Posted by AAA on August 18, 2001 at 01:32:44:
In Reply to: July 24th 2001 Exam PLAB MCQS posted by PLAB TUTOR on August 07, 2001 at 15:42:10:
July 24th 2001 Exam PLAB MCQS
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Posted by PLAB TUTOR on August 07, 2001 at 15:42:10:
JULY 24,2001 EMQS kindly donated by Wilf
Guys,I sincerely hope thes qns.help you all in your prep.too.Regardless of what happens on the 31 AUG.(fingers xd),I am largely indebted to this site(and esp.the PLAB TUTOR)for being a gateway to a pool of EMQS/other relevant info.
Plab tutor,this is the way I felt I could reciprocate your generosity to us.Loads of thanks for broadening my,and our, academic envelope
May the other july candidates fine-tune some of the qns.,if necessary.And good luck to all july candidates!!!
Regards,wilf.
JULY 24,2001 EMQS
THEME1
PRESCRIPTION AND RENAL FAILURE
pick the appropriate drug responsible for the side effect.(options-ciclosporin,bendrofluazide,spirinolactone,cyclophosphamide,captopril,gentamycin..)
1.A ?60 yr old woman hypertensive was started on antihypertensive 2 weeks ago.Now has a creatinine level of 500 micromol/l(captopril)
2.A child with recurrent nephrotic syndrome is brought for treatment.3 weeks after start of treatment,he now has massive haematuria.(cyclophosphamide)
3.A patient in severe renal failure has K+ level of 2.5mmol/l.(frusemide)
4.Patient c/o ataxia and ?tinnitus+/-?hearing loss.He has moderate renal failure.(gentamycin)
THEME 2
INVEST/MGT OF CYSTITIS
(CT,cystoscopy,U/S kidney and bladder,MSU after 3/52,MSU monthly for 6/12,MSU culture)
6.A 3 yr old boy has a first confirmed UTI.Abdomen U/S is normal.(msu)
7.A female presents with freq.dysuria.This is the 3rd episode,@ time E.coli confirmed.(?)
8.A 70 yr old with prostatic symptoms.Urine culture is negative.(usg)
9 A 25 yr old male has a first confirmed UTI.IVU is normal.?
THEME 3
DD of vomiting in children
(GER,G/E,pyloric stenosis,,intussuseption,UTI,,DM..)
10.A 3/52 old presents with projectile vomiting ,appearing hungry after each emesis.O/E-deH2O,mass in abd.(PY. STENOSIS)
11.A ?yr old child presents with vomiting ,crying and lifting her legs.Nappy is stained red.O/E-sausage-shaped mass P/A.(INTUSSUSCEPTION)
12A 3/12 child is brought with recurrent vomiting,but is otherwise thriving well and healthy.The symptom seems to subside when the child is strapped in baby’s seat.(GASTRO-OESO REFLUX)
13.Child with features suggestive of infection(can’t recall the wording of this qn.)(UTI)
14.Child with vomiting etc.Brother had a similar problem 2/52 ago(rest of the wordings out of my mind)(?GASTROENTERITIS)
THEME 4
DD OF ACUTE DYSPNOEA(DATA INTERPRETATION-CO2,O2,CXR,ECG)
Options were:(anxiety,asthma,p.embolism,cor pulmonale,aspiration pneumonia..)
15.Patient had bilateral fluffy opacities.Had low o2,normal co2.(PULMONARY EDEMA)
16Pt with acute shortness of breath,wheeze.CXR-normal,low o2,?co2.PEFR-120 ml/min.(ASTHMA)
17Pt with NO other abnormalities apart from acute dyspnoea.CXR-N,low co2,high 02.ECG-sinus tachycardia.(ANXIETY)
18An alcoholic admitted semi-comatose.low o2…..??(ASPIRATION PNEUMONIA)
THEME 5
MGT OF XPLE TRAUMA
Choose next appropriate next action
(Gain IV access+N/S,Gain IV access+blood transfusion,apply external pressure,needle thoracostomy,chest drain,maintain open airway,intubation+ventilation,splint fracture)
19Pt involved inRTA,neck immobilised .Has massive head and facial injuries,together with noisy breathing despite adminstration of 100% o2.(INTUBATION)
20.Girl in RTA.Neck is immobilised and line established.Has deformed ,swollen thigh,pale.(BT)
21.Known asthmatic patient involved in RTA.Has a Rt-sided chest pain and hyperesonance on the same side.Trachea is deviated to the left.(NEEDLE THORACOSTOMY)
22A 19 yr old has fallen off her horse.Neck is immobilised+100% o2.Has left upper abd.pain,is pale and tachycardic.(IV FLUIDS)
23.A 15 yr old girl has cut her wrist and bled profusely.She is pale,tachycardic and does not want to live.(EXTERNAL PRESSURE)
THEME 6-
DD OF ALTERED BOWEL HABIT
(Ca rectum,ca caecum,IBS with diarrhoea,IBS with constipation,faecal impaction,diverticulosis)
24.A 19 yr old female c/o a 1 yr history of bloody diarrhoea and tenesmus.Has pale skin lesions on the skin.O/E-sigmoidoscopy shows inflammation and granulomata(ULCERATIVE COLITIS)
25.65 yr old with wt.loss,Rt-sided pain,tenesmus.O/E-mass in the rectum(CA RECTUM)
26.18 yr old presents with frequent diarrhoea for about 3/52,relieved by defaecation.Sigmoidoscopy is normal.(IBS WITH DIARRHOEA)
27.?80 yr old c/o diarrhoea and urinary retention(FAECAL IMPACTION)
THEME-7-
DD OF ACUTE URINARY RETENTION
(ureteric colic,ca prostate,BPH,UTI,stricture..)
28.A patient of multiple sclerosis has had urinary catheterisation for 4 years with intermittent obstruction(BLADDER STONE)
29.60 yr old c/o frequency ,dysuria.PSA is 120ng/l,also has back pain(CA PROSTATE)
30.Female patient c/o sever flank pain,is restless and the pain radiates to the groin.(URETERIC COLIC)
THEME 8
INVEST/MGT OF MENINGITIS
next most appropriate action.Options(ZN,reduce fluid intake,CT,parenteral penicillin,iv aciclovir,rifampicin..)
31.A young boy back from holiday in N.Africa presents with night fever,weight loss.Began on antibiotics with minimal improvement.CSF shows:protein-960mg/dl,glucose-2mmol/l,cells-? Lymphocytes(ZN)
32.A boy on treatment for meningitis .Initially improving ,but now developing swinging fever,headache ,vomiting.(CT)
33.A pt on appropriate antibiotics for meningitis now has Na+-125mmol/l(REDUCE FLUID INTAKE)
34.Lady presents with occipital headache.neck stiffness but no fever.(CT)
35.Young patient suspected of having meningitis has purpuric rash.GP calls for the ambulance but asks for your advice.(PARENTERAL PENICILLIN)
THEME 9-
DD OF SHOCK
(anaphylaxis,tension pneumothorax,aortic aneurysm,rup.ectopic pregnancy,salpingitis,acute pancreatitis,adrenal insufficiency)
36.Pt stabbed in right chest.U/S showed no free fluidP/A,patient is breathless,pale.(PANCREATIC INSUFFIENCY)
37.woman h/o 8/52 amenorrhoea presents with abd.pain rigidity and is pale.(ECTOPIC PREGNANCY)
38.Pt with h/o suggestive of atherosclerosis,now presenting with shock.(AORTIC ANEURYSM)
39.Pt.admitted with suspected tetanus and is given tetanus immunoglobulin and an antibiotic to which he is not allergic.?hrs later the patient is breathless and tachycardic(ANYPHYLAXIC)
40.A known asthmatic on treatment with inhaled B2agonist and steroid.Now presents with hypotension.(TENSION PNEUMOTHORAX)
THEME 10
INVEST.OF AA
(Abd.U/S,spiral CT,IVU,coronary angiography,echo,plain abd x-ray..)
41.A 60 yr old attends A/E and it is thought he may have AA.(ABD. USG)
42.A pt is to have a repair of his AA but wants to r/o renal involvement.(SPIRAL CT)
43.A pt is to have a repair of of his AA but also has severe myocardial ischaemia(CORONARY ANGIOGRAPHY)
44.Pt with AA has unstable angina?
45.Pt suspected of having aortic dissection c/o abd.pain yesterday,but is now haemodynamically stable.(ECHO)
THEME 11-
INVEST/DD OF XNIC ABD.PAIN
(mesenteric angiogram,perf.P.U,…..)
46.A pt presents with intermittent abd. Pain for about 30min. after meals .Also has h/o abd.pain radiating to the back.O/E-abd.bruit.Also has interm.claudication(MESNTARIC ANGIOGRAM)
47.Pt on antacids for xnic epigastric pain presents with acute abd.pain,rigidity and is pale.((PERFORATED P U)
THEME 12-
DD OF FRACTURES IN CHILDREN
(Fractures of the :scaphoid,shaft radius/ulna,shaft of humerus,neck of humerus,supracondylar humeral fracture..)
48.A 7/7 old baby cries whenever lifted.Labour was difficult(FRACTURE SHAFT HUMERUS)
49.Young girl tripped while holding mother’s hand.Now can’t use arm at all(PULLED ELBOW)
50.Young boy fell off horse onto his hand.Now c/o mild tenderness but able to use forearm(green stick injury)
51.Young patient fell on outstretched hand and now has absent radial pulse(S/C FRACTURE)
THEME-13-
MULTIPLE SCLEROSIS-ANATOMICAL SITES INVOLVED
(cerebellum,optic disc,optic nerve,optic radiation,cerebral cortex,brain stem,cervical spinal cord,thoracic spinal cord)
52.Known patient of multiple sclerosis now c/o urinary incontinence,weakness in all 4 limbs and difficulty walking(CERVICAL SPINE)
53.Pt has nystagmus,diplopia,and +ve past pointing.(CERREBELLUM)
54.Pt has repeated attacks of M/S,and now has pale temporal disc(OPTIC NERVE)
55.Pt c/o blurring of vision ,papilledema,pain in eye(OPTIC DISC)
THEME-14-
DD OF CHRONIC NEUROLOGICAL DISEASES(Alzheimer’s,multiple sclerosis,mysthaenia gravis,….)
56.Pt gets diplopia when he works very hard(MYSTHENIA)
57.Pt with attacks of numbness in left hand and right sided headache(SOL)
THEME-15-
MGT OF BURNS
(iv fluids,escharotomy,admit to hospital,COHb level,iv blood transfusion,deroof blister,aspirate blister..)
58.Pt after escaping from fire in a building has singed nostrils..(CO HB)
59.Pt has a large tense blister(ASPIRATE BLISTER)
60.Pt has partial thickness burns on the anterior chest and upper thighs(IV FLUIDS)
61.An adult patient has circumferential burns(both FT+PT)from the elbow to the fingers,covering them completely(FASOTOMY)
THEME –16-
DD OF HEARING TESTS
(bilateral sensory deafness,bilateral conductive deafness,bilateral total deafness,unilateral sensory deafness,unilateral conductive deafness..)
62.otosclerosis(B/L CONDUCTIVE)
63.presbycusis(B/L SENSORY NEURAL)
64.OM with effusion(UNLATERAL CONDUCTIVE)
65.acoustic neuroma(UNILATERAL SENSORY)
66.noise-induced hearing loss?
THEME-17-BIOSTATISTICS
(specificity,sensitivity,mode.mean,medin,chi-square..)
67.The measure of detecting sth. Which is actually present
68.measure…of dispersion..
THEME-18-
EPIDEMIOLOGY IN CARDIAC CONDNS
(IHD,atrial fibrillation,warfarin,……
69.The single largest cause of death in adults in the UK(IHD)
70.warfarin decreases the incidence of stroke by about 30%(ATRIAL FIBRILLATION)
71.inteferes with the function of vitamin K(WARFARIN)
THEME-19-
MGT OF MI(diuretic,thrombolysis,b-blockers,nitrates,o2,cardiac pacing..)
72.A patient who developed MI one month ago is now breathless and has basal crackles(DIURETIC)
73.Pt presents with one and a half hours of epigastric pain radiating to his arm.ECG shows acute inferior MI.O2+analgesia have already been given(THROMBOLYSIS)
74.Pt recovering from MI has a heart rate of 36/min(PACING)
THEME-20-CAUSATION OF DISEASES(skin-to-skin,close community contact,animal-to-human,tinea,female mite,immuno deficiency,blood..)
75.scabbies(female mite)
76.candidal nappy rash(IMMUNOSUPRRESION)
77.impetigo(SKIN TO SKIN)
78.toxoplasmosis (animal-to-human)
79.A first year university student develops headache,fever,photophobia, in the 1st week of term (close community contact)
THEME-21-
MGT OF SPEECH DISORDERS
(hearing test,speech therapy,reassure,refer to ENT ,milestone assessment..)
80.Pt has nasal speech,snores at night.Day time he is sleepy(ENT)
81.?yrs been developing well,but now has decreased hearing.Motor function is normal(HEARING TEST)
82.18/12 old patient still says a few words,…mother is worried(MILE STONE ASSESSMENT)
THEME-22-
TRANSMISSION OF DISEASES
(HPV,faecal-oral,blood-borne…..)
83.warts(HPV)
84.typhoid fever(FEACO ORAL)
85.hepatitis C(BLOOD BORNE)
THEME-23-
MGT OF ACUTE PSYCHOSES
(hospital hostel,family therapy,supportive counselling,rehabilitation,education,oral antipsychotic,risk management strategy,detention under mental health act,ECT,pschiatric general wards)
86.A schzizophrenic who stabbed his mother’s hand with a screw driver was recently admitted and treated with depot injection antipsychotic.He is now symptom-free and ready for discharge
87.Pt(schizo) has had about 8 admissions in the last 5 years.He is uncompliant with drugs….
88.Young patient now 25 yrs was diagnosed with schizo.at 15,but despite different medications has not recovered fully.The family is very supportive.
89.Pt ? yr old is admitted depressed and has not been eating /drinking for many days.Has lost weight.
90.Pt with features of paranoid schizo.
91.??Another qn.was related to a patient who took 5 tabs of diazepam,wants to die???
THEME-24-
MGT OF ANXIETY(beh-cog.therapy,psychoanalysis,desensitisation,supportive therapy,interpersonal therapy,relation therapy)
92.arachnophobia(DESENSETISATION)
93.PTSD(?)
94.Bereavement(SUPPORATIVE THERAPY)
95.Public speaker who’s anxious(DESENSETISATION)
THEME-25-
BASICS OF POISONING(CO,TCA,paracetamol,digoxin,aspirin…..)
96.Interferes with glutathione(reversible by methionine and acetyl cysteine)(PARACETAMOL)
97.Interferes with Hb(CO)
98.Anticholinergic effects,arrhythmic(TCA)
99.Pt on treatment for atrial fibrillation,now has palpitations(DIGOXIN)
THEME-26-
INVEST.OF ANAEMIA-
Most app.INITIALinvest (dietary h/o,B12,folate,FBC,schilling’s,test,barium enema,LFT,isotope scan of liver,alcohol history,vitamin C)
100.Patient with atrophic gastritis has megaloblastic anaemia (schilling’s, test)
101.Pt who is a strict vegans has an MCV of 110(B12)
102.Pt has both Fe+Folate def.?Radiology/sigmoidoscospy-normal,has pale stools which is difficult to flush away.
103.Elderly patient c/o anaemiaand has bleeding gum (vitamin C)
104.Elderly patient in residential homestay c/o tiredness.. (DIETARY HISTORY)
105.A patient being investigated for anaemia has normal investigation except raised MCV and raised GGT.(ALCHOL)
THEME-27-MGT OF ASTHMA
(inhaled long acting b2,inhaled short acting b2,nebulised b2 agonist,oral theophylline,oral steroid,iv hydrocortisone,iv aminophylline,inhaled steroid,inhaled cromolyn,reduce seroid dose)
106.25 yr old patient now has to use inhaled b2 2-3 times a day.(INHALED STERIOD)
10735 yr old uses b2 agonist+lowdose steroid but symptoms still uncontrolled(INHALED LONG ACTING b2)
108.37 yr old female presents with breathlessness,high RR(NEBULISEDb2)
109.A patient who was on 1000 microgramof beclomethasone has now developed oral thrush(REDUCE STERIOD)
THEME-28-INITIAL MGT /INVEST IN EYE CONDITIONS
(ESR,CT,intraocular pressure,sjogren’s syndrome,visual acuity assessment,visual fiel mapping..)
110A 70 yr old c/o diplopia,wt loss,anorexia.Then develops sudden left-sided visual loss(ESR)
111.60 yr old develops tunnel vision,also reports seeing hjaloes(visual field)
112.50 yr old woman with h/o symmetrical joint pains complains of ?eye symptoms and Schirmer’s test is positive(SJOGREN’S)
113.woman,? yrold c/o blurred vision.CT is normal but she has bilateral papilledema
114??A woman who is a Visual Display Operator develops headache when she works several hours(VISUAL ACUITY)
THEME-29-
MGT/INVEST OF HEAD INJURY
(Admit to hosp.,D/C,D/C with advice after normal SXR,CT,iv mannitol,IV dexamathasone,burr hole..)
115.A 2 yr old boy ran and hit his forehead on the door.No h/o LOC,and since then is playing well.No neurological signs.
116.A 12 yr old boy fell from 6 metres.No h/o LOC,but cannot recall events of the incident
117.A 19 yr old involved in an RTA.He is talking,responding and smells of alcohol
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