Unspecified hospital in Adelaide

80-year-old woman day 2 in ICU following presentation with haematemesis and aspiration pneumonitis, intubated for endoscopy that was negative. Background history included atrial fibrillation and short bowel syndrome on home TPN. Findings on examination included an awake patient on minimal respiratory support, raised JVP, atrial fibrillation with a displaced apex beat, and a Hickman line in situ.

Candidates were directed to assess her suitability for extubation.

Discussion points also included differential diagnosis for her presentation and further investigation and management of the GI bleed