Ospe for mbbs imagings

• Welcome you all Dear Students

• OSPE

• X- Rays

• Dr. Rajat SR Biswas, MD

• Resident Physician CMSOGH Chittagong, Bangladesh

OSPE- Total-10

• Scenario- 2-3• Pictorial- 2-3• X-rays - 1-2• ECG - 1-2• Instruments- 2-3• Charts- 0-1• Medical substances like bottle, IV fluids,

Injections, ORS etc- 0-1

Question: CXR-16

1. Mention radiological findings

2. What is the diagnosis?

3. Mention 2 non-invasive investigations to confirm presence of fluid

4. Write 3 most common causes of exudative PE

Question: CXR-12-15

• Mention radiological findings

• Write 5 common D/D

• What 5 important signs you will look for immediately?

• Which 3 investigations will you do on priority basis?

• What may be found in abdominal exam?

Answer:

1. Multiple miliary shadow involving all the zones of both lung fields

2. Miliary TB Sarcoidosis Pneumoconiosis Histoplasmosis P. Eosinophilia

3. Temperature Neck rigidity Kernig’s sign Level of consciousness Fundoscopy (choroidol tubercle)

4. Sputum for AFB CBC with ESR Blood sugar Hepato-splenomegaly

Question: CXR-16





Answer:

1. Homogenous opacity occupying left lower, mid & part of upper zone with upper Curvilinear margin Both costophrenic & cardiocphrenic angles are obliterated Patchy opacity present in right upper & lower zone

2. Left sided pleural effusion with PTB (R)

3. Left lateral decubitus view USG of chest

4. TB Malignancy Parapneumonic effusion Pulmonary infarction

Question: CXR-16





Answer:

1. Homogenous opacity occupying left lower, mid & part of upper zone with upper Curvilinear margin Both costophrenic & cardiocphrenic angles are obliterated Patchy opacity present in right upper & lower zone

2. Left sided pleural effusion with PTB (R)

3. Left lateral decubitus view USG of chest

4. TB Malignancy Parapneumonic effusion Pulmonary infarction

Question: CXR-9

1. Mention radiological findings?

2. What is the likely diagnosis?

3. Mention 5 causes of cavitary lesion

4. Write 5 indication of FOB

5. Indication of drainage

Answer:

1. A cavitary lesion in right mid & lower zone with air-fluid level

2.Right sided lung abscess

3. Lung abscess Cavitary malignancy Fungal infection W. granulomatosis TB

4. Failure of antibiotic therapy Mediastinal adenopathy Suspected malignancy Suspected Foreign body Atypical presentation

5. Size more than 4 cm Failure of medical treatment Airway obstruction if rapidly expanding in immunocompromised

Question: CXR-8


2. Two most common cause in this case

3. What single history may give you definite clue?

4. Causes of opaque hemithorax (write 5 causes)

Answer:

1. Radio-opaque shadow occupying whole of the left hemithorax Trachea shifted to left Left dome of diaphragm elevated

2. Foreign body Enlarged lymph node (TB)

3. H/O choking will indicate FB

4. Pleural effusion (massive) Massive consolidation Whole lung collapse Pneumonectomy Large mass Pleural thickening

Question: CXR-2



3. What is the most likely primary site?

4. Write 2 further investigations.

Answer:

1. Trachea & heart shifted to right Right hemithorax is opaque with obliteration of right costo & cardiophrenic angle & right dome of diaphragm. Multiple rounded opacity of variable size is present in all the zones of left lung field.

2. Collapsed right lung with multiple metastasis left lung.

3. Right lung

4. Sputum for malignant cell FOB

Question: CXR-3

1. Radiological findings

2. From which organs commonly it arises (mention 5)?

3. Mention 3 further investigations.

Answer:

1. (Multiple) (Rounded shadow) of (variable size) involving (all the zones) of (both lung fields)

2. Kidney Prostate Liver Bone Testes Thyroid Breast Ovary

3. USG/CT scan of abdomen CT scan of brain Whole body bone scan

Female

Question: CXR-2





Answer:

1. Trachea & heart shifted to right Right hemithorax is opaque with obliteration of right costo & cardiophrenic angle & right dome of diaphragm. Multiple rounded opacity of variable size is present in all the zones of left lung field.

2. Collapsed right lung with multiple metastasis left lung.

3. Right lung

4. Sputum for malignant cell FOB

Question: CXR-3

1. Radiological findings

2. From which organs commonly it arises (mention 5)?

3. Mention 3 further investigations.

Answer:

1. (Multiple) (Rounded shadow) of (variable size) involving (all the zones) of (both lung fields)

2. Kidney Prostate Liver Bone Testes Thyroid Breast Ovary

3. USG/CT scan of abdomen CT scan of brain Whole body bone scan

Female

Questions: CXR-1

1. What are the radiological findings?


3. Mention 3 further investigations

4. What clinical findings may be found in Eye Neck Hand

5. Name 4 syndrome the patient may develop

6. What will be the clinical findings in left lower chest

7. Mention 3 recent advances in investigation for early diagnosis in this case.

Answer:

1. A radio-opaque shadow in left upper zone - Destruction of 1st, 2nd and posterior end of 3rd rib on the left side. - Left dome of diaphragm elevated

2. Bronchial carcinoma

3. Sputum for malignant cell FOB CT guided FNAC

4. Eye = Features of Horner syndrome/ congestion of eyes. Neck = Cervical lymph node/Swollen neck/engorged vein (SVCO) Hand = Wasting/Sensory abnormality/Clubbing

Answer- cont’d.

5. Horner’s syndrome Pancoast syndrome Paraneoplastic Nephrotic syndrome Lambert – Eaton syndrome SIADH

6. ↓VF & ↓ VR dull percussion not ↓ breath sound

7. Fluorescence FOB Endoscopic ultrasound TTNB

Question: CXR-2





Ospe for mbbs imagings

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