Viva 3

You have been asked to assist with the management of a 70-year-old female in the Emergency Department who has presented with a history of altered conscious state and left sided weakness. She has been intubated and has a blood pressure of 240/120 mmHg. She has a history of ischaemic heart disease and atrial fibrillation. A CT scan of her head has demonstrated a large right sided tempo-parietal intracranial haemorrhage with intraventricular extension.

What are your initial management priorities?

(This viva dealt with the management of intracranial haematoma, and strategies for dealing with poor
neurological outcome.)

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.