60-year-old male, day 6 ICU admitted with GCS 3, query cause, and persisting coma and a background history of alcohol abuse. Clinical findings included GCS 5-7 off sedation, brain stem reflexes present (except oculo-vestibular), weak extension of upper limbs to pain, global hyporeflexia with up going plantar responses bilaterally, and presence of skin abrasions and sacral pressure sore.
Candidates were asked to examine him with a specific focus on his neurology with a view to establishing a differential diagnosis for his presentation and a management plan.