    5. Complexity. (Skin is not the only organ of human body, of course! Many important diseases of the other body systems can affect skin (e.g. diabetes or other endocrine pathologies). The skin signs and symptoms usually due to their clear visibility might be even the very first manifestation noticed by patient of his physicians and in certain cases, if properly identified, can contribute to early diagnosis even of a deadly disease (e.g. paraneoplastic skin syndromes). On the contrary even a primarily skin disease (e.g. Streptococcal infection) can lead to serious damage in other organs (e.g. glomerulonephritis). Here You simply proof Your ability to see Your patient in more complex way relating skin and other organs.

    6. Differential diagnosis. (Even a highly experienced physician has doubts about his diagnosis, of course! The course of the disease might be variable and the patient may present less typical symptoms different from textbook cases. In such complicated cases it is not possible to make a final diagnostic conclusion immediately but You have to make a shortlist of relevant diseases to test and You will have to wait for e.g. results of laboratory or observe the following development. Here You test Your ability to make priorities and also ability of (self)critical thinking. You should ask "what supports my theory about this diagnosis? " as well as You simply must ask at the same time "what disproves my theory about this diagnosis?". This ability of consideration of "broader view" might be very helpful and gives You a chance to avoid shameful consequences of neglecting some important disease. Every medical speciality has certain nightmares of neglected cases. In our field of in interest it would be e.g. scabies, syphilis and from tumours melanoma.

    7. Diagnostic Methods, Indication, Interpretation. (Here You should demonstrate Your understanding of the value of specific dermatological methods and general medical imaging or laboratory test. You cannot simply make all e.g. biochemical tests which are available. Here You should prove ability to select suitable method and evaluate expected results. You also have to consider benefits and risks for Your patient as well as economical burden.)

    8. Therapy. (Here You have to demonstrate Your ability to select suitable therapy, if needed. You have to consider not only local and systemic pharmacotherapy, but also physical therapy and regime measures. Dermatology has notably long tradition of individualised treatment prepared in pharmacy which formulation is specifically tailored to skin of each individual patient and You should be aware of principals used in these possibilities.)

    9. Education. (Patient is leaving his physician not only with a prescription but mainly with a good advice and understanding. How can You clearly instruct Your patient about his disease? How can patient prevent recurrence or worsening of his disease? How can e.g. patient` s family be instructed about the disease to be helpful? How can the disease affect e.g. working ability of the patient? How can the disease affect daily activities, life style and leisure? Are any of prescribed drugs causing any serious adverse events? Is there necessary any follow up control of patient or of other persons? Is there a legal need to seek patient`s informed consent declaring full understanding to any particular aspect of his disease or treatment?

    10. Legal. Here You demonstrate understanding to legal duties of physician and protection of general health. Is the disease associated with any specific reporting duties to authorities? Who can You report such information to and how can You secure the confidentiality of e.g. intimate information obtained during history taking? Consider these dilemmas in e.g. cases of infectious disease, sexually transmitted disease, malignant disease, adverse drug reaction, occupational disease, working disability, mental disorder etc.)

 

 

 

 

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