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Opening (30 s)
"Mitral Regurgitation — give a one-line definition and the single most important immediate risk."
Model: Mitral regurgitation (MR) is systolic backflow of blood from the left ventricle (LV) into the left atrium (LA) through an incompetent mitral valve. Chronic MR runs an asymptomatic compensated phase (LA and LV dilate, eccentric hypertrophy) before decompensation with dyspnoea, fatigue and atrial fibrillation. Acute MR (papillary-muscle or chordal rupture post-MI) presents as fulminant pulmonary oed
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: Acute severe MR post-MI with pulmonary oedema and shock - papillary muscle or chordal rupture; emergency echo, vasodilators, IABP, urgent surgery
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.)