Chest X-ray images --> OSCE

Question 1

Answer 1

• Right middle lobe consolidation (pneumonia) –> loss of right heart border

Question 2

Answer 2

• Left lingula consolidation (pneumonia) –> loss of left heart border

Question 3

Answer 3

• Right-sided pneumothorax –> no lung markings on right side, increased rib spacing on right side

Question 4

Answer 4

Left-sided tension pneumothorax

Question 5

Answer 5

Left-sided mass –> lung cancer
–> small cell or squamous bc centrally located

Question 6

Answer 6

Right upper lung abscess –> cavitating mass

Question 7

Answer 7

Bilateral hilar enlargement –> TB or sarcoidosis

Question 8

Answer 8

Pleural effusion –> can see fluid level fill from base of lung

Question 9

Severe shortness of breath. Recent weight loss

Answer 9

Massive left-sided pleural effusion (‘white-out’) with mediastinal shift –> heart and trachea displaced to the right (right lung clear)

Question 10

Hx of asbestos exposure

Answer 10

mesothelioma –> pleural thickening with secondary pleural effusion (exudative)

Question 11

Answer 11

Pulmonary oedema

Question 12

Answer 12

Cardiomegaly

Question 13

Answer 13

Normal CXR –> go through full interp.

Question 14

Answer 14

Pulmonary fibrosis –> IPF

Question 15

Answer 15

‘honeycomb’ pattern –> IPF

Question 16

Answer 16

‘ground glass’ appearance –> ILD

Question 17

Answer 17

Calcified pleural plaques –> caused by asbestos

Question 18

Answer 18

‘signet ring sign’ –> bronchiectasis

Question 19

Answer 19

• Hyperinflation, flattened hemidiaphragm
  –> chronic COPD findings

Question 20

Answer 20

• Caseating lesion –> right middle lobe –> TB
• Dx –> small cell lung cancer

Question 21

Answer 21

Pulmonary oedema –> Kerley B lines, cardiomegaly

Question 22

Answer 22

Cannonball metastases