75-year-old female, day 5 ICU post jejunal flap to the hard palate for SCC palate and background of cardiomyopathy with PPM/AICD, and chronic kidney disease requiring intermittent haemodialysis, now managed with CRRT. Clinical findings included gross oedema, swollen neck, abdominal incision, previous donor graft sites, AV fistula right upper limb, dusky oral jejunal flap, hypothermia, presence of CRRT circuit and TPN.
Candidates were told she was day 5 post-jejunal flap for oral cancer and asked to examine her with a view to a plan for ongoing management.