Chest X-ray OSCE 1

Answers to OSCE Questions

  • Question 1

Can you link the X-ray findings to the presenting signs and symptoms?

Shortness of breath - consolidation and loss of volume due to raised hemidiaphragm (see question 4)

Arm swelling - venous and/or lymphatic compression

Hand pain - brachial plexus invasion

Voice changes (see questions 2)

Eye abnormality (see questions 3)

  • Question 2

Can you explain the change in her voice?

Recurrent laryngeal nerve invasion

  • Question 3

What is the cause of the small pupil of the left eye?

Horner's syndrome - ptosis, miosis, enophthalmos, anhydrosis - due to interruption of the sympathetic supply to the eye

  • Question 4

Why is the left hemidiaphragm raised?

Phrenic nerve invasion/dysfunction

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