Scenario: A 34 year old Para 1 Gravida 1 primary school teacher presents at 28 weeks gestation with a blood pressure of 170/120.
She has generalised tissue oedema and 3+ proteinuria.
Her liver function tests are abnormal with bilirubin 30umol/l (N<17), AST 300 IU/l (N<30).
The haemoglobin is 78 g/L, the blood film shows fragmented red cells. Her platelet count is 75 x
Introductory question: What do you think this patient is suffering from?
Nineteen 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.