PLAB (Psychiatry) Sample Questions Set-14
Categories: U.K. PLAB (Professional and Linguistic Assessments Board)
Question. A 29 year old woman is overly paranoid that her partner is being unfaithful to her. She checks his phones, email accounts and bank statements several times a day for evidence of infidelity. She dislikes him going out as she fears that he would look at other women while he is out on his own. She does not allow any social media for fear that he may meet other women. What is the SINGLE most likely diagnosis?
A. Fregoli delusion
B. Cotard syndrome
C. Capgras syndrome
D. Ekbom syndrome
E. Othello syndrome
Answer: (e)
Question. A 45 year old woman presents with complaints of abdominal pain and blood in the stool. She brings the stool sample from home but has never been able to produce a sample at the hospital. A urinalysis was done which was negative. Her blood tests are normal. This is the third time she is presenting to the hospital in the last month. On examination, multiple scars on the abdomen consistent with laparoscopies are seen. She insists on getting further investigations although no abnormalities are found. What is the SINGLE most likely diagnosis?
A. Somatization disorder
B. Hypochondriasis
C. Munchhausen’s syndrome
D. Conversion disorder
E. Malingering
Answer: (c) [Munchausen's syndrome would fit best. Likely she is inserting blood into her stools at home for medical attention. This can easily be done with a pin prick on the finger.
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.
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
o'negative test results.
Somatization disorder →The experience of bodily symptoms with no physical cause for them, with presumed psychological causation. The patient refuses to
accept reassurance or negative test results.
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.
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).]
Question. A 36 year old woman contacted the police to notify them that she was responsible for a recent disastrous flood which had resulted in loss of lives. What is the SINGLE most likely kind of delusion she is suffering from?
A. Persecutory delusion
B. Fregoli delusion
C. Delusion of guilt
D. Nihilistic delusions
E. Delusion of reference
Answer: (c) [Delusion of guilt → involves feeling guilty or remorseful for no valid reason. An example would be someone that believes they were responsible for a war in another country or hurricane damage in another state. The object of delusion believes that they deserve to be punished for their sins.]
Question. A 22 year old woman comes to the clinic with an obsessive ideation that she is overweight. Her body mass index is 17 kg/m2. She is on a strict diet and does aerobic exercises 3 times a day. While taking a history lesson, she admits to laxative abuse. On examination, she has patches of thickened calluses on the dorsal aspect of the first interphalangeal joint. What is the SINGLE most appropriate action?
A. Refer to medical team
B. Discharge with advice
C. Refer to eating disorder clinic
D. Prescribe a trial of antidepressants
E. Advise on a food diary and review in one month
Answer: (c) [The thickened calluses on the knuckles is from self-induced vomiting which is called “Russell’s sign. It may be found on examination in patients with bulimia nervosa or anorexia nervosa. She falls into the category of moderate anorexia. Admission to the hospital is not warranted because her blood pressure, heart rate are fine and her BMI is still above15. Referral to an eating disorder unit or service would be the most appropriate. No drug treatments for anorexia nervosa are validated by good randomized trials although fluoxetine prevents relapse in open trials. Nonetheless, do not pick antidepressants when it is the option for management of anorexia nervosa for this exam.
BMI <15kg/m2, rapid weight loss + evidence of system failure: requires urgent referral to eating disorder unit (EDU), medical unit (MU) pediatric medical wards.
In moderate anorexia (BMI 15–17.5, no evidence of system failure): routine referral can be to the local community mental health team or eating disorder unit (EDU) if available.
In mild anorexia (BMI >17.5): focus on building a trusting relationship and encouraging use of self-help books and a food diary.]
Question. A 64 year old man has a firm belief that the person on the billboard outside his window is sending messages that are meant specifically for him. What is the SINGLE most likely type of delusion that this man is suffering from?
A. Persecutory delusions
B. Grandiose delusions
C. Delusion of control
D. Delusion of reference
E. Nihilistic delusions
Answer: (d)
Question. A 33 year old woman has been feeling down for the past one year. She feels fatigued and is eating more than usual. Several times a week she would wake up during the night and would not be able to go back to sleep. Occasionally, she hears voices of her late husband who died two years ago. What is the SINGLE most likely diagnosis?
A. Obsessive compulsive disorder
B. Psychotic depression
C. Grieving
D. Severe depression
E. Hypomania
Answer: (b) [This affected individual has lost her husband. Depression should be something to consider. The auditory hallucinations are signs that this woman is having some form of psychosis. The most probable diagnosis here is psychotic depression. Very commonly in PLAB they would give a scenario of a person having symptoms of an atypical or typical depression plus having some form of hallucinations. In the majority of the cases, the answer to that scenario would be psychotic depression.]
Question. A 37 year old woman believes that her neighbours have been using her shower while she is away at work. She is convinced that they dry the bathroom and escape just before she goes into the bathroom. Her husband comes to share the same belief and informs the police. What is the SINGLE most appropriate term for these symptoms?
A. Capgras syndrome
B. Cotard syndrome
C. Persecutory delusions
D. Folie a deux
E. Munchhausen’s syndrome
Answer: (d) [Folie à deux is the best term to describe this. It is symptoms of a delusional belief and hallucinations that are transmitted from one individual to another usually by two people in a close relationship like in this case, husband and wife.
Folie à deux → is French for “madness of two”. It is a situation where two people with a close relationship share a delusional belief. This arises as a result of a psychotic illness in one individual with development of a delusional belief, which comes to be shared by the second. The delusion resolves in the second person on separation, the first should be assessed and treated in the usual way.]
Question. A 64 year old woman has been brought by her son for psychiatric evaluation. She says that she has stopped living with her husband because she is convinced that it is someone else posing to be him. What is the SINGLE most likely condition she is suffering from?
A. Delusion of reference
B. Delusion of guilt
C. Cotard syndrome
D. Delusion of persecution
E. Capgras syndrome
Answer: (e)
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.