Unspecified hospital in Adelaide

68-year-old male day 3 ICU admitted with respiratory failure and septic shock secondary to pneumonia complicated by acute kidney injury. Background included type 2 diabetes and alcohol dependence. Findings on examination included mechanical ventilatory support with relatively high ventilatory requirements, bilateral chest signs and vasopressor dependent shock.

Candidates were told he had presented with dyspnoea increasing over several days and were directed to provide a differential diagnosis for his initial presentation and make a management plan.