64-year-old male, day 6 ICU, having presented to a regional hospital six days earlier with infected left foot ulcer and Hb 67 g/l. He was transfused one unit of packed red cells and rapidly developed respiratory failure. He was transferred later that day for respiratory support and was intubated on arrival at the second hospital. Background included diabetes, peripheral vascular disease and coronary artery grafts. The patient had been extubated the previous day, requiring BIPAP overnight.
The candidates were directed to assess his current respiratory status and postulate causes of his initial respiratory failure.