Scenario
An 11 year old female with Down’s syndrome presents with acute respiratory distress following a 3 day history of fever, rhinorrhoea and dry cough.
A CXR is performed following her intubation.
Question
Describe and interpret her CXR. (100%)
Answer
FACEM VAQ Exam 2006.1 – Question 5
- The overall pass rate for this question was 35/40 (87.5%).
- The CXR given shows extensive, bilateral pulmonary infiltrates
- It was expected that the candidates would be able to describe the CXR accurately and demonstrate that they are able to interpret the CXR in a systematic way, noting major positives and negatives,and including lung fields, cardiac size and borders, bone, diaphragms etc.
- It was also expected that the candidate could interpret the CXR sensibly in the clinical context (Down’s syndrome, dry cough) that was given, form a reasonable differential diagnosis, recognizing that the most likely diagnosis was infection, types of infection likely (both typical and atypical organisms), with other possibilities less likely.
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