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You are the in-charge consultant of a regional emergency department. A 55-year-old man has been brought to your ED after a UNwitnessed collapse on the golf course. Effective bystander CPR was commenced for 10 minutes until ambulance arrival. He has sustained ROSC by the time of ED arrival.

1. Other than lightning strike, list differentials for this presentation. 6 marks

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2. What is the name and significance of this clinical finding? 3 marks

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3. List features specific to lightning strike that are associated with poorer neurological outcomes. 3 marks

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