Station - Instructions for candidate
You are an intern in the general medical clinic of a Perth teaching hospital.
Priya Nair, a 31-year-old primary school teacher, has been referred urgently by her GP with two weeks of painful red lumps on her shins and swollen ankles. The GP arranged a chest X-ray because of a low-grade fever, and the report is on your sheet. The GP's letter says she is 'very anxious about the X-ray result'.
Chest X-ray report (PA and lateral, one week ago)
| Item | Value | Reference range |
|---|---|---|
| Report | There is bilateral, symmetrical enlargement of the hilar lymph nodes with a lobulated contour, and fullness of the right paratracheal stripe. The lung fields are clear with no nodules, reticulation or consolidation. Heart size is normal. No pleural effusion. No bony abnormality. Impression: bilateral hilar lymphadenopathy - clinical correlation recommended. | n/a |
Reported by a consultant radiologist.
Your tasks are to:
- Take a focused history.
- Interpret the chest X-ray report and explain what it shows to Ms Nair.
- Discuss your initial management plan with Ms Nair.
- You do NOT need to examine the patient; the examination findings are available from the examiner on request.
This is a 10-minute station, with 2 minutes of reading time.