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Opening (30 s)
"Atrial Fibrillation — give a one-line definition and the single most important immediate risk."
Model: Atrial fibrillation (AF) is the commonest sustained cardiac arrhythmia: irregularly irregular rhythm, absent P waves, fibrillatory f-waves. Care follows the ABC pathway: Avoid stroke (anticoagulate if CHA2DS2-VASc ≥2 in men, ≥3 in women, with a DOAC preferred), Better symptom control (rate vs rhythm control), Cardiovascular risk-factor optimisation. Unstable AF with rapid ventricular response need
Station 1 — Pathophysiology (2 min)
Explain the mechanism chain from cause to clinical features and one major complication.
Station 2 — Clinical diagnosis (2 min)
Classic presentation, atypical groups, named bedside signs, and what you examine for red flags.
Red flag cue: Haemodynamically unstable AF (hypotension, heart failure, ischaemic chest pain, reduced GCS) = emergency synchronised DC cardioversion, not rate-control drugs
Station 3 — Investigations (2 min)
First-line tests, definitive tests, and any named score with exact components.
Station 4 — Emergency management (3 min)
ABC priorities, first drugs with dose and route, procedures, and when to escalate to ICU/theatre.
Station 5 — Definitive / long-term care (2 min)
Stepwise definitive therapy, monitoring, complications of treatment, follow-up.
Station 6 — Special populations (2 min)
Child / pregnancy / elderly / immunocompromised / renal impairment — what changes.
Station 7 — Evidence & pitfalls (2 min)
Landmark trial or guideline name if standard; three classic exam traps.
Station 8 — Rapid-fire pearls (1 min)
Five high-yield facts a candidate must not forget under time pressure.
Examiner pass criteria
- Speaks in mechanisms and numbers, not vague lists
- Gives at least one exact dose or threshold
- Names escalation criteria
- Avoids dangerous delays (imaging when unstable, etc.)