Posted by hemant on June 20, 2001 at 04:58:27:
May 2001 Plab Exam Questions
themes
1. the diagnosis of non-accidental injuiry
2. the treatment of visual impairment
3. The treatment of septicemia
4. the diagnosis of neurological complaints
5. pain relief
6. complications of blood dyscrasias
7. the Diferential diagnosis of ectopic pregnancy
8. the management of an injuired patient
9. the differential diagnosis of hypertension
10. the investigation of hoarseness
11. The DDX of developmental delay
12. the management of coma
13. The management of depression
14. The investigation of hemoptysis
15. the diagnosis of shock
16. the management of head injuiry
17. Stroke ? investigation ? causes
18. the preventionof jaundice/hepatitis
19. the management of earache
20. the types of skin cancer
2. 21. DDX fever and rash
22. causes of pneumonia
23. differential diagnosis of rectal lesions
24. investigation of joint pain
25. diagnosis of central chest pain
26. management of miscarriage
27. the disease process in asthma
28. management of meningitis
29. prevention of infectious diseases
30. investigation of acute abdomen
31. tests in diabetes
32. treatment of anxiety dosorders
33. diagnosis of vaginal discharge
34. treatment of limb ischemia
35. interpretation of hematology tests in anemia
36. alcohol and drug abuse - causes
37. causes of urinary incontinence
38. daignosis of dementia
39. pharmaceutical management in renal failure
40. diagnosis of dysphagia
41. management of heart failure
42. investigation of hematuria
43. cervical carcinoma - age groups
Questions
1. the diagnosis of non-accidental injuiry
options
a) accidental injuiry
b) emotinal abuse
c) physical abuse
d) sexual abuse
e) child neglect
f) osteogenesis imperfecta
g) ITP
h-normally present in a child.
1. A 6 month old is brought to the emergency department witha scald on the arm. he is noted to have a severe nappy rash. it is found that the baby has lost weight in the previous2 months
2. An 8 year old boy is brought to the emergency department with bruising over both legs. he is noted to have a history of epistaxis.
3. A 3 month child is brought to casualty with a thigh swelling. An xray reveals a spiral fracture of the femur with no sinificant callus formation.
4. A 4 day old girl is brought to casualty by the maternal grandparent who is worried about two dark bluish patches on the child's buttocks. the Child's mother is white and the father is black.
5. An 8 year old girl is noted to have fresh bloody staining of her pants. She also suffers from eneuresis. she has recently started horse-riding lessons
the treatment of visual impairment
Options
a) intrao-ocular steroids
b) intravenous steroids
c) oral steroids
d) laser treatment
e) no treatment required
1. A 73 year old complains of a severe right sided headache associated with an acute loss of right sided
vision. Urgent treatment is needed to prevent left sided vision loss
2. A 75 year old has difficulty watching television complaining of a peripheral constriction of vision. On examination there is cupping of both optical discs
3. A 50 year old with a history of SLE complains of loss of vision. On examination he is found to have multiple opacities in the lens of his eyes
4. A diabetic on oral hypoglycemics complains of sudden deterioration in vision of his right eye. On examination he is found to have bilateral proliferative retinopathy with retinal hemorrahge on the right side
5. An 80 year old has markedly decreased visual acuity. On fundoscopy she is found to have bilateral macular pigmentation
The treatment of septicemia
Options
a) percutaneous drainage
b) ventilatory support
c) stent
d) acyclovir
e) open surgical debridement
f) resection of superficial tissue with wide margin
1. A 60 year old with a history of perforated gall bladder develops sudden shortness of breath. her pO2 falls to 6kPa
2. a 22 year old with recent chickenpox develops severe loss of urine output. She is noted to have large petechiae over her body and she is febrile.
3. A 40 year old has right sided loin pain and fever. An ultrasound examination reveals a dilated renal pelvis
4. A middle aged man with acute pancreatitis develops hypotension. On CT he is found to have peripancreatic fluid and a lack of enhancement of the pancreatic tail
5. following a perforated bowel a middel aged man develops severe shock and septicemia as well as a central dark discolration on his abdomen which is growig larger
6. A 75 year old woman one week following surgery for a large bowel obstruction develops a high temperature. she is found to have an elevated C-reactive protein and on ultrasound she is found to have a left sub-phrenic abscess
the diagnosis of neurological complaints
Options
a) 24 hour holter monitor
b) EEG
c) glucose
d) random glucose
e) CT scan
f) MRI
g) lateral cervical spine radiograph
h) Chest x ray
i) ESR
1. A 16 year old girl suddenlt collapses after standing for a while. Her limbs are flaccid and she is not incontinent. Following 30 secinds she recovers fully
2. An 82 year old has 5 episodes of loss of conciousness with no convulsions
3. A 22 year old collapses and develops sudden jerking movements of all limbs. he recovers gradually within 2 hours
4. A 50 year old male wakes up with a tingling and numbness in his right hand. this is accompanies by slurring of speech which recovers following about four hours
5. a 72 year old has a typicla grand mal seizure. he is a long time smoker and has been losing weight over the last 6 months
pain relief
a) diamorphine
b) NSAID
c) paracetemol
d) carbamezepine
e) nifedipine
1. 49 year old with severe retrosternal pain radiating to the left arm for 30 minutes
2. 52 year old with severe left loin pain . A dipstick examination reveals a positive result.
3. A 43 year old with breast carcinoma and known metastasis develops severe headache
4. A 53 year old develops a sudden hot painful right first metatarsal joint
complications and associations of blood dyscrasias
a) splenomegaly
b) hepatomegaly
c) generalised lymphadenopathy
d) gingival hpertrophy
e) macroglossia
f) meningitis
g) petechial rash
h) sub-arachnoid hemorrhage
i) intracerebral hemorrhage
1. A 51 year old is lethargic and found to be anemic. his blood picture is found to have a granulocytic tendency with an increase in the platelet count
2. A 5 year old with generalised lymphadenopathy develops fever and neck stiffness and headache.
he is found to have a lot of lymphpblasts in the blood picture
55 yr. old man with h/o hypertension untreated presents with hemiparesis
A 72 year old is having a routine examination. he is found to have a mild lymphocytosis and splenomegaly
the Differential diagnosis of ectopic pregnancy
Options
a) appendicitis
b) inevitable abortion
c) missed abortion
d) septic abortion
e) PID
f) diverticular disease
g) torsion of an ovarian mass
h) irritable bowel syndrome
1. A pregnant woman with an LMP of 9 weeks and a positive home pregnancy test presents with an enlarged tender uterus and bright red bleeding per vagina. on examination her cervical os is fully open
2. a 16 year old with right iliac fossa pain has a vaginal ulatrsound which demonstrates an echogenic cystic mass just superior ro the right fornix.
3. An 18 year old girl is doing her exams and is very stressed. she has missed her last period. Her preganacy test is negative. She complains of a three month hsitory of generalised abdominal pain and bloating
4. A 22 year old girl with a hitory of two terminations complains of right iliac fossa pain, a water y brownish vaginal discharge and fever. She is found to have an elevated white cell count
5. A 27 year old girl reliably on oral contraceptives develops a high white cell count, fever and a malodourous vaginal discharge
young woman with 9 weeks pregnancy presents with heavy bleeding &passage of clots. USG shows fetal heart activity. how to manage?
the management of an injuired patient
a) diagnostic needle and thoracocentesis
b) Ct scan
c) Xray femur
d) splinting of the femur
e) auscultation
1. a young man involved in a motorcycle accident is stable in the casulaty department. his neck is cleared but when he sits up he develops sudden shortness of breath. His breath sounds are dimished on the right side
2. a young man involved in a motorcycle accident has a secure airway and a normal glasgow coma scale . he is noted to have a swollen right thigh
3. a young man involved in a motorcycle accident has a secure airway, is ventilated, immobilsed and anesthesized after admission with a glasgow coma scale of 9 . he is noted to have a swollen right thigh
the differential diagnosis of hypertension
a) Conn's disease
b) Cushing's disease
c) Co-arctation of the aorta
d) exerbation of chronic hypertension
e) renal artery stenosis
f) carcinoid syndrome
g) essential hypertension
h) phaeochromocytoma
1. a 17 year old girl with hypertension of 160/100 is found to have a femoral pulse delay.
2. a 40 year old with a blood pressure of 180/115 is found to have a loud bruit in his right upper abdomen
3. a 50 year old male complains of flushing , tremor, palpitations. he is found to have a fluctuating blood pressure of 200/120
4. A middle aged woman with a blood pressure of 160/110 is found to have abdominal striae and facial hirsutism
the investigation of hoarseness
Options
a) fibre-optic bronchoscopy
b) Ct scan
c) laparoscopic mediastinotomy
d) surgical mediastinotomy
e) laryngoscopy
f) no further investigation required
1) A patient is suspected of having bronchiectasis
2) a patient with an area of consolidation and fever on his chest xray is treated with antibiotics. His fever resolves but four weeks later he still has a large area of consolidation
3) A singer has a six month history of hoarseness
4) A 55 year old smoker complains of shortness of breath and a cough. Laryngoscopy is normal
5) A 30 year old complains of hoarseness since he came back from a football match the day before
The DDX of developmental delay
options
a) birth dysphyxia
b) Fragile X syndrome
c) Duchenne muscular dystrophy
d) Storage disorder
e) Hnter's disease
f) hypothyroidism
g) meningitis
h) constitutional delay
i) treatment of hyperthyroidism
j) prematurity
1. A four year old boy walks with a prominent lordosis. he has goood speech, can build objects using blocks and has good social awareness.
2. A nine month baby born at term has a weight in the 97th percentile. His development is delayed
3. A nine month baby born at term has a weight in the 3rd percentile. his development is delayed. his head and body size are both small.
4. A nine year old girl has difficulty with speech. she has recently been hospitalised for a medical reason. her speech before hospitalisation was completely normal
5. A four year old boy has delayed speech. both his father and paternal uncle has the same problem
the management of coma
Options
a) 50% dextrose drip
b) 5% dextrose drip
c) naloxone
d) direct intravenous insulin
e) insulin through a drip
f) one litre of normal saline
1. A middle aged woman remains unconcious 12 hours following a cholecystectomy. On examination both pupils are seen to be pinpoint.
2. A young diabetic is admitted in a comatose state. his plasma glucose level is 2mmols
3. A young diabetic is admitted in a comatose state. his plasma glucose level is 17mmols and he is dehydrated
The management of depression
Options
a) ECT
b) amitryptaline
c) tricyclic
d) imipramine
e) psychoanalysis
f) marital counselling
g) lithium
1) a middle aged woman has had several admissions for severe depression. She now turns up with a very severe depression despite all treatment
2) A woman has bouts of depression alternating with bouts of mania. She has had first line antidepressants but they haven't worked
3) A young dentist , successful at work lacks confidence in himself. he finds that he is unable to socialise properly and has early morning waking. he is on no treatment
The investigation of hemoptysis
a) CT
b) MRI
c) laryngoscopy
d) sputum culture
e) sputum cytology
1. A elderly gentleman has a lower lobe consolidation and fever. he is treated with antibiotics which resolves the fever but the consolidation persists after four weeks.
The diagnosis of shock
Options
a) anaphylaxis
b) septic shock
c) cardiogenic shock
d) hypovolemic shock
e) pulmonary embolism
1. A middle aged man has recently been operated after sustaining a perforated gall bladder. he becomes increasingly comatose and on examination is noted to have peripheral warming.
2. Following a motorcyle accident a young man ha a pule rate of 110 and a blood pressure that falls to 90/50. On examination of the CXR he is noted to have fractures of the lower ribs on the left
the management of head injury
Options
a) CT scan
b) neck collar
c) MRI
d) skull Xray
e) discharge home with head injury instructions
f) admit overnight for observation
g) suction of skull vault
h) antibiotics
i) intracranial pressure monitoring
1. following an alcoholic binge a 36 year old male falls and comes to Casualty with a cut in his temporal region his Glasgow Coma Scale is normal and his neck is cleared by the orthopedic SHO .
2. An 8 year old boy falls off a swing at his school. He is brought to Casualty by one of his teachers. He has a bruise over his right eye but the examination is otherwise normal. He is fully conscious with no history of blackouts since the accident. A skull Xray is performed, which is normal.
3. A young woman is involved in an RTA and is brought in with a Glasgow Coma Scale of 6 . A CT scan shows evidence of diffuse cerebral oedema but no evidence of haemorrhage. She has bilateral papilledema.
4. A young man is involved in a fight and suffers a blow to the back of the head. A skull Xray reveals a depressed fracture of the occiput. His Glasgow Coma Scale on admission is 14 but falls rapidly within an hour .
Stroke ? investigation ? causes
options:
a) ESR
b) Carotid Doppler
c) Arteriography
d) CT scan
?? questions
the prevention of jaundice/hepatitis
Options:
a) hepatitis A
b) hepatitis B
c) hepatitis C
d) cirrhosis
e) hepatocellular carcinoma
f) sclerosing cholangitis
1. Immunization of health workers who are in contact with body fluid
2. Immunization of hepatitis B, besides preventing hepatitis B also prevents
the management of earache
Options:
a) Removal of foreign body by suction under GA
b) Removal of foreign body using forceps under GA
c) amoxycillin
d) amoxicillin with clavulinic acid
e) trimethoprim
f) no specific treatment required
g) paracetamol
h) antibiotic against otitis externa
1. A 7 year old has right sided ear ache and rhinorrhea .On examination his right sided tympanic membrane appears pink in colour.
2. A 4 year old with right sided ear ache is examined using otoscopy. This reveals a red bulging tym[panic membrane
3. An 8 year old boy who has been playing outside now complains of right sided ear ache. On inspection a green bead is seen protruding into his ear canal. The walls of the canal are red.
4. A 9 year old girl with a history of recurrent otitis media now complains of left sided ear ache. On examination the right sided tympanic membrane appears scarred. On examination of the left ear, pus is seen throughout the ear canal
5. An 8 year old is noted to have a discharge from the left ear. He has only mild irritation and no significant ear ache. On examination his external canal is inflamed but the tympanic membrane appears normal.
the types of skin cancer
a) Kaposi
b) Lentigo
c) Squamous cell Ca
d) Basal cell Ca
e) melanoma
f) keratosis
g) acanthoma
1. A fair 18 year old girl has had dark black facial patches, one of which is now growing rapidly in size.
2. A 70 year old bald gardener has had a brownish patch on his scalp which has been slowly growing for the last 30 years
3. A young HIV positive man develops raised patches in his skin and in his mouth
4. A builder has been exposed to sun for long periods of time devlops an ulcerated lesion on his face
1.18 yr. girl with moles on her back of diff. colour&sizes
2.70 yr. male has mole on forehead for 20 yrs. now slowly increasing in size.
causes of pneumonia
Options
a) bronchiectasis
b) hemophilus influenza
c) mycoplasma pneumonia
d) staphyloccus aureus
e) streptococcus pneumonia
f) pneumocystis carinii
g) acid fast bacillus
h) candidiasis
1. a middle age d woman develops a purulent cough with some hemoptysis. A chest Xray reveals right upper lobe consolidation
2. A young woman with no relevant medical history develops a severe purulent cough. A chest xray reveals multiple cavitating bilateral lung lesions
3. a young male prostitute develops a dry cough. A chest xray reveals bilateral interstitial infiltrates.
4. A young man has recently sufferes from a bout of influenza. he now develops a puruoent cough
differential diagnosis of rectal lesions
options
a) amebic dysentery
b) pseudomembranous colitis
c) Crohn's involvement of the colon
d) ulcerative proctitis
e) ulcerative pancolitis
f) diverticular disease
g) cecal carcinoma
h) sigmoid carcinoma
1. A business man has just returned from a business trip to Asia. he now develops copious watery and bloody diarrhea
2. A middle aged man develops constipation with overflow dairrhea and bright red bleeding per rectum. A barium enema reveals an ulcerated stricture in the sigmoid colon
3. a young man develops bloody diarrhea. A rigid sigmoidoscopy examination revealed granular ulceration in the sigmoid colon with proximal sparing
4. A middle aged woman has been on several antibiotic treatments recently because of a persistent pneumonia. She now develops a severe watery dairrhea. Colonoscopy reveals whitish plaques scattered throughout the colon
5. An elderly woman is found to be anemic. As part of her examination she has a barium enema which reveals a mass lesion in the ascending colon
investigation of joint pain
Options
a) serum uric acid
b) joint fluid uric acid crytals
c) plain radiograph of the knee
d) plasma rheumatoid factor
e) joint fluid rheumatoid factor
f) ESR
g) antinuclear DNA antibody
h) joint fluid culture
1) A middle aged woman with a history of rheumatoid arthritis develops sudden swelling in one of her knees. this knee is swollen and hot to touch
2) An elderly gentleman with recently diagnosed heart failure has been treated with diuretics. He now develops severe joint pain in his left ankle with swelling and redness
3) A 78 year old woman complains of a stiff left hip joint after walking some distance. This is most evident when she attempts to abduct the hip joint with limited abduction.
4) A 34 year old woman complains of bilateral stiff and painful joints in her hands and feet
diagnosis of central chest pain
Options
a) dissecting aortic aneurysm
b) myocardial infarction
c) osteochondritis
d) acchalasia
e) pericarditis
f) pulmonary embolism
1. A tall 34 year old man develops severe central chest pain radiating to his back. he soon develops a dense hemiplegia.
2. An elderly gentleman suffers a sudden severe crushing central chest pain radiating to his neck
3. A middle aged man has severe chest pain . repeated St elevation patterns are seen and a percardial rub is heard.
management of miscarriage
options
a) serum HCG levels
b) lupus plasma marker
c) hysteroscopy
d) colposcopy
e) ultrasound examination
f) no treatment required
1. A woman in the eight week of her pregnancy develops bright red bleeding of four hours duration. On examination her cervical os is completely closed
2. A woman in the twelfth week of her pregnancy develops bright red bleeding of four hours duration with large clots. on examination the cervical os is wide open
3. A woman in the tenth week of her pregnancy develops bright red bleeding of one days duration. her Gp organises an ultrasound examination which reveals heart contractions
4. A 23 year old woman has a history of a termination of pregancy at 12 weeks. she subsequently suffers a spontaneous misacarriage atr 22 weeks of pregnancy.
the disease process in asthma
Options
a) IgA
b) IgM
c) IgE
d) IgG
e) T cells
f) histamine
g) improvement of FEV of 5% after treatment
h) improvement of FEV of 15% after treatment
i) vital capacity
j) antigen provocation test
1. this test of lung function is characterstically NOT involved in asthmatic patients
2. This substance is released by mast cells and causes flushing
3. This substance is characteristically found in the saliva of most asthma patients
management of meningitis
Options
a) lumbar puncture
b) CT skull
c) xray
d) immunisation
1. An HIV patient develops a severe headache and confusion. She is discovered to have bilateral papillodema.
2. An 8 year old with acute leukemia is admitted in a comatose state. he is found to have lymphoblast depletion
prevention of infectious diseases
Options
a) salmonellosis
b) leptospirosis
c) legionella
d) leptospirosis
e) schistosomiasis
1. not swimming in foreign lakes
2. wearing gloves when handling sewage
3. not eating raw shelllfish
4. cleaning out airconditioning towers
.avoid swimming in reservoirs-leptospirosis
2.immunization of sewage workers-hepatitis A
3.some q. about hep.B
4.handling of shellfish-hepatitis A.
hepatitis b vaccine prevents what other condition apart from hepatitis
options were
hepatitis a
hepatitisb
hepatitisc
hepatocellular ca
cirrosis
leptospirosis
legionella
investigation of acute abdomen
options
a) serum amylase levels
b) Ct scan
c) ultrasound
d) erect chest xray
e) plain film of the kidneys, ureter and bladder
f) stent
g) barium enema
1. middle aged man with hematuria and colicky left loin pain
2. an elderly gentleman with left iliac fossa pain and tenderness and rectal bleeding
3. A middle aged woman with recurrent right upper abdominal pain radiating to the right shoulder. She is tender in this region
tests in diabetes
options
a) glucose tolerance test
b) random glucose level
c) fasting glucose level
d) determination of diurnal steroid level pattern
e) serum insulin levels
f) hemoglobin Ac
1. A patient with a high blood glucose level is noted to be obese and has abdominal striae
2. An elderly gentleman with frequency is found to have a raised random blood glucose level
3. An elderly gentleman with polyuria is found to have a raised fasting blood glucose level
4. A known diabetic on treatment has several episodes of hypoglycemia.
treatment of anxiety disorders
options
a) fluxetine
b) amitryptaline
c) tricyclics
d) psychosurgery
e) marriage counselling
f) psychoanalysis
g) Ect
h) desensitisation
i)
1. A female lawyer is becoming increasing anxious when she has to speak in front of people. this is affecting her work as she needs to speak out in court
2. A student appproaching her secondary level exams is becoming increasingly anxious a few days ahead of her exam
diagnosis of vaginal discharge
Options
a) cervical epithelial ocnversion
b) candiasis
c) herpes simplex
d) gonnorhea
e) syphylis
f) chlamydia
g) endometriosis
h) cervical epithelial conversion
1. A woman has a vaginal discharge. the Ph is 2 and mycelia are seen
2. A woman has a vaginal discharge. the Ph is 8 and clue cells are seen
3. A woman has a vaginal discharge. the Ph is 8 and clue cells are seen
4. A woman has severe right sided abdominal pain and fever. She has a foul smelling vaginal discharge. She has a palpable right sided firmness
5. A woman on the contraceptive pill for several years has a slight whitish vaginal discharge. On inspection she is found to have a pinkish coloration of the outer cervix
6. A middle aged woman with a vaginal disharge is found to have several ulcers at the vaginal introitus
treatment of limb ischemia
a) amputation
b) arteriography
c) bypass graft
d) intrarterial vasodilator
e) femoral embolectomy
f) advise stop smoking and exercise
g) fasciotomy
1. man involved in road traffic accident is found to have sominuted fractures of the tibia and fibula. he develops rapid swelling of the lower limb below the knee. Arterial pulses are absent below the knee
2. An elderly male develops pain in his thigh and leg when walking for approximately 20 metres. This pain resolves with rest. He is a long time smoker. n examination his dorsalis pedis pulse on the affected side is absent
3. A 70 year old with known atrial fibrillation on treatment dvelops a sudden cold leg . Pulses are absent in the level at and below the knee.
4. A 67 year old male with a history of peripheral vascular disease develops sever ulceration and celllitis in his left foot and extending up his left leg above the left ankle.. The popliteal pulse is absent on that side. he has a history of ulceration on the contralateral side which resolved following a bypass graft operation on that side.