The Bottom Line
- Speed comes from scripts: the same order, every time, under time pressure.
- Build a small pattern library and drill it weekly (not ‘random exposure’).
- Label errors so you fix the cluster (not the individual question).
Interpretation questions feel hard because candidates ‘scan’ and improvise. The solution is to run a fixed script that catches the common patterns and prevents misses. Once your brain trusts the script, you get faster and calmer — which produces better answers.
1
ABG: the 60-second script
1) Oxygenation: PaO2/SaO2 (context: FiO2). 2) pH: acidemia/alkalemia. 3) Primary driver: PaCO2 vs HCO3/BE. 4) Compensation: appropriate or mixed disorder? 5) Anion gap / delta thinking if metabolic issue suspected. 6) One-line clinical meaning + next step (e.g., ventilatory failure → escalate).
2
CXR: the 90-second script
1) Quality: rotation, inspiration, exposure. 2) A/B/C: Airway, Breathing (lungs/pleura), Circulation (heart/mediastinum). 3) Diaphragm (free air, effusions). 4) Everything else: bones, soft tissues, devices/lines. 5) One-line summary + ‘so what’ action.
3
The drill (10 per week, sustainable)
Every week: 5 ABGs + 5 CXRs. For each: run the script out loud, commit to a one-line diagnosis and next step, then check the explanation. Capture the error label. Re-test your common error label set 48 hours later.
Error labels (use these so you can fix the cluster)
1
2
3
4
5
Why scripts win
Under time pressure, your working memory is the bottleneck. A fixed script reduces cognitive load and makes your thinking predictable — which is exactly what exams reward.
Practice
Test your knowledge
Apply this concept immediately with a high-yield question block from the iatroX Q-Bank.
SourceABGs made easy: stepwise method (open access, PMC)
Open Link SourceBlood gas interpretation: structured five-step approach (open access, PMC)
Open Link SourceAmerican Thoracic Society: ABG interpretation (six-step process)
Open Link SourceNCBI Bookshelf: a systematic approach to chest radiographic analysis
Open Link SourcePatient.info (Doctor): systematic chest X-ray approach
Open Link