PLAB 2003 Nov paper

Talk about PLAB (UK) exams here

PLAB 2003 Nov paper

Postby drwatson » Mon Nov 29, 2010 2:01 pm

Theme-1: Diabetes mellitus

A- Excess insulin
B- Relative deficiency of insulin
C- Absolute deficiency of insulin
D- Deficiency of catecholamines
E- Excess of catecholamine
F- Deficiency of glucocorticoids
G- Excess of glucocorticoids
H- Hypoglycemia
I- Hyperglycemia


1- Young man, obese, hyperglycemia but no ketosis
2- Female with all signs/symptoms of Cushing’s disease
3- Old man with signs & symptoms of hypoglycemia
4-







Theme-2: Causes of hypertension.

A- Renal artery stenosis
B- Conn’s Syndrome
C- Pheochromocytoma
D- Pregnancy
E- Cushing’s
F- Steroids induced

5- 45-year old obese women with moon face, hirsutism & hypertension
6- Pt with Hypertension, hypokalemia & altered serum phosphate
7- Young pt had Hypertension with bruit in abdomen.
8- Hypertension with pallor palpitation
9-



Theme-3: Differential Diagnosis of thyroid disease

A- Hypothyroidism
B- Drug induced
C- Treated hyperthyroidism
D- Anaplastic CA
E-
F- Papillary CA
G- Thyrotoxicosis
H-
I-

10- 45-year-old female with palpitation, tachycardia & diarrhea.
11- Pt with exophthalmus, but no other signs of hyperthyroidism.
12- Thyroid disease following amiodarone for arrhythmias
13- 75-year old female with hard fixed thyroid-swelling shows poor response to medicines.
14- Lady presented with diarrhea, all investigations done but no cause found.


Theme-4: Investigation Bites-Repeat

A- HIV antibodies
B- Skin prick
C- Skin swab culture
D- Blood film for malaria parasite (thick smear)
E- Lyme serology
F- Immunization
G-
H-

16- Girl walks in forest & bitten from an insect, develops a red lesion.
17- A middle age Police officer bit by an i/v drug user
18- Man returns from Zambia with fever & rigors
19- A pt returning from ancola & with some symptoms ______________________,


Theme-5: Chronic renal failure management

A- Erythropoietin
B- Captopril
C- Haemodialysis
D- Beta Blockers
E- Ca++ channel blocker
F- Spironolactone.
G-
H-
I-

20- Pt with hypertension, asthma & Renal failure what will be the next step?
21- HIV positive pt with serum Cr 1300 & serum-K 7.0 what will be the next step?
22- End stage renal failure with anemia
23- Renal failure due to polycystic kidney & hypertension


Theme-6: Palliative Care (Analgesia)

A- i/v morphine
B- i/v benzodiazepines
C- Paracetamol
D- TENS
E- Oral benzodiazepines
F- S/C morphine thru syringe driver
G- i/m morphine
H- Steroids
I- Radiotherapy
J- S/C opioid
25- Man with CA prostate wants relief from skeletal pain as opioids failed.
26- Man with CA pancreas in last stages but suffering from pain, not responding to i/v morphine
27- Man with CA bronchus c/o anorexia & breathlessness after surgery.
28- Pt with CA breast c/o edema & pain in arm.
29- CA bronchus with metastases, critical stage, & high doses of opiates did not help him.
30- CA stomach with pain on oral morphine.


Theme-7: Prognosis & natural course of respiratory disease


A- 80% chance having wheeze in adult life
B- 50% chance of becoming normal by 6 yrs
C- If untreated leads to abscess
D- Very bad prognosis
E- 70% chance of getting clubbing in adult hood
F- Complaints end by the age of two
G- Complaints end by proper feeding
H- Prognosis not known
I- Extrinsic allergic alveolitis
J- Double auto Anti body
K- 10% chance of COPD
L- 60% chances of developing COPD in future



31- A mother brought her 6-month old girl with difficulty in breathing & vomiting related to feed.
32- A 5-year-old boy having exercise & cold induced wheeze mother has eczema
33- A 2-year-old boy with respiratory wheezing, coughing during winter, & hyper inflated lungs.
34- Child normal was playing suddenly developed breathlessness & monophonic wheeze
35- A 6-month old boy with nocturnal wheeze, not controlled by steroids.
36- 4-year old develops wheezing & chest tightness following exposure to pollens.
37- One question about Sjogren’s investing.
38- Allergic symptoms in bird fancier
39- Child with purulent sputum & cough
40- 2-year old boy who has started Rx for recent onset of asthma.


Theme-8: Cause (Toxicology)

A- Salicylates
B- Paracetamol
C- Metoclopramide
D- Opioids
E- Tricyclic Antidepressants
F- Digoxin
G- CO
H- Diazepam
I- Carbamizipine.
41- Development of hepatitis 3-4 days after indigestion
42- Dystonia, occulogyric crisis
43- Pinpoint pupils respiratory depression
44- Women on neuropsychiatric drugs at night now c/o agitation & dizziness
45- Visual problems, & bradycardia
46- Man with shingles in thoracic area 2nd day


Theme-9: Neurological diagnosis

A- Glioma
B- Menigioma
C- Multiple sclerosis
D- Stroke
E- Hydrocephalus,
F- Cerebrovascular
G- MND
H- Alzheimer’s
I- Meningitis
J- Parkinsonism
K- Creutzfeld Jacobs
48- 40 year old lady is having progressive weakness of limbs for the last 18 months & she also developed slurring of speech. now presented with loss of vision on Right eye
49- Patients age around 40 is having headache & vomiting is waiting for neuro-surgery & radiotherapy.
50- Dysarthria head ache dysphagia
51- Hoarseness dysphagia LL paresis
52- Wheel chaired with neurology problems blurring vision
53- Bed ridden with increasing forgetfulness

Theme-10: Child hood convulsions management

A- EEG
B- Drug levels
C- i/v Diazepam
D- Cerebral angiography
E- Lumbar puncture
F- Teach parents of rectal diazepam
G-
H-

54- Child with high fever & fit
55- Child with recurrent febrile, convulsions.
56- Child with fever, fits, rashes, confusion.
57- Obese Child taking valrproate but epilepsy still not controlled.
58- Child with seizure before arrival at hospital but all right now. GPE & systemic exam was unremarkable.


Theme-11: Diagnosis of anaemia

A- Macrocytic anemia
B- Sickle cell anemia
C- Iron def anemia
D- Aplastic anemia
E- Spherocytosis
F- Sideroblastic anemia
G-
H-
I-


60- Lady presented with sore tongue
61- Old man with bruising on chest, infection & low Hb
62- Lady presents with menorrhagia with brown clots.
63- Something about sickle cell anemia
64- CA. stomach with anemia


Theme-12: Enzyme Defect

A. Creatinine phosphokinase
B. Troponin-T
C. Phenylalanine hydroxylase
D. Aspartate aminotransferase
E. Alanine aminotransferase
F. The MM isoenzyme of creatinine kinase
G. The MB isoenzyme of creatinine kinase
H. The BB isoenzyme of creatinine kinase
I. Cystathionine synthetase
J. Lactic dehydrogenase


66. Which enzyme occurs in high concentration in the sarcoplasm of skeletal muscle?
67. Which enzyme regulates the Ca-mediated contractile process of striated muscle & is most specific for minor degrees of myocardial necrosis?
68. A Middle Eastern male child with fair complexion adopted soon after his premature birth, is noted to have delayed milestones at 8 months of age. He is also noted to have eczema. At 2 years of age the child has severe mental retardation with no pyramidal or extra pyramidal signs. Mental retardation in this child is more likely to be a defect in which enzyme?
69. A 20-year-old male with mild mental retardation has had 2 successive strokes within a year. On examination he had a marfinoid habitus, with long limbs & pectus excavatum. What is the most likely enzyme defect?
70. Liver congestion is most commonly associated with the elevation of which enzyme?


Theme-13: Types of emboli

A. Thrombus emboli
B. Fat emboli
C. Amniotic fluid emboli
D. Malignant emboli
E. Atheromatous emboli
F. Septic emboli
G. Paradoxical emboli
H. Fibrin emboli
I. Bone fragment emboli
J. Air emboli



71. A patient with DVT, was complicated by cerebral & extremity emboli. On ECHO he was noted to have a patent foramen ovale. The combination of DVT , PFO & arterial emboli suggest which phenomenon
72. A 28 year old with known congenital heart disease, develops small tender subcutaneous nodules in the pulp of the digits. On examination the nodules were red & tender. The patient was noted to have splenomegaly & a new heart murmur. The finger tip nodules are most likely secondary to
73. A 30 year old in her 3rd trimester of pregnancy presents with chest pain & dyspnoea increasing in severity over the last 24-hrs. She has no lower limb pain or swelling. The pt is likely to have what
74.







Theme-14: Diagnosis of peripheral vascular disease

A- Mural thrombus
B- Acute thrombus
C- Burger’s
D- Diabetes
E-
F- DVT

75- Young smoker with peripheral vascular disease.
76- AF with pulselessness pallor of extremities.
77- MI with claudication & angina with ischemia of lower limb.
78- Old age with gangrene following chiropody.
79- Pregnant lady with sudden breathlessness & calf pain.


Theme-15: Anatomy Of Heart (causes)

A- Left atrium
B- Right atrium
C- Left ventricle
D- Right ventricle
E- Mitral valve
F- Tricuspid valve
G- Coronary arteries
H- Interatrial septum
I- Interventricular septum
J- broncho pulmonary displasia
K- SA-node
L- AV-node
M- Bundle of His
80- Location of endocardidits in iv drug abuser
81- Location of patent foramen ovale
82- Blood spurts into left atrium & increase left atrial pressure (regurgitation from LV).
83- Site of Cardiac aneurysm
84- Regurgitation of blood in the left ventricle
85- Structure responsible for heart rhythm in third degree, complete heart block.
86- Increased pulmonary pressure


Theme-16: Management of cardiac conditions

A- Surgical ablation of tracts
B- Verapamil
C- Digoxin
D- Enalapril
E- Amiodarone
F- DC cardioversion
G- Adenosine
H- Atropine
I- Lignocaine

87- A patient with heart failure presents to you with afibrillation....
88- A patient having SVT with BP 90/60. Sinus massage & adenosine has failed. Whats next?
89- A patient with Myocardial Infarction presents with recurrent Ventricular tachycardia controlled with lignocaine now need maintenance.
90- WPW –no response to drugs



Theme-17: Chest Trauma

A- Aortic rupture
B- Tension pneumothorax
C- Spontaneous pneumothorax
D- Ruptured EsophagusE
E-


92- Chest trauma with absent breath sounds & tracheal shift & absent radial pulse
93- Young tall thin worker with signs of pnemothorax
94- Injury to sternum with steering wheel widened mediastinum




Theme-18: Acute abdomen diagnosis

A-X-Ray KUB
B- Chest x-ray
C- X-ray abdomen
D- Pregnancy test
E- Sigmoidoscopy
F- Laparoscopy.
G- Urine R/E.
H- Colonoscopy.
I- Usg Abdomen.
J- Barium enema.

96- 32-year old male with nausea, vomiting, colicky abdominal pain & distention O/E abdominal tenderness, high-pitched bowel sounds
97- 60-year old male with signs of ileus & peritonitis following diverticulitis
98- Carcinoma colon investigation
99- 23 year old female presents with left sided abdominal pain for 4 hours , her last period was 7 weeks back


Theme-19: Management Of Sprains & Injuries

A- Paracetamol
B- Suture repair
C- Cast
D- No weight bearing use crutches
E- NSAIDs
F- Manipulation
G- Morphine
H- Observe

100. A Pt with dislocated patella & he is on inhaled analgesia (nitrous oxide).
101. Pt had rupture Achilles tendon earlier, which was managed medically, now presented with rupture again. Medical treatment is not responding now.
102. Pregnant lady had fall, pain, mild swelling & bruising at medial maleuolus. On x-ray no #.
103. During a match rugby player injured his knee, on x-ray no fracture but pain++.
104. A 4 year old child brought to A&E with knee trauma & in pain despite Paracetamol.


Theme-20: Investigation ORTHO

A- Spine x ray
B- DSA scan
C- Serum electrophoresisi
D- MRI
E- CT
F- Serum Ca
G-
H-
I-

106- Man presents with foot drop on x ray there is narrowing b/w l4 & l5 foot drop does not resolve in 2 weeks
107- Pt present with back pain x ray gives sacroilitis like picture
108- Old aged male Pt with back pain, fractured spine & high ESR (Ankylosing spondylitis)





Theme-21: Pre-Op Investigation

A- Do nothing
B- FBC
C- ECHO
D- ECG
E- Sickle screening #
F- CXR
G- Hepatitis serology
H- Coagulation screen



110- British fit man for bilateral inguinal hernia
111- Afro-Caribbean man bilateral inguinal hernia
112- Man on list for hernia repair who takes recreational i/v drugs
113- Man with irregular pulse having hernia
114- Lady for some surgery h/o antibiotic prophylaxis in a dental extraction



Theme-22: Investigations (Renal Stones)

A- Serum ca
B- Serum phosphate count
C- Parathyroid level
D- Urine cystine
F- Urine oxalate count
G- IVU
H- X ray KUB
I- 24 hr urine
J- Ultrasound
K- Urine culture
L- Isotope scan
M- Nephrostomy
115- A patient with right loin pain & pyrexia. recent IVU showed Right hydronephrosis. Next investigation that may help in the management?
116- Man with h/o ca prostate on x ray nothing on IVU bilateral hydeonephrosis
117- Man with recurrent renal stones & high serum Calcium levels.
118- Post-op CA cervix with anuria. B/L obstruction of the ureters & B/L hydronephrosis


Theme-23: Next step in the following conditions

A- USG abdomen
B- Catheterisation
C- Ascending urethrogram
D- Splenectomy
E- Laparoscopy
F- Observation
G. Abdominal tapping
H. Laparotomy
I. Blood transfusion
J. Get an expert opinion
K. IVU
L- MRI
120- A rugby player was hit in the back & come with loin pain & haematuria. management
121- Young man with one episode of frank haematuria & he was stable but presented with anuria.
122- A male with anuria brought to A&E after injury with brusing on perineum, the digital rectal exam was normal next step
123- A pt with h/o RTA have fracture of Left lower ribs. Pt is having left sided abdominal pain & progressive guarding of Left hypochondrium. O/E, PR=110/min & BP 90/60. What is the next step?


Theme-24: diagnosis of GI conditions

A- Achlasia
B- GORD
C- Esophagitis
D- Peptic ulcer
E- Duodenal ulcer
F- H Pylori
G- Strongyloides stercolaralis
124- Pt with pain in epigastrium endo scopy confirm spiral shaped organisms.
125- Change of epithelium from columnar to
126- Female with pain in epigastrium at night relieved by eating.


Upper GI bleeding (miscellaneous)
- UGI bleeding with primary billiary sclerosis (Inv. )
- UGI bleeding with h. pylori (Mx)
- UGI bleeding with spiral forms in microscopy (BA meal)
- UGI bleeding with retching & vomiting (Mgt )
- Dyspepsia with NSAID (Erosions)


Theme-25: CT-scan findings in a Pt with hearing Loss

A- Acoustic neuroma
B- Metastatic CA breast
C- Paget’s disease of bone
D- Otosclerosis
E- Cholesteatoma
F- Noise induced deafness
G- Otitis media with effusion
H- high frequency hearing loss
I-
J-
128- 9-year-old boy CT-scan of petrous bone shows air on mastoid cells malleus, incus & stapes normal, collection of fluid found
129- 40-year-old lady. CT petrous bone normal. Maleus & incus normal. Cochlea with rarefaction & densities
130- 19-year-old boy with mass in the antrum resolution of some bone
131- 60-year-old man CT of petrous bone normal with both contrast


Theme-26: Diagnosis of Epistaxis

A-Septal perforation
B- Hypertension
C- ORF
D- Coagulopathy
E- Nasopharyngeal CA
F-
G-
H-
I-

132- Sheep farmer with epistaxis
133- Boxer with gurgling sound & epistaxis
134- Chrome factory worker with epistaxis
135- Old man with epistaxis
136- Young girl with h/o bleeding fol. dental extraction


ENT Miscellaneous Qs
A- CA maxillary antrum
B- Sarcoidosis
C- Nasal polyposis
-Man with swelling over cheek.& signs/symp of ca maxillary sinus
-Sheep keeper got a polyp in nose



Theme-27: Red Eye Investigation

A- X-Ray orbit
B- Conjunctival swab cytology
C-
D- Fluorescin stain
E- Refer to ophthalmologist
F-
G- Fundoscopy
H- Measure IOP

138- Hedge gardener develops sudden photophobia & blepharospasm
139- A man working of a metal factory c/o something in his eye
140- Pt with herpes zoster c/o ophthalmic shingles terrible conjunctivitis & is unable to close eye
141- Headache, photophobia, diminished vision


Theme-28: Prenatal screening [Repeat]

A- Downs syndrome
B- Cystic fibrosis
C- Duchenne’s muscular dystrophy
D- Spina bifida
E- Spinal muscle atrophy
F- Patau syndrome
G- Klinefelter’s syndrome
H- Weber’s syndrome
I- Multiple sclerosis
J- Neural tube defects

143- Raised AFP & very high HCG
144- Previous sibling has some disease now mother pregnant with boy & she wants to know whether the new comer will have it
145- Raised HCG & low AFP
146- Previous child has recurrent infection & below percentile. Mother wants to know whether next child has it
147- This disease is related with increased risk of Alzheimer’s disease
148- Pregnant mother given folic acid to prevent some disease.


Theme-29: Treatment of STDs

A- Single dose long acting Penicillin
B- Ciprofloxacin
C- Doxycycline
D- Erythromycin
E- Metronidazole
F- Topical co-trimazole
G- Nystatin oral
H- Steroids

149- Essential drug to be included in Gonococcal cervicitis
150- Lady with Chlamydial Infection
151- Drug Rx in Pregnant lady with Chlamydial infection
152- Lady with bacterial Vaginosis
153- Lady with candidiasis



Theme-30: Next step of management GYN

A- Cervical smear
B- Cervical biopsy
C- Laporoscopy
D- Per speculum exam
E- Colposcopy
F-



155- Lady with diagnosed CIN-1. CA cervix 6 months back now comes for follow up
156- Lady with CIN-2 diagnosed 6 month back now comes for follow up
157- Post menopausal women with bleeding & dyspareunia
158- Pre menopausal women with ectropion & bleeding





Theme-: Miscellaneous Qs Diagnosis GYN

A- Stress incontinence,
B- Urge incontinence
C- True incontinence
D- Fibroids
E- Ectopic pregnancy
F- Endometrial carcinoma
G- Uretro vaginal fistula.
H-


159- After surgery dripping of urine
160- Lady presented with urine voided on coughing.
161- Africo-caribian lady with problem of heavy menorhagia.
162- Post menopausal women with bleeding pervaginum


Theme-31: Epidemiology in Psychiatric disorders

A- Depression
B- Schizophrenia
C- Obsessive Compulsive Disorder
D- Anorexia Nervosa
E- Bulimia Nervosa
F- Anxiety
G- Starvation
H- Alcohol
I- Drug Addiction
163- Most commonly seen in developed countries where the females are more conscious than men about weight gain.
164- The psychiatric disorder occurs less in elderly & 4-time more in women.
165- A student preparing for the exam for the last 4 weeks & having weight loss of 10 kg. But feeling perfectly alright.
166- A business man presents to you having trouble sleeping & poor appetite Due to some changes in his business.. dont remember exactly.
167- This disease is more common in females increases as age advances


Theme-32: Causes of confusion

A- EDH
B- Hypothyroid
C- Alzheimer’s
D- UTI
E- DM
F-

169- Confusion with intake of drugs prescribe for his parents
170- Alcoholic with confusion
171- Confusion with increased forgetfulness
172- Confusion with incontinence
173- Confusion with constipation hoarseness hypotonia


Theme-33: Alcoholism & Drugs Addiction

A- Less coffee
B- Starvation
C- Diazepam
D- Admit
E- Methadone
F- Chlorpromazine
G- Benzodiazepines
H- Increase oral vitamin doses
I- Naltraxone
J-
K-

175- Shaking after alcohol abstinence
176- Alcoholic been to support groups before & not helped. Wants to give up alcohol
177- An alcoholic who was on a 36 hr non stop alcoholic binge, came to A&E after 2 days(when he didn’t drink )but he is prone to getting violent when drunk,. He comes with drowsiness
178- An alcoholic who has features of Korsakoff’s comes with auditory hallucinations; he is already taking oral vitamin supplements.
179- Cocaine user willing to stop
180- A heroin addict wants to quit
181- Student with more tremors before exams
182- Old man with nutritional deficiencies
183- Delirium tremens treatment



Theme-34: Treatment in skin lesions (Eczema)

A- Hydrocortizone 2%
B- Topical antibiotis
C- Topical hydrocortisone 1%
D- Systemic steroids
E- Topical aciclovir,
F- i/v aciclovir,
G- Oral aciclovir,
H- Flucloxacillin,
I- Emollients
J- Carbamazepine
K- Amitryptaline.
185- A boy with eczema wiping vesicles, redness.......etc
186- A boy with eczema, intense itching & scratch marks
187- A man with eczema that topical hydrocortisone 1% did not help
188- A child with herpetic whitlow come with some blisters over the trunk, Rx?
189- 80 yr old lady with herpetic rash appearing 5 days back on the back of her trunk. Rx.
190- HIV with herpes
191- Qs about Herpetic neuralgia
192- Pregnancy with shingles




Miscellaneous EMQs

193- Factory worker with loss of wt thickened plueru etc
194- African with supra clavicular LN enlargement & weigh loss

Chest pain
Angina MI Peptic ulcer
195- A young man p/w pain in chest radiating to left jaw
196- Old man p/wpain in epigastrium related to exertion

197- Lady with breast cancer presents with confusion investigation,
S. calcium
Dexa bone scan
S. urate
bone X-rays

198- Appendicular mass in child afebrile management






Answers November 2003

Hidden text: LOCKED
Available only to registered users. Register now for Free.
Hidden content: UNLOCKED
1
2
3
4
5
6 E
7 B
8 A
9 C
10 G
11
12
13 E
14
15
16 E
17 C
18 A
19 A/D
20 C/F
21 C
22 A
23 B
24
25 I
26 D
27 B
28
29 I
30 F
31
32
33
34
35
36 H
37 J
38 I
39 L
40
41 B
42 C
43 D
44 H
45 F
46 B
47
48
49
50 D/C
51 G
52 C
53 H
54 C
55 F
56 E
57 B
58 A
generalized convulsions
59
60
61
62 C
63
64 C
65
66 G
67 B
68
69
70
71 G
72 F Infective endocarditis
73 C
74
75 C
76 A
77 B
78 D
79 F
80 F
81 H
82 E
83 C
84 E
85 M
86 J
87 C
88 F
89 E
90 A
91
92 B
93 C
94 A
95
96 C s/s of perforation of diverticultitis
97
98 E
99 D
100 F
101 B
102 D/A
103 C
104
105
106 D
107 E
108 A
109
110 D
111 E
112 G
113 D
114 C
115 ? acute pyelonephritis
116
117
118 M




119
120 A
121 K
122 C/K
123 A/H
124
125 ?
As Berette,s Oesophagitis was not in options
126
127
128 G
129
130
131
132 C
133 A
134 E
135 B
136 D
137
138 D
139 A
140 E/B
141 H
142
143 D/A
144 C
145
146
147 A
148 J
149 A
150 C/D
151 D
152 E
153 F
154
155 A
156 E
157
158
159 G



160 A
161 D
162 F
163 E
164 A
165 G
166 A
167
168
169 E
170 A
171 C
172 D
173 B
174
175 C
176
177
178
179 E
180
181 A
182 B
183 C
184
185 C
186 B/C
187 A
188
189
190 F
191 J/K
192 E
193 mesothilioma
194 TB
195
196
197
198 conservative management
199
200
Please DO NOT private message me for help.
Post all questions in the public forums only so that the answers will benefit others who may have the same question in the future.
Undergraduate & postgraduate Scholarships Info
Post & Apply to Medical Jobs for FREE
Admissions to Chinese Medical & Engineering Universities


Image
User avatar
drwatson
 
Posts: 204
Joined: Fri Jun 18, 2010 7:26 pm
Location: Pakistan
Country: Pakistan (pk)
Has thanked: 12 times
Have thanks: 10 times

Return to PLAB Exams

Who is online

Users browsing this forum: Alexa [Bot] and 0 guests