Explaining a chest X-ray result
PLAB 2 practice station

The task

You are a GP. Mr Ewan Gallagher, aged 59, saw you three days ago with a cough, fever and a sore chest. You arranged a chest X-ray and blood tests. He has come back for the results, which you have in front of you. Explain the results to him, discuss what they mean and what should happen next, and answer his questions. The examiner will give you any results you ask for. The examiner will not take part in the conversation.

What this station tests

• Ask what the patient already thinks and fears before giving results.
• Use a warning shot, plain language and pauses; avoid jargon and false reassurance.
• In general practice assess severity with CRB65, together with clinical judgement, before deciding where the patient is treated.
• Arrange a chest X-ray after about six weeks for patients with persisting symptoms or a higher risk of cancer, especially smokers and people over 50.
• Safety-net specifically, and use the illness as a teachable moment for smoking cessation.

Sources for the clinical content

• NICE NG250: Pneumonia: diagnosis and management
• BTS Guidelines for the management of community acquired pneumonia in adults
• NICE NG209: Tobacco: preventing uptake, promoting quitting and treating dependence

An original practice scenario with invented patients. Not an exam question.

Practise next

• Starting a statin to lower heart disease risk
• Helping a smoker who wants to stop
• Choosing contraception when pills are forgotten
• Diet advice after a diabetes diagnosis
• Alcohol advice after raised liver blood tests