Allow yourself ONE MINUTE to consider the following clinical information. After this time click the Next button to show the OSCE scenario image.
Mrs Smith is a 67 year old life long smoker.
She presents to the medical outpatients clinic complaining of pain and swelling in her left arm, and increasing breathlessness on climbing the stairs. She has also recently noticed a 'gravelly' quality to her voice.
On examination her GP had noticed a small pupil in the left eye, and referred her for a chest X-ray which you will see on the next page.
The scenario involves presentation of a chest X-ray. You will be expected to link the radiological findings to the clinical features.