ADC Practice Question — Oral mucositis (cancer therapy related)

What is the most concerning potential complication that requires urgent hospital assessment?

Pharmacology questions in the ADC written exam test applied prescribing decisions, not rote recall of drug names. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

Priya Sharma, a 29-year-old pregnant woman at 16 weeks gestation, presents to your clinic with a 5-day history of painful oral lesions and difficulty eating. She reports that the symptoms began 2 days after starting amoxicillin for a urinary tract infection. On examination, you observe haemorrhagic crusting of her lips, extensive ulceration of the buccal mucosa bilaterally, and erythematous areas on her tongue. She appears uncomfortable and has lost 2kg since her last antenatal visit. Her temperature is 37.8°C and she reports no skin lesions elsewhere. What is the most concerning potential complication that requires urgent hospital assessment?

A. Malnutrition affecting fetal development
B. Fetal complications from maternal illness
C. Secondary bacterial infection of oral lesions
D. Progression to Stevens-Johnson Syndrome/toxic epidermal necrolysis
E. Dehydration from poor oral intake

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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: D

According to TG (p.171), urgent hospital referral is required because of the possibility of potentially life-threatening severe cutaneous drug reactions such as Stevens-Johnson Syndrome/toxic epidermal necrolysis (SJS/TEN).

Source: Ch 16: Severe cutaneous drug reactions

Remy's study tip — For pharmacology vignettes, read the patient’s medical history and allergies BEFORE looking at the drug options.

Exam preparation FAQ

Should I memorise guidelines word-for-word for Oral mucositis (cancer therapy related)?

Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

How are Oral mucositis (cancer therapy related) questions structured in the ADC written exam?

ADC Oral mucositis (cancer therapy related) questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

Every answer, traced to the source.

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What is the most concerning potential complication that requires urgent hospital assessment?

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