PLAB (Psychiatry) Sample Questions Set-12

Categories: U.K. PLAB (Professional and Linguistic Assessments Board)

Question. A 19 year old college student has a firm and unshakable belief that he is being followed by terrorists who are plotting against him. He says they follow him wherever he goes. What is the SINGLE most appropriate term for his condition?

A. Persecutory delusions

B. Grandiose delusions

C. Delusion of control

D. Delusion of reference

E. Nihilistic delusions

 

Answer: (a) [Persecutory delusion → is a delusional belief that one’s life is being interfered with in a harmful way. It refers to false beliefs or perceptions in which a person believes that they are being treated with malicious intent, hostility, or harassment despite significant evidence to suggest otherwise. This may occur in the context of being tormented, followed, or spied on.

Grandiose delusions → or delusions of grandeur are the fantastical beliefs that one is famous, omnipotent, wealthy, or otherwise very powerful. They believe that they have exceptional abilities or talents and keep praising themselves.

Delusion of control → is the false belief that another person, group of people, or external force controls one's general thoughts, feelings, impulses, or behavior.

Delusion of reference → is the false belief that insignificant remarks, events, or objects in one's environment have personal meaning or significance. Example, someone constantly gives him or her special messages through the newspaper.

Nihilistic delusions → is the delusional belief that the patient has died or no longer exists or that the world has ended or is no longer real. Nothing matters any longer and continued effort is pointless. It is a feature of psychotic depressive illness. Patient may believe that he/she is dead and may ask people to bury them.]

 

Question. A 23 year old man feels anxious and agitated when faced with stress. He has an interview in 3 days and would like some help in relieving his symptoms for the interview. What is the SINGLE most appropriate management?

A. Selective serotonin reuptake inhibitors

B. Cognitive Behavioural therapy

C. Propranolol

D. Diazepam

E. Rebreathe into paper bag

 

Answer: (c) [Medication usually is not used to treat phobias. However, it is sometimes prescribed to help people cope with the effects of anxiety. Beta-blockers are commonly used. It would be appropriate here as it is only for a short term.]

 

Question. A 43 year old woman presents with low mood, and loss of libido. She feels tired all day and she attributes this to the fact that she wakes up 3 hours sooner than usual. She feels like she has been gaining weight. She also finds it difficult to concentrate for long periods of time. What is the SINGLE most likely diagnosis?

A. Seasonal Affective Disorder

B. Bipolar disorder

C. Attention deficit hyperactivity disorder (ADHD)

D. General anxiety disorder

E. Depression

 

Answer: (e) [Symptoms of depression:

i. Present for at least 2 weeks and represent a change from normal.

ii. Depressed mood: present most of the day, nearly every day, with little variation.

iii. Anhedonia: markedly diminished interest or pleasure in all, or almost all, activities most of the day.

iv. Weight change: loss of weight when not dieting or weight gain associated with decreased or increased appetite

v. Disturbed sleep: insomnia (with early morning waking 2–3 hr sooner than usual) or hypersomnia (especially in atypical depression).

vi. Fatigue or loss of energy.

vii. Reduced libido.

viii. Feelings of worthlessness or excessive or inappropriate guilt

ix. Diminished ability to think or concentrate or indecisiveness.

x. Recurrent thoughts of death or suicide]

 

Question. A 32 year old man thinks nurses are plotting to harm him and are stealing his ideas straight out from his mind. Sometimes he feels the nurses are able to control his body. What is the SINGLE most likely diagnosis?

A. Schizoid personality disorder

B. Borderline personality

C. Schizophrenia

D. Psychotic depression

E. Paranoid personality disorder

 

Answer: (c) [The patient is suffering from schizophrenia. This can be shown by the fact that he thinks that ideas are being stolen from his mind (thought withdrawal), and that the nurses are plotting to harm him (persecutory delusion). The feelings of nurses controlling his body are consistent with schizophrenia. It is called passive phenomena.

Schizophrenia:

Features:

Auditory hallucinations:

i. third-person auditory hallucinations → voices are heard referring to the patient as ‘he’ or ‘she’, rather than ‘you’.

ii. thought echo → an auditory hallucination in which the content is the individual’s current thoughts

iii. voices commenting on the patient's behaviour

Thought disorder:

i. thought insertion → The delusional belief that thoughts are being placed in the patient’s head from outside

ii. thought withdrawal → The delusional belief that thoughts have been 'taken out' of his/her mind

iii. thought broadcasting → The delusional belief that one’s thoughts are accessible directly to others

iv. thought blocking → a sudden break in the chain of thought.

Passivity phenomena: bodily sensations being controlled by external influence

Delusional perceptions: a two stage process where first a normal object is perceived then secondly there is a sudden intense delusional insight into the object's meaning for the patient e.g. 'The traffic light is green therefore I am the King'.]

 

Question. A 43 year old man attends the GP clinic complaining that his arm is dead and rotten and he wants it removed. He has very poor eye contact and stares at the floor for the majority of the consultation. On physical examination, the arm looks normal. What is the SINGLE most appropriate diagnosis?

A. Somatization disorder

B. Hypochondriasis

C. Conversion disorder

D. Nihilistic delusions

E. Capgras syndrome

 

Answer: (d)

 

Question. A 26 year old woman has a history of bipolar disorder for 10 years and is taking lithium for it. She has been symptom free for the past 4 years. She is now planning her pregnancy and wants to know whether she should continue to take lithium. What is the SINGLE most appropriate advice?

A. Continue lithium at the same dose and stop when pregnancy is confirmed

B. Continue lithium during pregnancy and stop when breast feeding

C. Reduce lithium dosage but continue throughout pregnancy

D. Reduce lithium gradually and stop before pregnancy is confirmed

E. Switch to sodium valproate

 

Answer: (d) [Despite problems with tolerability, lithium still remains the gold standard in the treatment of bipolar affective disorder. Lithium is teratogen. If a woman taking lithium is planning a pregnancy, and is well and not at high risk of relapse, she should be advised to stop taking the drug because of the risk of cardiac malformations in the fetus. This should be done by gradual discontinuation before conception. Lithium should be reduced gradually over 1–3 months as abruptly stopping lithium may cause their moods to become quite unwell. Gradually stopping lithium is usually a decision that a psychiatrist would need to take after weighing the risk of damage to the fetus, especially in the first trimester against the risk of untreated bipolar disorder.

Key points from NICE CKS:

i. Do not offer lithium to women who are planning a pregnancy or pregnant, unless antipsychotic medication has not been effective.

ii. If a woman taking lithium becomes pregnant, consider stopping the drug gradually over 4 weeks if she is well.

iii. If a woman continues taking lithium during pregnancy, check plasma lithium levels every 4 weeks, then weekly from the 36th week and adjust the lithium dose to maintain plasma lithium levels at a therapeutic range.]

 

Question. A 16 year old boy has been performing poorly in school since moving to a new school. He lacks interest and has very little social interactions. He has very few friends and finds it difficult to express himself. He prefers solitary activities. His teachers often complained that he is seen organising his stationaries on his table while counting to twenty each time and if disrupted, he would be very upset and anxious. One of his interests is collecting toy cars. He has over 2,000 toy cars and often spends hours lining them up. What is the SINGLE most likely diagnosis?

A. Borderline personality disorder

B. Dissocial personality disorder

C. Obsessive compulsive disorder

D. Autism spectrum disorder

E. Nonverbal learning disorder

 

Answer: (d) [This boy displays traits of autism. It is clear that he has difficulties in communication and forming relationships alongside having a repetitive and obsessive behaviour that brings anxiety when disturbed. Patients with autism usually present at particular times of change. The change in this stem is represented by moving to a new school.

AUTISM SPECTRUM DISORDERS:

Autism spectrum disorders are a group of lifelong developmental disorders characterized by their effect on social and communication skills as well as by a restricted, stereotyped, repetitive repertoire of interests and activities. It can be recognized for the first time at any age. They usually present in more particular times of stress such as when moving to a university or after the death of a spouse.

It can be characterised by:

1. Severe difficulties in communicating and forming relationships

2. Difficulties in language

3. Repetitive and obsessive behavior]


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.


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