Viva 5


Scenario:  You are asked to review an 84-year-old semi-retired farmer on the general ward.
He was admitted to the general ward complaining of weakness, predominantly of his upper limbs, which had progressed over the previous 12 hours. He says that he first noticed that he was unable to undo his shirt buttons, then he couldn’t lift his arms.  Now he says it is becoming difficult to move his legs in bed.

Introductory  question:   What further history and examination of this patient would assist you to establish a diagnosis?

Twenty-four out of twenty-eight 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.