Chest X-ray interpretation 1

Interpret a chest X-ray of an acutely unwell patient

Candidate Instructions 🧒

You are the FY1 working in A&E.

Your consultant asks you to explain the CXR which you have just been handed.

Please answer all of the questions which he has for you.

Patient details:
Name: Mr John Kingston
DOB: DD/MM/YYYY
Age: 20
Basic info: clinically stable, no relevant medical history, non-smoker

Recommended time: 5 minutes


Station Material (ONLY OPEN WHEN PROMPTED)

Media 1

Actor Instructions 🤒

Please open Media 1 (candidate instructions - station material - media 1)

Question 1: What does the CXR show?

Question 2: Describe 3 symptoms which the patient may present with?

Question 3: Describe the specifics of the procedure required to treat this patient?

  • Rim of air is > 2 cm

Question 4: Fine-needle aspiration is unsuccessful, what would you do next?

Question 5: What discharge advice should the patient be told?

Mark Scheme ✍️

Questions

What does the CXR show?

Pneumothorax
Primary occurrence
Right sided
all-markschemes.questions

Describe 3 symptoms/signs which the patient may present with?

Chest pain
Hypoxia
Shortness of breath
Ipsilaterally reduced breath sounds
Ipsilateral hyper-resonance on percussion
all-markschemes.questions

Describe the specifics of the procedure required to treat this patient?

Ipsilateral side to PTX
16-18G cannula
2nd intercostal space
Mid-clavicular line
Directly above rib
all-markschemes.questions

Percutaneous aspiration is unsuccessful, what would you do next?

Chest drain
Insertion into safe-triangle
all-markschemes.questions

What discharge advice should the patient be told?

Avoid smoking (life-long)
Avoid diving/high altitude climbing (life-long)
Avoid flying until cleared to do so
all-markschemes.questions

Convert your points into a realistic exam mark

10:00
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Diagnostic expert
Listen to murmurs, interpret CXRs and read ECGs. Integrated media to help you become a diagnostic expert.