- 80 year old lady with cardio-pulmonary compromise (obstructed expiratory flow and stigmata of steroid use, heart failure) who experienced respiratory failure following hip replacement under epidural. Significant post operative troponin rise. Candidates were asked to explain why they think this might have happened. X ray showed significant hiatus hernia (but otherwise clear lung fields) and flow trace on the ventilator showed marked obstruction, ECG showed LBBB.