Unspecified hospital in Sydney

  • 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.