- 48 year old female, admitted last night with hypotension, respiratory failure and reduced LOC. She had left thumb cellulitis commenced on fluclox and she has now developed a generalised rash.
Issues:
° Toxic epidermal necrolysis
° Morbid obesity
° SIRS/shock
° ARDS
Areas of weakness identified by examiners:
Candidates did not look comfortable at the bedside; they looked like they don't examine a patient as part of their daily work. These candidates fiddled with the bed sheets, didn't expose the patient adequately, missed skin biopsy site sutures, struggled to exam a morbidly obese patient from just the right side of the bed and performed disjointed exams moving from the hands to face to legs to chest to leg to face in an illogical sequence. Some took unsafe approaches with their discussion of technique to intubate the patient or overdosed the patient with dangerous amounts of intubating drugs, despite an opportunity presented to clarify their chosen drug amounts.