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An OSCE case where the candidate acts as a retrieval consultant advising a rural doctor on a 69-year-old morbidly obese man with respiratory sepsis and type 2 respiratory failure. The scenario focuses on interpreting an ABG showing acute respiratory and metabolic acidosis, initiating BiPAP, and discussing management options such as fluids, noradrenaline, steroids, posture, and potential intubation — balancing clinical need with retrieval logistics.