Phys Vivas · pharmacological
Tricyclic Antidepressant AND Sodium Channel Blocker Toxicity — Viva Defence
DCE viva defence for Tricyclic Antidepressant AND Sodium Channel Blocker Toxicity.
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Target exams
Tricyclic Antidepressant AND Sodium Channel Blocker Toxicity Viva
Long Case Viva Defence
Opening statement
"This patient presents with a problem best framed as Tricyclic Antidepressant AND Sodium Channel Blocker Toxicity. My priorities are to identify red flags, confirm the mechanism with purposeful investigations, start a sequenced management plan, and integrate multimorbidity and follow-up." [1] [2]
Examiner questions
Q1: "What makes this urgent?" [1]
"I look for threats to airway, perfusion, neurology, metabolism, infection or bleeding, and I escalate those before elective work-up." [1] [2]
Q2: "What is your first investigation package?" [2]
"I order tests that change management now, not a scattergun panel." [1] [2]
Q3: "Walk me through treatment." [1]
"Stabilise, treat the mechanism, prevent complications, and plan monitoring." [1] [2] [3]
Q4: "What is the classic trap?" [2]
"Treating a label without confirming the discriminating mechanism, or delaying escalation." [1] [2]
Short case
Counsel the patient on the plan, risks and warning symptoms in plain language. [1] [2]
References
- [1]Avau B, Borra V, Vanhove AC, Vandekerckhove P, et al. First aid interventions by laypeople for acute oral poisoning Cochrane Database Syst Rev, 2018.PMID 30565220
- [2]Rajpurohit N, Aryal SR, Khan MA, Stys AT, et al. Propafenone associated severe central nervous system and cardiovascular toxicity due to mirtazapine: a case of severe drug interaction S D Med, 2014.PMID 24791374
- [3]Braitberg G, Oakley E Small dose... big poison Aust Fam Physician, 2010.PMID 21301654
- [4]Doan HN, Chang MC Comparative Effectiveness of Unstable Versus Stable Resistance Training on Lower Limb Strength, Mobility, and Fear of Falling in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials Am J Phys Med Rehabil, 2026.PMID 42468010
- [5]Liu HW, Tsai TL Virtual Reality-assisted Physiotherapeutic Training for Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis Am J Phys Med Rehabil, 2026.PMID 42468005
- [6]Osborne AK, Brown RD, Sillence E Effects of Social Media Narratives on Affective and Behavioral Responses to Menopause Content: Randomized Online Experimental Study JMIR Form Res, 2026.PMID 42467962
- [7]Carroll S, McGee M, Audette M, Tuttle M, et al. Lidocaine for diphenhydramine-induced ventricular tachycardia: A case report Am J Emerg Med, 2026.PMID 41610479
- [8]Zaccara G, Franco V Pharmacokinetic Interactions Between Antiseizure and Psychiatric Medications Curr Neuropharmacol, 2023.PMID 35611779