Viva 3


Scenario: The plain Chest X-Ray and CT thorax below are those of a 25 year old man admitted to the Intensive Care Unit after a motorcycle accident in which he suffered bilateral fractured femurs and a ruptured spleen.  He required a 15 unit blood transfusion before and during a laparotomy for splenectomy and open reduction and internal fixation of his fractured femurs (6-hour procedure).

CXR day 2 post injury


CT scan day 5 post injury


Introductory Question: What are the most likely causes of the CXR appearances?

Twenty-one out of twenty-two candidates passed this section.

Disclaimer: the viva stem above may be an original CICM stem, acquired from their publicly available past papers. Or, perhaps it is a slightly altered version of the original CICM stem. Or, it is a completely original viva stem, concocted by the monstrously amoral author of Deranged Physiology for nothing more than his own personal amusement. In either case, because the college do not make the main viva text or marking criteria available, almost everything here has been confabulated. It might sound like a plausible viva and it could be used for the purpose of practice, but all should be aware that it does not represent the "true" canonical CICM viva station.