“A 26 year old girl is admitted to your intensive care following a drug overdose. She admits to taking twenty-four tablets of paracetamol and twenty paracetamol-codeine tablets a few hours ago. She says that she recently broke up with her partner and has been feeling suicidal and depressed. She also admits to drinking heavily for the last few hours. On examination she appears drowsy and has slurred speech and smells of alcohol. Outline your initial approach to management of this patient.”
Follow up question: “What blood tests will you perform and why?”
Common problems encountered including those related to knowledge deficits, inability to recognise the knowledge deficit, failure to recognise clinically significant issues, and inability o prioritise. Seventeen 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.