Liverpool Hospital

  • 59-year-old female, day 5 in ICU, post in-hospital PEA arrest of unknown cause with a background of insulin-dependent diabetes and chronic renal failure. Clinical findings included a pansystolic murmur, peripheral oedema, left pleural effusion, hepatomegaly and Charcot's joints. Candidates were told that she had been admitted to hospital for insertion of a permacath for dialysis and subsequently had a PEA arrest in the ward. Candidates were asked to examine her and establish likely causes for the arrest. Other discussion points included interpretation of investigations and indications for dialysis.