Posted by MY on April 26, 2001 at 12:34:20:
Questions from April 2001 PLAB Part 1 Exam
Theme 1 Differential Diagnosis of Depression.
Options
a. General Anxiety
b. O.C.D
c. Panic Attacks
d. Schizophenia
e. Agarophobia
f. PTSD
Questions
1. Male patient suddenly stops while talking and says “somebody is removing thoughts from my mind.”
2. 50 year old male, has just returned to the UK. His family was killed in an accident in the USA, He feels he cannot cope.
3. Male patient has the habit of repeatedly checking doors, to see if they are locked.
4. Woman scared to go out, When she takes two steps outside , she comes back sweating and has to take tablets to relive anxiety
5. Female patient gets scared suddenly with no precipitating factor, and starts hyperventilating.
Theme 2 Contraceptive Choice
Options
a. Progesterone Only pill (POP)
b. Combined Oral Pill (COC)
c. Norplant
d. Tubal Ligation
e. Diaphragm
f. Condom with cap
Questions
6. 22 year old Female, has a steady relationship, non smoker
7. 22 year old Female, heavy smoker with a familial history of Thromboembolism , involved in a steady relationship asks for contraceptive advise
8. 21 year old Female, suffering from slight Mental Retardation, stays far off in a rural area
9. 22 year old Female, 6 weeks post partum has developed menorrhagia and comes to you for contraceptive advice
10. 27 year old Female, involved in a relationship with a HIV positive partner.
Theme 3 Mechanism of Action of Drugs.
a.Amoxycillin
b.Clomiphene Citrate
c.Salbutamol
d.Trimethoprim
e.Doxazocin
f .Doxapram
Questions.
11. This has an agonist action on B2 Adreno receptors.
12. This is used as a respiratory stimulant
13. This acts on the cell wall of ?fungi
14. This drug is used for the induction of ovulation.
Theme 4 Fluid Resuscitation
Options
a. Don’t do anything
b. I.V. saline 0.9%
c. I.V. saline 9%
d. I.V. Dextrose 5%
e. Water to sip
f. ORS 90 Na meq
g. ORS 150 meq of Na
Questions
15. 24 month old child, brought with a history of having been accidentally locked up in a car for about 3 hours. On examination in the A&E child is crying but his vitals are stable. What is the next step.
16. Female from Ghana, brought to the A&E with a history of nausea and vomitting, On investigations Ketone 1+, Na 148meq, Glucose 18mmol/ltr.
17. Mother comes to the A&E with her child of 3yrs, history of D&V. On examination the child appears mildly dehydrated.
18. Boy has been brought to the A&E following a traffic accident. He has suffered from moderate blood loss. What is the most optimum method of fluid resuscitation.
Theme 5 Investigation of Unconsciousness
Options
a. CT scan
b. MRI scan
c. Blood Glucose
d. Toxicology Screen
e. Xray Skull
f. U&E
g. Blood Alcohol
Questions
19. 21 year old Female found unconsciousness next to her 22 year old husband, who was found dead. Her ECG shows evidence of Acute MI
20. 42 year old Female, previously normal, was suddenly found unconscious. Brought to the A&E shows respiratory depression, dilated fxed pupils and extensor plantar response
21. 21 year old rugby player, had suffered from an episode of brief unconsciousness. Comes to the A&E the next day with paresthesias of the left arm.
Theme 6 Treatment of Tesitcular Swelling
Options
a. Herniotomy
b. Surgical Exploration
c. Reassurance
d. Tumour Markers
e. Orchidectomy
f. Orchidopexy
g. Surgical Aspiration
h. CT
i. MRI
Questions
22. 10 year old male brought to the A&E with bilateral swelling of the scrotum, He was treated 1 wk ago for swelling of the face
23. 24 hr baby brought with swelling of the scrotum, one sided non painful
24. Cyclist comes to the A&E complaining of severe sudden pain on one side of the scrotum, o/e the testes is elevated
25. 72 year old man, was recently tapped for unilateral hydrocoele, has now come with recurrence within one week
26. A 21 year old male, with a painful small blue swelling, This appears separate from the testes.
Theme 7 Diagnosis of Breast Lump
Options
a. Carcinoma
b. Fibroadenoma
c. Cyst
d. ANDI
e. Breast Abscess
f. Pagets disease
g. Cystosarcoma Phyllodes
Questions
27. 72 year old lady, comes with a complaint of unilateral mass, hard, in the Rt upper quadrant, with axillary nodes enlarged and fixed
28. 21 year old lady comes with a firm mass in the lower quadrant. This mass is mobile, no axillary nodes are palpable
29. 58 year old woman, comes with excoriation of skin of the nipple, with bloody discharge
30. 52 year old patient comes with a history of a bloody discharge from the nipple on squeezing
31. Post partum patient, with a unilateral localised swelling, accompanied by tenderness and rise in temperature.
Theme 8 Diagnosis of Anaemia
Options
a. Sickle cell disease
b. Hb S trait
c. Anemia of Chronic disease
d. Iron Def. An
e. B Thallesemia Major
f. B Thallesmia Minor
g. AIHA
h. Aplastic Anemia
i. Pernicious Anemia
Questions
32. A 60 yr old Female patient, with destructive arthropathy, currently on NSAIDS, Faecal occult blood tests are negative. Examination also shows subcutaneous nodules.
33. A 30 year old Female with menorrhagia since 2 years complains of tiredness and lethargy
34. A 14 year male of Jamaican origin, complains of periodic bone pain and abdominal pain. He is feverish, and has a chest infection
35. Male patient brought with history of repeated infections, easy bruising and epistaxis. He looks pale.
36. A middle aged lady with a history of treatment for thyroid dysfunction, with a history of sore tongue since few months, examination also shows angular stomatitis.
Theme 9 Substance Abuse
Options
a. Digoxin
b. PCT
c. Turpentine
d. Organophosphorus compounds
e. Opiods
f. Paraquat
Questions
37. 10 year old boy staying with his grandmother, was brought unconsciousness. ECG shows a heart block.
38. 15 year old male, brought with history of consumption of unknown substance. Investigaton reveals, increased K+, decreased Na, decreased PaCo2 and PaO2
39. 8 year old, brought to the A&E , Examination reveals hyperthermia, hyperglycemia, dilated pupils and profuse sweating.
40. Boy brought with Vomitting and has Jaundice, Serum AST levels were 1900 IU/ltr
Theme 10 Non Accidental Injury ( Child Abuse)
Options
a. Refer to child care centre
b. Coagulation Screen
c. Improve nutritional status
d. Continue regular child health
e. Complain to the police
f. Send to Juvenile home
g. UTI
Questions
41. 8 year old female child, brought with fractured femur. No evidence of trauma is detected. Child is crying
42. Teacher comes to the A&E with a child. There is a bruise on the hand., where the child’s mother is supposed to have caught her to prevent her from running
43. 3 year old child, of unemployed parents, Examination reveals no development in physical standards from last check up.
44. 1 week old baby, delivered at 26 weeks of gestation, weighing 1.5 kg, delivered via Breech Delivery.
45. 3 year old Female child, brought with Bleeding P/V. O/E her vagina is sore and itchy and shows excoriations.
Theme 11 Prevention of Fever with Rash
Options
a. Destroy all soft toys
b. Check pets for fleas
c. Rifampicin to the patient
d. Rifampicin to the contacts
e. 5% permethrin for all in the family
f. Do nothing
Questions
46. A three yr old child , presented to the A&E with fever and rash. On examination was found to have neck stiffness and was febrile.
47. A eight year old child complains of an itchy rash. Skin examination reveals burrows between the fingers, of the hand.
48. A 12 year old boy, gives a history of wheals on the legs which come and go, These have responded to anti – histaminic medications
49. A 6 yr old boy complains of intense itching on the lower limbs, with scab formation.
Theme 12 Management of childhood asthma
Options
a. Sodium Chromoglicate
b. Steroids
c. Avoid Allergens
d. Advice to stop Smoking
e. Beta 2 Agonists (long Acting)
50. A 6 year old presents with C/O Recurrent bouts of Asthma. Both the parents are smokers.
51. A 15 year old boy presents with H/O recurrent acute exacerbations of Asthma on doing exercise.
52. A 5 year old female child, presents with C/O Acute attacks of Asthma. Her brother rears Rabbits during holidays.
53. A 16 year old Asthmatic patient presents with C/O of breathlessness especially during nights and not controlled by 2 doses Salbutamol .
Theme 13 Drug Abuse
Options
a. Inform Police
b. Advise Self-help group
c. Advice how to decrease harm
d. Inform Narcotics and Drug abuse Center
e. Psychiatric Referral
f. Start on Naloxone
g. Wait and Watch
54. A 25 year old Female, who was addicted to heroin, has now left the habit, but her male partner is forcing her to use the same.
55. A 23 year old Female on heroin, is now pregnant. Concerned about the effects on her foetus.
56. 23 year old married female has left the heroin habit, Husband also wants to leave the drug abuse but not immediately, The wife has come to you for advise.
57. A 24 year old male patient comes to you with some minor complaint, you notice injection marks on his forearm. What do you do.?
Theme 14 Treatment of Suicidal Tendencies
Options
a. N Acetyl Cysteine
b. Urgent Psychiatric Admission
c. Referral to Psychiatric OPD
d. Contact GP
e. Give ECT
f. Haloperidol
g. Counselling
Questions
58. Female patient with history of consumption of about 40 tablets of Paracetamol, has now come to the A&E after 12 hrs of consumption
59. 25 year old Female patient comes to the A&E saying that she is an addict and says that she has counsumed tablets prescribed by her GP. The moment you go to call the Registrar she has disappeared
60. A 23 year old Female patient is seen in the A&E with cuts on her hand, says that she had an argument with her boyfriend.
61. An elderly male comes to the A&E with thoughts of suicide, and feels that his wife and children would be better off without him.
Theme 15 Diffrential diagnosis of Abdominal Pain.
Options
a. Ectopic Pregnancy
b. Chronic Pancreatitis
c. Ac. Pancreatitis
d. Ac. Cholecystitis
e. Duodenal Ulcer
f. Ca. Pancreas
g. Ruptured Spleen
Questions
62. A 62 year old male alcoholic, comes with complaints of weight loss, pale stools, and of abdominal pain radiating to the back.
63. A 35 year old male patient, presents with abdominal pain more in the epigastric region, On history taking he mentions hunger pains at night.
64. 22 year old Female, has presented to the A&E with severe pain in the left iliac fossa, accompanied by nausea and vomitting
65. 35 year male patient is brought to the A&E with a history of a blow to the abdomen, following which he has developed pain abdomen. On examination his BP has fallen and he is tacycardiac.
Theme 16 Investigative modalities in Acute Abdomen.
Options
a. Emergency Laparotomy
b. Laparascopy with Biopsy
c. Urgent Fluids/Blood
d. CT Scan
e. MRI Scan
f. Peritoneal Dialysis
g. Angiography
h. Full Blood Count
Questions
66. A 60 year old male patient, with a previous history of pain in calves and decreased pulses in the leg, has suddenly developed pain the back and BP decreased with Increased pulse rate
67. 24 year male, has recently finished his exams, and had been partying with friends, now presents with complaints of vomitting blood and malena.
68. 66 year old male, gives history of chronic blood loss PR, and decreased weight, he complains of increased acidity.
Theme 17 Endocrine Abnormalities.
Options
a. Adrenaline
b. Cortisol
c. Desmopressin
d. TSH
e. T4 levels
f. TRH estimation
Questions
69. 32 year old Female, has presented to the OPD, she has a moon face and striae marks on the trunk
70. A 42 year old Male, has come with complaints of palpitations and sweating. On examination he is found to be hypertensive.
71. A 22 year old female patient was seen, with a history of polyuria and a feeling of increased thirst, however no glycosuria was seen and blood glucose levels were normal.
72. A 32 year old female, with complaints of palpitations, increased sweating, and cannot tolerate warmth. Her BP is found to be normal.
Theme 18 DD of Falls (loss of consciousness)
Options
a. Blood glucose
b. CT Scan
c. MRI scan skull
d. Blood Cortisol levels
e. BP test
f. Tilt test
g. Caloric Test
h. Standing and Supine BP
Questions
73. Elderly female patient found unconscious. Has a bag containing Gliclazide, Metformin and paracetamol tablets.
74. A 43 year old female patient, was brought unconscious. On pupillary examination the right pupil appears dilated and fixed
75. A 55 year old lady complains of increased dizziness on getting up from bed. She also falls down especially in the early morning hours.
76. A 50 year old male, comes with complaints of giddiness and vertigo. He says that the surrondings are spinning around him. On examination nystagmus is seen.
77. A 35 year old Female, patient complains of giddiness manifesting on moving her head.
Theme 19 Treament of Confusion
Options
a. Discuss with GP
b. Haloperidol
c. CT scan
d. MRI scan
e. Neurology referral
f. Blood Glucose
g. U&E
Questions
78. Man found wandering aimlessly, brought to the A&E by neighbours, who inform that his GP had called on him yesterday.
79. A 57 year old male comes to the A&E with his daughter, in a confused state. The daughter said that her father was started on some medication by his GP, but he still suffers from the same symptoms
Theme 20 Drug Therapy in Ear Pain
Options
a. Amoxicillin Oral
b. Amoxicillin I.V
c. Cefotaxime I.V
d. Paracetamol
e. Gentamicin I.V
f. Supportive Tx only
Questions
80. A 24 hour old female infant, is brought to the A&E with incessant crying. On Examination an inflamed ear drum is noted.
81. A 12 year old boy, complains of ear pain, following an air journey. On examination the drum is not inflamed, but fluid is noted in the middle ear
82. 3 year old boy is brought to the A&E with a history of tugging at his ear, A red inflamed drum with fluid is noted
83. A 3 year old girl, who appears very toxic, with a history of nausea and vomitting. Typmanic membrane appears read and inflamed with fluid behind it.
Theme 22 Care of terminally ill
Options
a. Decrease Opiods
b. Increase Opiods
c. Use syringe driver
d. Palliative Radiotherapy
e. Aledronate
f. Methoperazine
g. Start O2 therapy
Questions
84. A 72 year old male patient suffering from terminal multiple myeloma, is being treated for bone pain with high doses of opiods, now complains of increasing constipation
85. A 75 year old patient was started on low dose opiod therapy with naloxone for control of pain. The patient still feels that the pain is unbearable.
86. A 66 year old female patient with Ca Breast having multiple metastases, is on palliative care. She develops severe nausea and vomitting. Lab tests ordered show an increased Serum Calcium level
87. A 80 year old male patient, under treatment for Ca prostrate, is noted to have increasing pelvic infiltration. And he now complains of pain.
88. A 70 year old male patient, under treatment is noted to have breathlessness. He is noted to have compromised respiratory function.
Theme 22 Differential Diagnosis of Dementia
Options
a. Chronic Alcoholic Dementia
b. Alzheimers Disease
c. Senile Dementia
d. Multi infarct Dementia
e. AIDS dementia
f. Huntington’s disease
g. Lewy Body Dementia
h. Picks disease
i. Wernicke’s encephalopathy
Questions
89. A 50 year old Male patinet, suffering from Dementia , with a family history of Dementia proceeding to early death
90. A progressive dementia leading onto death within 10 years
91. Dementia developed all of a sudden with quick progression and death resulting in less than 5 years
92. Dementia with loss of recent memory, but old memory is preserved with remembrance of dates.
Theme 23 DD for Joint Disease
Options
a. Ankylosing Spondylitis
b. Gout
c. Pseudogout
d. SLE
e. Sceleroderma
f. Rheumatoid Arthritis
g. Rheumatic Heart Disease
Questions
93. This condition is more commonly seen in Males than in Females, in the age group of 20- 30 years, and becomes better as age progresses.
94. This leads to crippling arthropathy
95. Shows symmetrical involvement, with a female preponderance. There appears destruction of the joints, and is associated with eye problems.
Theme 24 DD of Sudden loss of vision
Options
a. Retinal Detachement
b. CRAO
c. Cerebral Embolism
d. Cerebral Haemorrhage
e. Temporal Arteritis
f. Chr. Glaucoma
g. Cataract
Questions
96. An 85 year old lady, presents with a history of sudden loss of vision in both eyes. On visual field examination a homonymous heminanopia is noted
97. A 65 yr old male, comes with a history of sudden loss of vision in the right eye, painless. On examination the fundus appears pale, Pt is a chronic smoker
98. A 75 year old male, has noticed pain in the scalp while combing. He is otherwise symptom free and has now come with a recent history of loss of vision in the Rt. Eye
99. A 52 year old Diabetic with coexisting hypertension, complains of painless loss of vision, and describes it as a ‘curtain coming down’
100. A 33 year old young man, gives a recurrent history of red painful eye mainly at night, and this is associated with decreased vision.
Theme 25 Immunisation
Options
a. Omit Pertusis/HiB/ Measles
b. Continue as per schedule
c. Delay the vaccines
d. Don’t give any vaccines
e. Give Inactivated vaccines.
Questions
101. Child of HIV +ve patients, also serum HIV+ve
102. After taking DPT, Measles, and Hib, baby cried
103. Baby is scheduled for immunisation. Febrile and is noted to be suffering from Otitis media.
104. Male baby, is noted to have allergy to Egg Protein, and familial history of allergy is also known.
Theme 26 DD of chest pain
Options
a. Tension Pneumothorax
b. Spontaneous Pneumothorax
c. Hiatus Hernia
d. Acute MI
e. Reflux Oesophagitis
f. Aortic Dissection
g. Hiatus Hernia
Questions
105. A middle aged female, has presented with sharp central chest pain and breathlessness, has a recent history of air travel. CXR and ECG appear normal
106. A 45 year old male patient with a sudden onset of chest pain radiating to the arm and the inner aspect of the shoulder. Pain lasted for about 2 hours. ECG appears normal.
107. A tall thin young male, has presented to the A&E with sudden onset of breathlessness and chest pain. This was brought upon following cycling.
Theme 27 DD of Jaundice
Options
a. Hepatitis A
b. Ca. Liver
c. Ca. Pancreas
d. Biliary Atresia
e. Galactosemia
f. Breast Milk Jaundice
g. Rh Incompatiblity
Questions
108. A 8 year old boy has presented with pain abdomen and Jaundice, is febrile.
109. A 60 year old male patinet, has come to the A&E with history of abdominal pain radiating to the back, associated with jaundice. On further questioning he mentions that he has noted pale stools.
110. A 1 day old male baby presenting with jaundice.
111. An 18 day old baby boy, who has gained 300 gms since birth, has no other problems, but examination shows jaundice and pale stools
112. A 10 day old baby, has shown no wt. Gain since birth, and has jaundice associated with clay colored stools.
Theme 28 Investigations in UTI
Options
a. Mid Stream Urine
b. Urethral Culture
c. Cathether Culture
d. Suprapubic Aspiration
e. Urine C&S
Questions
113. A 11/2 year old girl, was brought with complaints of dysuria. Culture of urine revealed mixed bacteria.
114. A 65 year old female invalid, confined to the bed, had been cathetrised. She now complains of dysuria
115. A 60 year old male patient, had been cathetrised. A few days later he complains of pain in the suprapubic region. Haematuria is noted.
Theme 29 Antibiotic Prophylaxis for surgical pt.
Options
a. Dental procedure for RHD pt.
b. Bronchoscopy
c. Angiography
d. Splenectomy
e. Thyroidectomy
f. Gut surgery.
g. Emergency Appendicectomy
h. Sigmoidectomy
Questions
116. 3 days of BSA i.v, starting in the O.T., with the induction of anaesthesia
117. 3 gram satchet of Amoxicillin oral, 1 hr. before surgical procedure
118. Long acting Benzathaine Pen. And pnuemovax II immunisation
119. Metronidazole i.v, during the induction of anestheia
120. Stop solids, fluids orally. 2 tablets of sod. Picosulfate, and I.V. BSA during anesthesia.
Theme 30 Management of Trauma
Options
a. Urgent blood transfusion
b. Chest Strapping
c. Do nothing
d. FBC next morning
e. Urgent Endoscopy
f. CXR
g. Abdominal US.
h. Analgesis
Questions
121. A 22 year old male, was involved in an automobile accident, complains of chest pain. Multiple injuries noted on the chest, CXR reveals fracture of many ribs, otherwise normal. The patient was wearing his seat belt
122. A 21 year old male patient, has had an alcholic binge of about 10 pints in the evening, has now come to the A&E in the late evening with complains of a small amount of haematemeis.
123. A 40 year old male, was involved in a brawl, and had been kicked in the chest. He comes the next day to the A&E and a single rib fracture is noted
124. An 18 year old male, was brought to the A&E after a RTA. He was breathless and pale. On examination his BP was 50/00 mm of Hg, Pulse – 116/min, and CVP was 2 mm H20.
Theme 31 Prenatal Diagnosis
Options(not obtained)
125. A 42 yr old mother with a previous child suffering form Down’s syndrome, is now 6 weeks pregnant. She wants to know at the earliest if the foetus is suffering from Downs, so that she may consdier MTP.
126. A 32 year old mother, with a prior child afflicted by Down’s syndrome with VSD and wants to know if she has conceived another Down’s baby.
127. Rh+ve father and Rh-ve mother, Which modality will help in finding signs of Foetal distress.
Theme 32 DD of Arrythmias
Options
a. Sinus Rhythm
b. SVT
c. Atrial Flutter
d. Atrial Fibrillation
e. Ventricular Tachycardia
Questions
128. A 35 year old female, is perfectly well, but complains of occasional missed beats. No other symptoms or signs are noted
129. A 50 year old male, admitted for fracture ankle, complains of sudden onset of palpitations
130. A 54 year old male, was admitted for Acute MI, and had sudden onset of palpitations and breathlessness.
131. A 58 yr old male, presents to the A&E with a history of episodic palpitations accompanied by syncopal atttacks.
Theme 33 Management of Heart Failure
Options
a. ACE inhibtors
b. Loop diuretics
c. Thiazide diuretics
d. Digoxin
e. Amiloride
Questions
132. A young female patient , presents with breathlessness, and a history of sudden deaths in the family. Examination shows signs of Bilateral Heart Failure
133. A 66 year old Female, has recently been diagnosed as hypertensive., no family history is suggestive. Examinaton reveals Rt.sided heart failure
134. ?? Defnitive therapy in cases of Left sided Heart Failure.