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Radiography

Read the following information.

Free OET Writing Sample Test with Answer Subtest Radiography #5

Notes: Chest X-Ray for Persistent Cough

Case Notes:

  • Patient: Mrs. Linda Hughes, 56 yrs, retired teacher

  • Referral source: GP

  • Presenting issues: Persistent dry cough for 6–7 weeks, unexplained weight loss (~5 kg), intermittent night sweats

  • Associated symptoms: Occasional breathlessness on exertion, denies hemoptysis

  • Medical history: Mild asthma, controlled with inhaler; no previous lung infections; no known TB exposure

  • Smoking history: 25 pack years, quit 3 yrs ago

  • Family history: Father deceased (lung cancer, age 68)

  • Physical exam: Mild expiratory wheeze, finger clubbing, no lymphadenopathy

  • Request: Chest X-ray to investigate persistent cough and exclude underlying pathology (infection, malignancy, TB)

To: Dr. Evans (General Practitioner)
Date: 13 September 2025

Dear Dr. Evans,

I am writing to report the chest X-ray findings for your patient, Mrs. Linda Hughes, a 56-year-old retired teacher with a persistent cough, weight loss, and night sweats.

The radiographs demonstrate a right upper lobe opacity with irregular margins, associated hilar prominence, and mild hyperinflation. No cavitations or pleural effusion are observed. The cardiac silhouette and mediastinum are regular.

Clinically, she reports a cough lasting more than six weeks, unexplained weight loss, and intermittent night sweats. Her past medical history includes mild asthma, and she has a significant smoking history of 25 pack years, though she quit three years ago. Clubbing of the fingers was noted on examination.

Given her history and the radiographic appearance, an underlying malignancy or chronic pulmonary infection such as tuberculosis should be considered. I recommend CT thorax and referral to respiratory medicine for further evaluation.

Yours sincerely,
[Radiographer’s Name]

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