Syllabus · Current · V5 (2025) · Nervous System including autonomic and pain
H4 · Pain Physiology
H4.ii · Opioid & NMDA Receptors
Describe the classification (where relevant), distribution and role in pain sensation of: a. opioid receptors, b. NMDA receptors.
Written examination
SAQ history
Opioid Receptor Signalling, Analgesia & Adverse Effects
1 exam appearance
(a) Describe the intracellular events that occur following opioid receptor activation (25% of marks). (b) Describe the locations where opioids produce analgesia and the mechanisms by which they exert these effects (45% of marks). (c) Outline the mechanism by which morphine causes the following side effects: (i) Respiratory depression (15% of marks). (ii) Constipation (15% of marks).
43%
Opioid Receptors
1 exam appearance
Outline the classification, structure and distribution of the opioid receptors (50% marks). Describe the intracellular events following opioid receptor activation (50% marks).
20%
Ketamine — NMDA & Pharmacology
2 exam appearances
Outline the structure and function of the N-methyl-D-aspartate (NMDA) receptor (25% marks). Discuss the pharmacology of ketamine (75% marks).
74%
Describe the physiology of the NMDA (N-Methyl D-aspartate) receptor (40% of marks). Outline the pharmacology of ketamine (60% of marks).
49%
Oral examination
VIVA history
-
2023A · Day 1 · VIVA 1
This VIVA will examine opioid pharmacology. What classifications of opioid receptors do you know?
-
2023A · Day 2 · VIVA 2
This VIVA will examine neurophysiology, pharmacology and anatomy. Describe the n-methyl-d-aspartate (NMDA) receptor?
-
2021B · Day 3 · VIVA 1
This viva will assess your knowledge of opioids. What classification of opioid receptors do you know?
-
2020B · Day 4 · VIVA 6
This viva will explore your knowledge of opioids and their pharmacology. What classifications of opioid receptors do you know?
-
2008B · VIVA 4
The initial information given to the candidates was - This station will explore the pharmacology related to analgesic medications. How will you classify non opioid analgesic agents? This viva explored the candidates’ knowledge in relation to the following points Classification of non opioids, mechanism of actions of non opioids Classification of opioids, mechanism of action, some aspects of their general pharmacology, contrasting fentanyl and morphine, tolerance to opioids Examination feedback: Generally candidates performed better at classifying non opioids in comparison to the opioids. There was also a lack of depth and breadth in knowledge related to opioid receptors
Sources: objective text from the relevant CICM syllabus; historical SAQ and VIVA wording from CICM examiner reports.