Viva 5

“A 76 year old, previously well, male is admitted to the ICU following an emergency abdominal
aortic  aneurysm  repair.  Immediate  post  operative  ICU  care  has  been  exemplary,  the  patient receiving early and appropriate resuscitation. There has been improvement in the lactic acidosis, correction of coagulopathy and hypothermia. The patient however remains oliguric 4 hrs after the operation. List possible causes for the persistent oliguria?”

Follow   up   question:  “You   suspect   raised   Intra-Abdominal  Pressure   and   the   Abdominal Compartment Syndrome, how do you measure the Intra-Abdominal Pressure?”

Twenty-five 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.