Unspecified hospital in Adelaide

78-year-old male, day 2 ICU, admitted following a MET call for altered conscious state and hypoxaemia. He had been admitted to hospital for management of melaena and falls. Background included significant cardiovascular disease and limited mobility. Clinical findings included sedated patient with loud aortic stenotic murmur and left hemiplegia with upgoing plantar reflex

Candidates were directed to examine him and comment on the major current issues.

Discussion points included interpretation of arterial blood gas and imaging, the clinical dilemma of thrombotic stroke in a patient who is a bleeding risk and the implications of aortic stenosis in this patient.