Question. An 89 year old man has a basal cell carcinoma on his forehead which requires excision. He has dementia. The clinic nurse feels he is not competent to give consent for surgery.
Which is the most appropriate action for obtaining consent?
A. Ask a psychiatrist to assess his cognitive function
B. Ask his general practitioner to sign the consent form
C. Ask his wife to sign the consent form
D. Ask the patient to sign the consent form
E. Ask the surgeon to assess his mental capacity
Answer. (E)
Question. A 21 year old woman has increasing severe pain in her left leg. She had an undisplaced fracture of the midshaft of her left tibia 2 days ago which was treated conservatively with a plaster cast. Her toes are warm and pulses are present.
Which is the most important immediate action?
A. Elevate the limb
B. Refer to orthopaedics
C. Remove the plaster cast
D. Replace the cast with increased padding
E. Re-X-ray the fracture site
Answer. (C)
Question. A 14 year old girl attends the GP surgery requesting the oral contraceptive pill (OCP). She is sexually active and her boyfriend is in the year above her at school. Her parents are unaware of the appointment and her request for OCP.
Which is the most appropriate management?
A. Advise her about safe sex and prescribe the OCP
B. Contact her parents
C. Contact the local safeguarding team
D. Contact the police
E. Explain it is illegal to prescribe the OCP for her
Answer. (A)
Question. A 22 year old man has had a painful right eye for 1 day. He had similar symptoms 1 year ago. He has had episodic back pain and stiffness for 4 years which is relieved by exercise and ibuprofen. His right eye is red and his vision is blurred.
Which is the most likely cause of his red eye?
A. Chorioretinitis
B. Conjunctivitis
C. Episcleritis
D. Keratitis
E. Uveitis
Answer. (E)
Question. A healthy boy is born by vaginal delivery at 40 weeks gestation. His mother had confirmed acute hepatitis B during this pregnancy.
Which preventative intervention should be given immediately to the baby?
A. Confirm hepatitis B status of baby as first step
B. Full course of hepatitis B vaccine
C. Full course of hepatitis B vaccine and hepatitis B immunoglobulin
D. Hepatitis B immunoglobulin
E. Hepatitis B vaccine as a single dose
Answer. (C)
Question. A 66 year old man has tiredness and low back pain for 2 months. He has type 2 diabetes and hypertension and takes metformin and ramipril. He is a non-smoker and does not drink alcohol. His pulse rate is 88 bpm and BP 138/82mmHg. Clinical examination is normal.
Investigations:
Haemoglobin 78 g/L (130–175)
White cell count 3.4 × 109/L (3.0–10.0)
Platelet count 80 × 109/L (150–400)
Corrected calcium 2.71 mmol/L (2.2–2.6)
Albumin 36 g/L (35–50)
X-ray of lumbar spine: generalised osteopenia and vertebral collapse at multiple levels.
A. Which is the most appropriate next investigation?
B. Serum angiotensin converting enzyme
C. Serum parathyroid hormone
D. Serum prostate specific antigen
E. Serum protein electrophoresis
Answer. (D)
Question. A 17 year old woman has a painless lump on her right breast for 4 weeks. There is no history of trauma. She takes the oral contraceptive pill. Her maternal grandmother had breast cancer. She has a 1 cm painless lump in the upper outer quadrant of her right breast.
Which is the most appropriate initial investigation?
A. Excision biopsy
B. Fine needle aspiration cytology
C. Magnetic resonance imaging
D. Mammography
E. Ultrasound scan of the breast
Answer. (E)
Question. A 40 year old man takes an overdose of his antidepressant tablets and is seen in the Emergency Department. He is medically fit for discharge. He has bipolar affective disorder. He is tearful and feels hopeless about his future.
Which is the most appropriate next management step?
A. Arrange liaison psychiatric assessment
B. Arrange psychiatric outpatient follow-up
C. Discharge to the care of his general practitioner
D. Referral to clinical psychologist
E. Referral to local alcohol treatment team
Answer. (A)
(Psychiatric assessment of patients who present post overdose is important. This will help to determine an appropriate management plan and assess risk. Patients with bipolar depression and suicide attempts are high risk and require further psychiatric assessment.)
Question. A 6 week old girl has bronchiolitis and is seen in the Emergency Department. She is medically stable and ready for discharge. There were no problems in pregnancy. She was born at term by normal vaginal delivery. She is an only child. Her mother says that she cannot cope with her new baby.
Which is the most appropriate initial management?
A. Arrange temporary foster care
B. Contact social services
C. Refer back to her GP
D. Refer her to safeguarding team
E. Organise a Place of Safety order
Answer. (B)
[A mother voicing concerns that she cannot cope may be a sign of depression or other mental illness. Whatever the reason, such a comment is a ‘red flag’ that the child’s care may be compromised, and that her mother needs support. Social service departments are legally required to support family members who have additional needs beyond what health, education or community services can provide, so referral to social services is the best answer here. Social services have a duty to safeguard children who are at risk of harm, but in the case described in this question however there is no evidence to suggest an immediate risk of harm so that option is not the single best answer here. Likewise foster care might be needed at a future stage if the situation worsens, but not at this point. Her GP cannot provide the type of support required by this child’s mother. A Place of Safety order is not appropriate as this is used to detain a child because of the ill-treatment or neglect ant this is not the case here.]
Question. A 4 week old boy has had episodes of vomiting since birth. The vomiting occurs soon after feeding. He does not vomit after every feed and it is not related to the amount he takes. He is otherwise well and is gaining weight appropriately.
Which is the most likely diagnosis?
A. Cow's milk protein allergy
B. Gastro-oesophageal reflux
C. Lactose intolerance
D. Pyloric stenosis
E. Urinary tract infection
Answer. (B)
These questions cover various aspects of medical knowledge, clinical reasoning, and professional skills. Remember to refer to the PLAB exam syllabus and guidelines for a comprehensive understanding of the exam content and format.
The PLAB test is a prerequisite for international medical graduates who want to practise medicine in the UK. Passing both parts of the exam is also a requirement. To receive a licence to practise medicine in the UK after passing the exam, you might need to complete additional exams, such as the GMC registration process and securing a job offer or training placement.
In order to practise medicine in the United Kingdom, international medical graduates must pass the PLAB (Professional and Linguistic Assessments Board) exam. The General Medical Council (GMC), which oversees medical practitioners in the UK, is in charge of administering it.
The PLAB exam is divided into two parts:
PLAB Part 1: This written, multiple-choice exam gauges your knowledge and comprehension of clinical practise and medical principles. It has 180 single-best-answer questions and covers a variety of subjects, such as surgery, psychiatry, paediatrics, obstetrics and gynaecology, and more. The PLAB Part 1 exam is available in many different nations.
PLAB Part 2: This practical test evaluates your clinical abilities, communication abilities, and ethical standards. There are 18 situations in all, all of them take place in the UK and include interacting with fictitious patients. Your capacity to gather data, generate accurate diagnoses, and create treatment plans is evaluated by the examiners.
You must fulfil specific requirements, such as holding a primary medical certification recognised by the GMC and possessing the appropriate English language proficiency, in order to be qualified to take the PLAB exam. The GMC's website should be checked for the most recent and comprehensive qualifying requirements.
A strong foundation in clinical expertise and medical knowledge is necessary for PLAB exam preparation. Many applicants prepare by combining self-study, books, online sources, and practise tests. Additionally, a number of for-profit businesses provide training programmes and resources created expressly for the PLAB exam.