MRCP Part 1
MRCP Part 2 Written
MRCPI Part 2 Written
Specialty Certificate Examination in Endocrinology and Diabetes
Specialty Certificate Examination in Gastroenterology
GP ST Stage 2 Knowledge Test
Medical Student Finals
Situational Judgement Test
Medical Student Finals Modular
Medical Student Years 2 to 3
Medical Student Year 1
Medical Student Fresher
MRCPCH Foundation of Practice and Theory and Science of Practice
MRCPCH Theory and Science of Practice
MRCPCH Part 2
MRCPCH Foundation of Practice
Obs and Gynae
MRCOG Part 1
MRCOG Part 2
MRCS Part A Papers 1 and 2
FRCS General Surgery
FRCS Trauma and Orthopaedic Surgery
A 69-year-old retired miner was referred to the outpatient
clinic with a two month history of persistent non-productive cough.
He also complained of exertional dyspnoea and left sided chest
His appetite had been poor for the preceeding four months and he
had lost over one stone in weight. He had retired aged 45 years
after working underground for over thirty years. He lived with his
wife, drank 10 units of alcohol per week and was an ex-smoker of
forty cigarettes a day.
On examination he was apyrexial. Pulse regular at 90 beats per
minute, blood pressure 135/75 mmHg. There was no finger clubbing.
Chest expansion was reduced on the left with dullness to percussion
and diminished breath sounds at the left base and mid-zone. A chest
radiograph showed bilateral calcified pleural plaques and a large
left pleural effusion.
Which investigation is most likely to yield a diagnosis?
(Please select 1 option)