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Radiology StationOSCE

This is the chest X-ray of a 63 year old male MR JP (1/5/12) who presents with a three month history of exertional breathlessness. On examination he is noted to have finger clubbing, a pulse of 82 bpm, a blood pressure of 128/90 mmHg and his JVP is not seen. He appears to have central cyanosis and had bibasal crackles on auscultation of his chest.

Please present his x-ray to the examiner, and answer any questions.