Westmead Hospital

  • 81-year-old male admitted 17 days earlier with SAH secondary to ruptured right PCOM aneurysm with bradycardia and AICD malfunction and new onset fever. Clinical findings included signs of biventricular failure, left upper limb weakness and the presence of craniotomy wound, EVD and permanent pacemaker/AICD. Candidates were told he had presented with a headache and altered conscious state and now had a fever and were asked to examine him and determine a management plan. Discussion points included interpretation of imaging and investigations, the differential diagnosis and causes of fever.