| Viva 1 | Resuscitation of the septic shock patient (Infectious Disease Antibiotics and Sepsis) - Pass rate ; highest mark . |
| Viva 2 | A 76-year-old male presents following a fall down stairs. He is found to have multiple (>5) fractured ribs on the right side of his chest. Otherwise he has no other injuries. His past history includes depression, he requires a hearing aid and has a 30 pack-year smoking history. His daughter says he has recently become quite "forgetful" since his wife passed away. He is admitted to your intensive care unit for respiratory and analgesic management. When you meet this man he is in considerable discomfort with a pain score of 9/10. What medications would you use to provide analgesia for this man and give the pros and cons of each? (Equipment and Procedures) - Pass rate ; highest mark . |
| Viva 3 | A 60-year-old man has been transferred to your ICU from another hospital ICU, where he had been admitted with severe pancreatitis complicated by respiratory failure requiring mechanical ventilation. His oral intake was reported to be poor during the week leading up to that hospital admission. How would you assess his current nutritional state? (Endocrinology Metabolism and Nutrition) - Pass rate ; highest mark . |
| Viva 4 | A 25-year-old man was involved in a high speed motor vehicle accident. His GCS was M4 E2 V2. The patient was intubated and ventilated in the Emergency Department. Vital parameters post-intubation, SpO2 98% on 50% oxygen, BP 130/80, reactive pupils. A CT head was reported as diffuse axonal injury (DAI). Other imaging confirmed rib fractures and lung contusions and excluded any other injury. What is your understanding of DAI? (Neurology and Neurosurgery) - Pass rate ; highest mark . |
| Viva 5 | You are the intensivist on duty. A 50 year old woman has just been transferred from the surgical ward with worsening shortness of breath day 5 post-oesophagectomy and a presumed anastomotic leak. On arrival in ICU she is tachypneic and extremely agitated. Arterial blood gas analysis on 80% Oxygen via Venturi mask shows: pH 7.12 A CXR shows bilateral pulmonary opacification. What are the possible causes for her respiratory failure and outline your initial approach to her respiratory management? (Respiratory Medicine and Mechanical Ventilation) - Pass rate ; highest mark . |
| Viva 6 | Consisted of 3 X-ray images and 4 CT scans for interpretation (Radiology) - Pass rate ; highest mark . |
| Viva 7 | John is 64, and is a committed Jehovah’s Witness admitted to ICU following surgery for colonic bleeding, with an admission Hb of 42g/L. He has atrial fibrillation, stable on warfarin. Ten days prior, John had an uneventful colonoscopic snare excision of a colonic polyp. Warfarin had been ceased for the procedure, and was re-commenced day 3 post-op. John presented to the hospital Emergency Department today with massive PR bleeding and hypotension. He has had an emergency R hemicolectomy, with formation of a colostomy. Vitamin K was given for warfarin reversal; the presentation INR was 3.2. John was transferred to ICU one hour ago, intubated and ventilated with FiO2 of 0.6. His mean arterial pressure is 75 mmHg on 15 mcg/min nor-adrenaline with cool peripheries and urine output 10-20 ml/hr. Haemoglobin = 42 g/L, platelets = 32, INR = 2.6, pH = 7.28, lactate = 2.3 mmol/L. There is fresh blood in the surgical drains and the colostomy. (Communication and Ethics) - Pass rate ; highest mark . |
| Viva 8 | A 30-year-old man has presented to the Emergency Department with a single stab wound to the Left anterior upper chest. You have been called to see him to review him for an HDU admission, and arrive just as the Emergency department registrar has intubated him for agitation. As you enter, you hear the call for assistance from the only other doctor in the department, the emergency department registrar, who is bagging the unconscious patient. Please assess and manage the immediate priorities (Cardiac Arrest and Resuscitation) - Pass rate ; highest mark . |