“You have been called to the haematology ward to review a 55 year old man, who is 2 months post
allogeneic bone marrow transplant for acute myeloid leukaemia which is thought to be in remission. In the last 72 hours since admission to hospital, he has become increasingly dyspnoeic, pyrexial to 38.3 C, and neutropenic. His chest X ray taken today shows increasing bilateral interstitial infiltrates. What is your differential diagnosis in this case?”
Follow up question: “How would you differentiate between them?”
Fourteen out of twenty-seven 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.