| Viva 1 | A 50-year-old man has been admitted to your ICU with acute respiratory failure. He has a two-day history of fatigue, weakness, generalized myalgia, headache and fever; followed by dry cough and increasing shortness of breath. He is previously well and has recently returned from a business trip overseas. Physical examination reveals temperature of 390C, heart rate 120/min, blood pressure 140/75 mm Hg. He is being ventilated with Fi02 of 0.65 with oxygen saturations of 92%, and has bilateral crepitations audible on chest auscultation. He has been commenced on IV Ceftriaxone and Azithromycin as empirical antimicrobial therapy. Given the history, what infections will you consider as a cause for this man’s presentation? (Respiratory Medicine and Mechanical Ventilation) - Pass rate ; highest mark . |
| Viva 2 | Theophylline overdose and the use of haemoperfusion. (Pharmacology and Toxicology) - Pass rate ; highest mark . |
| Viva 3 | A 23 year old woman is the driver of a car involved in a high-speed motor vehicle crash and is brought to your hospital. She had been trapped for some time by her lower limbs, and at the time of extrication from the vehicle, she was talking and obeying simple commands. On arrival, she has obvious facial and scalp lacerations and localises bilaterally to pain, but does not open her eyes or vocalise. She has blood in her mouth, her breathing sounds noisy and obstructed with a respiratory rate of 22 per minute, and oxygen saturations are 91% on high flow oxygen. Her heart rate is 130/minute, systolic BP is 60mmHg. Paramedics have splinted her left lower leg, which was significantly deformed. Outline your immediate management. (Trauma, Burns, Drowning) - Pass rate ; highest mark . |
| Viva 4 | A 36-year-old woman presents to the Emergency Department with a three (3) day history of dry cough and increasing shortness of breath. She is profoundly hypoxaemic and is intubated by ED staff for institution of mechanical ventilation. A chest x ray confirmed the position of the ET tube but showed bilateral diffuse opacities in the lungs. In the ICU, the patient is placed on 100% oxygen and 10 cm H2O PEEP. She is commenced on volume control mode of ventilation and the ICU registrar has set the ventilator to deliver 500 mls tidal volume at a rate of 12 breaths per min. A few minutes later, you are called by the bedside nurse as she is concerned by the ABG taken on 100% oxygen. (Respiratory Medicine and Mechanical Ventilation) - Pass rate ; highest mark . |
| Viva 5 | A 54-year-old man with type 2 diabetes mellitus and psoriatic arthritis on monoclonal antibody therapy presents with a two week history of progressive headache, nausea and vomiting, fever and an unsteady gait. He has had a recent episode of sinusitis which was treated with oral antibiotics. He has returned one week previously from a camping trip to North America and transited via Hong Kong for two days on his return to Australia. He was born in Taiwan and visits regularly. On examination he is febrile to 38° celsius. He is stable from a cardiorespiratory point of view. His Glasgow Coma score is 15 with some slowness in answering questions. There is no neck stiffness. No cranial nerve abnormalities or other neurological deficits are noted. CT (non-contrast) of his Brain is normal apart from frontal sinusitis. What is your differential diagnosis for this man’s presentation?This is a returned (Infectious Disease Antibiotics and Sepsis) - Pass rate ; highest mark . |
| Viva 6 | You are taking over as the Intensivist on for the week and you meet with Chris who is the next of kin of 59 year old Pat, a patient in the ICU. Pat was admitted to hospital with dysarthria and limb weakness. Over the next four (4) days her neurological state deteriorated and she was intubated at a MET call for respiratory distress. One (1) week later in ICU she is quadriplegic and appears locked-in with only vertical eye movements and the ability to blink intact. She responds appropriately with these eye movements when questioned. Magnetic resonance imaging performed at the time of deterioration revealed extensive occlusion of the basilar and distal left vertebral arteries with acute pontine infarction. Chris wants to see you urgently as she/he is angry that Pat has not improved, despite a ward doctor telling her/him soon after the deterioration that she had a “90% chance of full recovery”. She/he has told the bedside nurse that she/he doesn’t understand what has happened and thinks people aren’t telling her/him the truth. (Communication and Ethics) - Pass rate ; highest mark . |
| Viva 7 | Candidates were asked to identify the salient abnormalities on four X-rays and three CT scans. (Radiology) - Pass rate ; highest mark . |
| Viva 8 | An obese patient with a history of emphysema has been admitted to Intensive Care with a HR of 23 and a BP of 80/40. He is drowsy but able to talk. He has been feeling very tired and washed out for two (2) days and had a fall after feeling dizzy. He has no injuries. (Cardiology) - Pass rate ; highest mark . |