Station - Instructions for candidate
You are an intern in the respiratory clinic of a Perth teaching hospital.
Margaret Dwyer, a 64-year-old retired school office manager, has been referred by her GP after two courses of antibiotics for a cough did not help. A chest X-ray showed a right upper zone opacity and a CT chest was arranged before this appointment. The CT report is on your sheet. The consultant has asked you to see Mrs Dwyer and go through the result with her; the consultant is available at the end of the clinic.
CT chest with contrast (report)
| Item | Value | Reference range |
|---|---|---|
| Report | There is a 3.5 cm spiculated soft tissue mass in the posterior segment of the right upper lobe, abutting but not clearly invading the pleura. An enlarged right hilar lymph node measures 1.8 cm in short axis. No mediastinal lymphadenopathy. No pleural effusion. Centrilobular emphysema. The imaged liver and adrenal glands are normal. Impression: spiculated right upper lobe mass with right hilar lymphadenopathy, highly suspicious for primary bronchogenic carcinoma. Tissue diagnosis and PET staging recommended. | n/a |
Reported by a consultant thoracic radiologist.
Your tasks are to:
- Take a brief focused history.
- Explain the CT result to Mrs Dwyer.
- Discuss your management plan with Mrs Dwyer.
- You do NOT need to examine the patient; the examination findings are available from the examiner on request.
This is a 15-minute station, with 2 minutes of reading time.