Does not suggest large bowel obstruction as a possible diagnosis or is not able to offer any cause for obstruction
Does not know that an erect chest X-ray should be requested
Average candidate
Describes all X-ray features succinctly and accurately with a systematic approach and states that the large bowel is dilated, likely indicating obstruction
Before being asked suggests performing an erect chest X-ray in this context
Is aware of the common causes of large bowel obstruction
Good candidate
Succinctly describes the radiological features of large bowel obstruction, suggesting the descending colon as the level of disease
Notices the anastomosis artifact on the X-ray image
Without prompting offers a management plan of 'drip and suck' (IV fluids and naso-gastric tube insertion) in the context of general
resuscitation. (You are not asked directly about initial management in
this scenario, but good candidates will offer this information without
prompting.)
Suggests CT as a definitive radiological test and knows why this is likely to be helpful
Shows awareness of the precautions required prior to transferring the patient to the Radiology Department for a CT scan, and that monitoring
renal function will need to continue following the scan - assuming
intravenous contrast material is given
CT of the abdomen
Many medical schools now expect a basic understanding of CT imaging at medical finals level. If you are asked to look at a CT in your finals examination then you will likely only be asked about simple concepts and anatomy, and to show an awareness of the process of requesting a CT appropriately and safely
