Viva 8

A 46-year-old male has been in your ICU for 48 hours. He collapsed at home following sexual
intercourse with his wife. A CT scan demonstrated a hypertensive intracranial bleed with
intraventricular, subdural and subarachnoid extension which the neurosurgical team have determined
is non-survivable.

Overnight he has been having extreme blood pressure surges, and this morning his left pupil has
become dilated and unreactive. He is breathing spontaneously but laboriously on the ventilator. He is
off all sedation, GCS 3, and has been for 24 hours. There are no other organ failures.

The intensivist who is handing over to you met with his wife yesterday. She has no friends or family
support. The intensivist commented that the wife did not seem to accept the gravity of the situation,
and said only that her church was praying for his speedy recovery.

You are now about to update his wife.



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.