An 18-year-old man presents to hospital two days following completion of induction chemotherapy for acute myeloid leukaemia. His main complaint is central abdominal pain. He is tachycardic at 120/min and his systolic blood pressure is 70mmHg. His temperature is 38.7 C. His serum creatinine is noted to be 300 (40-110) micromoles/l. You have agreed to admit the patient to ICU.
What will you do in the first thirty minutes?
Focus of discussion: - Neutropenic sepsis, causes of renal dysfunction in this setting
(chemotherapy, sepsis, tumour lysis)
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.