| Viva 1 | Toxicological primary survey; also, serotonin syndrome and decontamination (Pharmacology and Toxicology) - Pass rate ; highest mark . |
| Viva 2 | A 26 year old woman presents to the Emergency department having been found at home confused and jaundiced by her GP. Her GCS is E3V5M5 She has a Temp of 38 ˚C, BP 90/60, HR 90 and SpO2 94% on 4litres/min O2 She has a past history of alcoholism and intravenous drug abuse. Outline your initial assessment and management: The rest of the viva focussed on fulminant hepatic failure and its assessment and management (Gastroenterology and Hepatology) - Pass rate ; highest mark . |
| Viva 3 |
(Respiratory Medicine and Mechanical Ventilation) - Pass rate ; highest mark . |
| Viva 4 | A 56 year old, homeless man was admitted to the emergency department with clinical features suggestive of a bowel obstruction. As he is confused, it is not possible to elicit a clear history. The first set of blood tests show- Sodium 137 mmol/L (137-145) Potassium 4.0 mmol/L (3.1-4.2) Chloride 98 mmol/L (101-109) Bicarbonate 15mmol/L (22-32) Glucose 48mmol/L (3.0-6.0) Urea 18.0 mmol/L (3.0-8.0) Creatinine 0.2 mmol/L (0.05-0.12) What are the possible causes of his metabolic acidosis? The rest of the viva focussed on the management of hyperglycaemic emergencies (Endocrinology Metabolism and Nutrition) - Pass rate ; highest mark . |
| Viva 5 | A 67 year old man with a history of heavy alcohol use was found collapsed, unresponsive, and smelling of alcohol. On admission he was noted to have abdominal distention with thin, gaunt facies and cachexia. In the Emergency Department he had a massive haematemesis requiring resuscitation. A gastroscopy was performed with banding of several oesophageal varices. He subsequently arrives in your ICU intubated and ventilated and haemodynamically stable. 1. Comment on this patient’s likely nutritional status. The rest of the viva focussed on assessment of nutritional status and enteral nutrition. (Endocrinology Metabolism and Nutrition) - Pass rate ; highest mark . |
| Viva 6 | Radiology): 6 radiographs were shown including chest X-rays, and CT scans of head, chest and abdomen. Areas of weakness identified by examiners: • Failure to identifiy common pathologies, inability to point out to specific lesions on the X-rays. • Candidates did not always use the information given to them about each Xray eg CT abdomen post rectal contrast • Candidates did not recognise significant psoas abscess on abdo CT. (Radiology) - Pass rate ; highest mark . |
| Viva 7 | Mr Smith is a 54 year old male who was admitted to the ICU 7 days ago. He presented with severe hypoxic respiratory failure and has a background of advanced motor neurone disease. He is currently unconscious, intubated and ventilated. Mr. Smith has a valid advanced care directive stating that he would not want life sustaining measures should he require invasive life support. There is consensus amongst you and your colleagues that extubation and palliation are appropriate. Mrs. Smith agrees that this is what her husband would want under these circumstances. Mr Smith has a nephew/niece named Pat, who has not seen him for some years, and s/he has just arrived back from overseas to see him. Mrs Smith has asked that you talk to Pat to discuss his/her Uncle’s condition and treatment plan and is happy for you to discuss all of his medical information with Pat. (Communication and Ethics) - Pass rate ; highest mark . |
| Viva 8 | A 65 year old woman is in your ICU post left pneumonectomy. She was admitted overnight for HDU care. You are called to see her by the nurse looking after her as she has become haemodynamically unstable during her shift. 1) Discuss the possible causes for this haemodynamic instability? Areas of weakness identified by examiners: (Equipment and Procedures) - Pass rate ; highest mark . |