Viva 1

A 54 year old man was brought into the Accident and Emergency Department after having been found unconscious on the floor of his hostel accommodation. He was lying in vomitus and was noted to be incontinent of urine. His GCS was E2V2M4 at the hostel.

His initial observations were: Temp of 38.2 ºC, PR 96/min, BP 160/90 mm Hg and SaO2 92% on 6 lpm O .

The only available history was one of alcohol abuse and epilepsy. He was also known to be a heavy smoker.

1.  What are your differential diagnoses for his unconsciousness?

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.