PLAB (Psychiatry) Sample Questions Set-13
Categories: U.K. PLAB (Professional and Linguistic Assessments Board)
Question. A 20 year old man complains his movements are being watched. He feels as though his actions are being controlled by the radio. At times he hears voices describing his actions. What is the SINGLE most likely diagnosis?
A. Mania
B. Schizoid personality disorder
C. Paranoid personality disorder
D. Schizophrenia
E. Korsakoff psychosis
Answer: (d) [He describes his movements being controlled by the radio. This is known as passive phenomena. He also describes voices describing what he is doing. This is called third person auditory hallucinations. Sometimes these voices can be heard like a running commentary. Example, the patient hears one or more voices providing a narrative of their current actions, ‘he’s getting up…now he’s going towards the window’. All these features are features of schizophrenia.]
Question. A 45 year old woman has been extensively investigated for a lump she believes to be cancer. All investigations done show that the lump is unlikely to be cancer however she is not convinced and does not think the doctors are taking her seriously. She has demanded another referral. What is the SINGLE most appropriate term that describes her condition?
A. Munchhausen’s syndrome
B. Munchhausen’s by proxy
C. Hypochondriasis
D. Malingering
E. Conversion disorders
Answer: (c) [Her obsession and persistent belief that there is an underlying serious disease is evidence of hypochondriasis. As there is actually a lump and she is not falsifying the symptoms, it is not Munchausen's syndrome or malingering.
Hypochondriasis → is the persistent belief in the presence of an underlying serious DISEASE, e.g. cancer or HIV. The patient again refuses to accept reassurance or negative test results.
Munchausen's syndrome → also known as factitious disorder. Patients intentionally falsify their symptoms and past history and fabricate signs of physical or mental disorder with the primary aim of obtaining medical attention and treatment. The diagnostic features are the intentional and conscious production of signs, falsification, or exaggeration of the history and the lack of gain beyond medical attention and treatment.
Munchausen’s syndrome by proxy → manifest by a person feigning or inducing illness in a child (or others) in order to obtain medical attention. It is a form of child abuse in that it subjects the child to emotional abuse, unnecessary medical procedures, hospitalization or other treatments that are harmful to the child.
Malingering → Deliberately falsifying the symptoms of illness for a secondary gain (e.g. for compensation, to avoid military service, or to obtain an opiate prescription).
Conversion (dissociative) disorders → typically involve loss or disturbance of normal motor or sensory function which initially appears to have a neurological or other physical cause but is later attributed to a psychological cause. The patient does not consciously feign the symptoms or seek material gain. Patients may be indifferent to their apparent disorder.]
Question. A 33 year old woman in the psychiatric ward diagnosed with schizophrenia, complains that she is unable to think straight because the nurse is stealing her thoughts. What is the SINGLE most likely phenomenon?
A. Thought echo
B. Thought insertion
C. Thought broadcasting
D. Thought withdrawal
E. Thought block
Answer: (d) [This is thought withdrawal. Which is the delusional belief that thoughts have been'takenout' of his/her mind. It is commonly associated with thought block. But the difference is that in thought block, there is a sudden break of chain of thought and no one is stealing the ideas.]
Question. A 30 year old schizophrenic female attacks her mother believing that aliens have replaced her with an exact double. What is the SINGLE most likely condition she is suffering from?
A. Capgras syndrome
B. Ganser syndrome
C. Todd’s syndrome
D. Fregoli delusion
E. Cotard syndrome
Answer: (a) [Capgras syndrome → A type of delusional misidentification in which the patient believes that a person known to them has been replaced by a ‘double’ who is to all external appearances identical, but is not the ‘real person’.
Ganser syndrome → is a type of factitious disorder, a mental illness in which a person deliberately and consciously acts as if he or she has a physical or mental illness. They Mimic behavior that is typical of a mental illness, such as schizophrenia. It is also sometimes called prison psychosis, because the syndrome occurs most frequently in prison inmates, where it may represent an attempt to gain leniency from prison or court officials. They produce ‘approximate answers’. They may give repeated wrong answers to questions which are nonetheless ‘in the right ballpark’. Example, ‘what is the capital of Scotland?’ Answer ‘Paris’. These symptoms may occasionally be associated with organic brain illness but it is much more commonly seen as a form of malingering in those attempting to feign mental illness, usually prisoners awaiting trial.
Todd's syndrome → Also known as “Alice in Wonderland Syndrome''. It involves perceptual distortions of the size or shape of objects and altered body images.Patients may feel as though their body is expanding or getting smaller.
Frégoli delusion (Delusion of doubles) → is when a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise.
Cotard syndrome → is a presentation of psychotic depressive illness characterised By a combination of a severely depressed mood with nihilistic delusions. The patient may state that he is already dead and should be buried. He may state that his insides have stopped working and are rotting away, or that he has stopped existing altogether.]
Question. A 33 year old man with a history of severe depression says his insides are rotting and nobody has bothered to bury him. He feels the world no longer exists and nothing matters. His gaze is always downwards and has barely any eye contact with anyone. What SINGLE term describes his condition?
A. Nihilistic delusions
B. Delusion of guilt
C. Persecutory delusion
D. Fregoli delusion
E. Clang association
Answer: (a)
Question. A 26 year old woman is afraid to visit the shopping centre. Crowds and public places cause her panic. She even feels distress, short of breath and develops palpitations when she boards the train to travel to see her aunt. She feels more relaxed when she goes out to public places with her husband than when alone. Her anxiety has been worsening over the past few months and she now refuses to go out because of this irrational fear. What is the SINGLE most likely diagnosis?
A. Social phobia
B. Claustrophobia
C. Arachnophobia
D. Acrophobia
E. Agoraphobia
Answer: (e) [The answer here is agoraphobia as she has a fear of going out into the open.
Agoraphobia → Fear of open spaces
Social phobia (Social Anxiety Disorder) → persistent fear and anxiety about one or more social or performance situations
Claustrophobia → irrational fear of confined spaces
Arachnophobia → fear of spiders
Acrophobia → fear of heights
Agoraphobia:
Means "fear of open spaces". Many people assume agoraphobia is simply a fear of open spaces, but it's actually a more complex condition. Someone with agoraphobia may be scared of:
i. travelling on public transport
ii. visiting a shopping centre
iii. leaving home
A clinical definition is "a fear of open spaces, especially those in which getaway may be difficult, which leads to avoidance of the situation". When people suffering from agoraphobia are in situations where escape is difficult or embarrassing such as crowds or public places, they develop a sense of intense anxiety.
Symptoms of a panic attack, such as:
i. palpitations
ii. hyperventilating
iii. sweating
Some patients can manage to continue their daily lives (with difficulty), whilst some others who are severely affected and may even become incapacitated.]
Question. A 33 year old woman has been feeling low and having difficulty in concentrating since her husband passed away 6 weeks ago. She has been crying almost everyday, and feeling hopeless. She has been withdrawing from other people and does not want to go out for dinner with her mother. What is the SINGLE most likely diagnosis?
A. Adjustment disorder
B. Posttraumatic stress disorder
C. Panic disorder
D. Generalized anxiety disorder
E. Social phobia
Answer: (a) [Adjustment disorders: An adjustment disorder occurs when an individual is unable to adjust to or cope with a particular stress or a major life event. They must occur within 1 (ICD-10) or 3 months (DSM-IV) of a particular psychosocial stressor, and should not persist for longer than 6 months after the stressor (or its consequences) is removed.
Question. A 35 year old male is bitterly annoyed with everyone around him. He complains that they are putting ideas into his head. What is the SINGLE most likely phenomenon?
A. Thought block
B. Thought insertion
C. Thought broadcasting
D. Thought withdrawal
E. Thought echo
Answer: (b) [Thought insertion is the delusional belief that thoughts are being placed in the patient’s head from outside. It is a first-rank symptom of schizophrenia.]
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.