Viva 4

A 65 year old lady is admitted to your ICU with a 2 week history of weakness, lethargy, confusion, anorexia, vomiting and polyuria

On examination she has a Glasgow coma score of 8 with generally reduced deep tendon reflexes. Pupils are equal and react to light. Her pulse rate is 55 beats/minute and BP
150/80 mm Hg.

What is your initial management of this lady?

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.