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.
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.