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Seven Deadly Sins in Ocular 1: Missing the Tumor Not performing - - PowerPoint PPT Presentation
Seven Deadly Sins in Ocular 1: Missing the Tumor Not performing - - PowerPoint PPT Presentation
12/2/2016 Seven Deadly Sins in Ocular 1: Missing the Tumor Not performing adequate ophthalmoscopy Oncology 70F Bertil Damato MD PhD UCSF No financial declarations 1: Missing the Tumor 1: Missing the Tumor Not performing adequate
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1: Missing the Tumor
Not considering the diagnosis
1: Missing the Tumor
Not considering the diagnosis www.oculonco.com
2: Not communicating with the patient
Not mentioning nevi and other ‘trivial’ findings 34F
2: Not communicating with the patient
Not explaining meaning of ‘suspicious mole’
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2: Not communicating with the patient
Not telling patient of your diagnosis of melanoma
2: Not communicating with the patient
Not helping patients remember what they’re told
3: Giving bad news badly
Not showing compassion
4: Giving bad advice
‘Your baby has only a
- ne-in-a-million chance
- f getting a
retinoblastoma like yours.’ (Pediatrician)
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5: Performing dangerous biopsy Vitreous biopsy in a child
c/o Dr. Doris Hadjistilianous, Siena, Italy
5: Performing dangerous biopsy
Incisional biopsy of nodular conjunctival melanoma
6: Not performing essential biopsyPrimary acquired melanosis 6: Not performing essential biopsy
Unilateral conjunctivitis/blepharitis
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6: Not performing essential biopsy
‘Vitritis’ unresponsive to steroids
Jan 13 Floaters Multiple specialists Sep 13 Vitritis Predforte No improvement Refer to Proctor Vitritis OD Ret lesions OS Inves -ve Apr 14 Biopsy: failed May 14 Ref to Oc Onco Ref to Hem Onco No CNS lymphoma Sep 14 Enlargement of lesions Oct 14 +ve vit biopsy = Lymphoma Ref to Hem Onco Rx: High dose methotrexate Apr 15 Resolution OU 20/40 OD 20/50 OS Cataract OU