Life is a bed of roses and thorns. To get to the roses, you have to deal with the thorns.

The following is some information/advice I got from my seniors who are currently Med 5. They deliberately asked those who have taken viva exam before and I hope this is useful as a referencejust a REFERENCE. So please do not rely on this entirely. The answers are SUGGESTED answers ONLY. *When you dont know how to answer the questions, tell the examiners that you dont know that in a professional way, like saying you are not familiar with the topic, instead of just saying sorry I dont know. *They want some SAFE doctors. So be Be logical, Give organized answers. *Even if you want to make a guess (risky!), make sure there is sufficient educational ground for your answer because there will be follow up questions *Know the commonnest things Topics asked previously: Pharmacology (important) - Give definitions of 1st and 2nd order pharmacokinetics - Pharmacokinetics and pharmacodynamics are important topics, may refer to MED 2 PMDT Bridgittes notes (I remember there are two lectures on these two topics) - NSAID side effects - Phenytoin, warfarin - Drug-drug interaction** - Drugs especially in PCAR - Digoxin toxicity: management, symptoms, complications treatment: Digixab(not sure if the spelling is correct): bind digoxin intravascularly. Hence theres a concentration gradient between extracellular and intracellular drug concentration, hence the drug diffuses out of the cells Anatomical and Cellular Pathology - Cirrhosis: cause, presentation - TMN Staging of CRC - May take a look at pathology of common diseases

Chemical pathology - Thyroid function test

Hashimotos disease (it was asked by external examiner) Fe-deficiency anaemia Renal/Thyroid/Liver function test: may ask about the parameters, e.g. What is ALP or ALT? What is it measuring? (e.g. Alkaline phosphatase is an enzyme present on the biliary canaliculi, its concentration increases with biliary tree obstruction)

Theres one candidate actually did good in surgical osce and hence the examiners asked him a lot of surgical knowledge. - shock (clinically): Give DDXHx and P/E to differentiate the ddxmanagement, investigation - how to resuscitate - classify shock: warm peripheryseptic shock, anaphylactic shock; cold peripherythen check JVPwith JVP hypovolemic shock with JVP cardiogenic shock - hemicolectomy postop day3 fever likely complication (e.g. anastomotic leak) and management (e.g. antibiotics, draninage) e.g. hypotensionmanagement - GIB+if need to take NSAIDSapproach: -any indications? -give prophylaxis, e.g. PPI, H2 blocker. -how to follow up - NSAID with ulcerManagement - COX2: increased cardiogenic side effect Microbiology - antibiotics profile: certain antibiotic covers what organisms? - e.g. sepsismanagement according to the source of infectionit could be biliary, urinary tract, etc., if its skin flora, which antibiotics to use? - sepsissymptoms