OSCE 2

Chest X-rays.

Candidates were asked to describe the X-ray findings, list possible aetiologies, and suggest relevant further investigations or treatment.

Introductory questions included:

"Identify causes of respiratory inadequacy which are revealed on the initial Chest X-ray and outline appropriate treatments for these conditions"

"This is the Chest X-ray of a man who suddenly developed rapid AF and pleuritic chest pain which was proceeded by a 2-hour history of severe nausea and vomiting. What abnormalities are revealed on his Chest X-ray?"

"This is the Chest X-ray of a patient who was the subject of a Medical Emergency Team (MET) call due to hypoxia. He had his jaw wired 24 hours earlier for a major comminuted mandibular fracture. Describe the abnormalities on this Chest X-ray, and list the possible causes of the abnormalities."

Examples included tension pneumothorax, gastric dilatation, lobar collapse and oesoghageal rupture.

Seventeen out of twenty-two candidates passed this station.

Disclaimer: the viva stem above may be an original CICM stem, acquired from their publicly available past papers. Or, perhaps it is a slightly altered version of the original CICM stem. Or, it is a completely original viva stem, concocted by the monstrously amoral author of Deranged Physiology for nothing more than his own personal amusement. In either case, because the college do not make the main viva text or marking criteria available, almost everything here has been confabulated. It might sound like a plausible viva and it could be used for the purpose of practice, but all should be aware that it does not represent the "true" canonical CICM viva station.