March 2013 PLAB recall

Discussion in 'Plab 1 and 2 forum' started by Neha Gupta, Mar 23, 2013.

  1. Neha Gupta

    Neha Gupta Active Member

    March 2013 PLAB recall
    1. Death is notified to coroner if it might be due to an industrial cause.
    2. Patient 12 hours post-op is having pin-point pupils and others signs of opioid overdose. What will be given for treatment? Naloxone.
    3. Total number of bladder carcinoma cases over 5 years given. Annual incidence per million to be calculated. (The answer was 700)
    4. Patient is having dark skin, DM, heart failure. Which organ is most susceptible to get cancer? Liver
    5. A 55-year old modestly educated man suddenly thinks he is the principal of some college(or something like that). When confronted he says he is God. Answer was Identity Disorder, I guess.
    6. A clear cut case of agoraphobia.
    7. 2 ECGS. One was atrial fibrillation and the other was Supra-ventricular tachycardia.
    8. A question about prospective cohort.
    9. Few questions on drug dependence.
    10. Drug to be given in PIH. Atenolol.


    11.tetanus immunglobulin and antibiotics
    12.child milestones
    13.OCD
    14.Impetigo
    15.middle meningeal artery
    16.raial nerve injury
    17.Treatment of Acute Gout: NSAIDs
    18.Isolation of child at home with Chicken Pox
    19.Hepatitis B Vaccine and HBIG for newborn with
    Hepatitis infected mother
    20.Amniocentesis for diagnosing Down syndrome
    at 16 weeks.



    21.Antibiotics for PID include: Metronidazole, Ceftriaxone and doxycycline
    22.Trichomoniasis: Metronidazole twice daily
    23.Heroin Addict: Treatment Methadone
  2. Q: Lymph Nodes draining Scrotum ( Inguinal)
    Q: Vomiting in widespread Breast mets ( Intest Obstruction)
    Q: Swollen Arm after Bee bite in pt with removed Lymphnodes ( Lymphoedema)
    Q: Afro Caribean with Butterfly rash ( SLE)
    Q: Post Delivery Seizure ( Mg SO4)
    Q: Post ERCP Jaundice with Fever ( Infection)
  3. Patient worked in the shipyard and smoked, admitted with SOB, treated with antibiotics and died. Pleural thickness was found.What you need to talk with coroner about ?
    - Death is due to an industrial cause.
    - wrong treatment

    .......
    Industrial Cause
    Q: Chlymedia Not Treated in Male will proceed to > Epididymitis & Orchitis
    Q: Trachomonas Viginalis Rx > Metronidazole
  4. electric pains in arm of woman. ans gabapentin?

    A Lady developes focal neurological symptons a week after head injury, which vessel is likely to be? ans. cerebral vein (i chose this as middle meningeal artery bleeds profusely and presents acutely, but this was delayed for 2 days)
    what do others think?

    lesion on nose: ans. basal cell ca

    A young man with Chlamydia what will be next if untreated?
    ans. Epidymitis & Orchitis?

    boy playing basketbal. pain in chest: ans: pneumothorax?

    A 2 days old child NOT cyanosed, but has Pan systolic murmer and sympt of heart failure
    ans VSD?
  5. March 2013
    1.Trichimonas Vaginalis
    Ans:Metronidazole

    2. Child with nose bleeding-immediate action is
    Ans: pinch the soft part of the nose


    3. bipolar disorder treated with anti depressants…which will make her free from the symptoms
    Ans: mood stabilizers

    4. pansystolic murmur- Mitral regurgitation

    5. hernia crosses the deep inguinal ring
    ans is indirect hernia

    6. child with sezuire
    Ans: lorazepam

    7.a women preg 38wks megaoloblastic anemia relatively,what to do
    iron tablet, ferrous tab/do nothing
    Ans:do nothing

    8.prolonged APTT only
    Ans: ... hemophillia

    9. Man with lesion on nose which is enalrging. Its center is depressed by 0.8cm.
    a. Basal cell carcinoma
    b. Squamous Ca
    c. Molluscum contagiosum
    Ans:A

    10. Pt with lung cancer. Na is 122. Whats the treatment for it?
    a. Demeclocycline
    b. Vasopressin
    c. Restrict fluids
    Ans :A
    11.Hypercalcemia….initial treatment
    Ans: iv fluids

    12.Fat kid with DM1 keeps eating haphazardly, skips insulin intentionally, hates school. Refer to:
    a. Child psychologist
    b. Pediatrician
    c. Dietician
    d. Social worker
    Ans: Clinical psychologist

    13. Boy with fever and now blisters on face and neck and now spreading?
    Ans: Chicken pox

    14.Alzheimers…blaming wife…forgets things…which other factor
    Ans: Progressive

    15.Ulcerative colitis…colonoscopy

    16.Faecal occult blood…rectum

    17. pain around the eyes and maxilla after a viral infection
    Ans:Sinusitis

    18.Migraine….count fingers, pain…..

    19.First thing to do in a child with nose bleed:
    a. Pinch soft part

    20.. Patient with swelling of toe in the past. Now swelling of knee with effusion. Definitive test:
    a. Aspirate the effusion
    b. Serum urate
    Ans: aspiration

    21.13 month old child…development normal



    22.Patient has passed a 4mm stone in urine. Also has a 3mm stone still left. Managment:
    a. ESWL
    b. Conservative
    Ans: no treatment/reassuraance


    23.Patient with BP 160/90 and hematuria. Mother had a ‘kidney problem’ and aunt needed a kidney transplant.
    Ans:a. U/S abdomen

    24.. Painless hematuria:
    a. Cystoscopy

    25.Asthmatic patient with pain. Rx:
    a. Morphine oral
    b. Paracetamol
    c. NSAID
    Ans: Paracetamol

    26.Patient with cancer has B/L finger paresthesiase and sensory loss afer chemotherapy:
    a. Mets to cervical spine
    b. Hypocalcemia
    c. Peripheral neuropathy induced by chemo
    Ans: Peripheral Neuropathy induced by chemo

    27. 2 yr old child with UTI:
    a. Suprapubic cath
    b. Clean catch urine
    Ans: clean catch urine


    28. Hyperemesis gravidarum patient. Fluids to be given:
    a. 0.9% saline
    b. 5%dextrose
    Ans:0.9% saline

    29.. Patient comes with alcohol withdrawal. Management?
    a. Acamprosate
    b. Disulfiram
    c. chlordizepoxide
    Ans: chlordizepoxide

    30. Patient admitted in a hospital with delirium
    a. Acamprosate
    b. Disulfiram
    c.chlordiazepoxide
    Ans: chlordiazepoxide

    31. Give anti-Rho in unsensitized woman by
    a. 6 hrs
    b. 24hrs
    c. 48hrs
    d. 72hrs
    Ans: 72hrs

    32.Man with pan systolic murmur radiating to axilla.
    a. Mitral regurg
    b. Mitral stenosis
    Ans: MR

    33. Man with bipolar disorder wants to know which medicine will help him prevent these manic and depressive phases:
    a. Mood stabilizers

    34. Boy with bleeding after trauma. Bleeding time NORMAL. APTT 40 sec.
    a. Hemophilia
    b. Von Willebrands

    35. Patient is obese and snores and day time sleepiness. Best test:
    a. Overnight pulse oximetry
    b. ABGs

    36.Patient left OCPS 18months ago. Amneorrhea since 9 months. Pregnancy test negative.
    a. Hypothalamic amenorrhea
    b. Prolactinoma
    c. PCOS

    37. Patient about to undergo surgery:
    a. Change warfarin to heparin
    b. Stop warfarin

    38. Features of fibroadenoma
    Ans:fibroadenoma

    39.
    Ans:Neisseria

    40.15year old girl irregular menstruation
    Tranexamic acid/ cop
    Ans:cop
    41.Bee stung swollen and got cured. Now there is pitting oedema. Previously treated from breast cancer
    a.cellulitis
    b.delayed allergic reaction
    c.lymphoedema
    d.thrombus
    Ans: delayed???
    42.26 year old lady wants to lose weight and bmi is 23.
    Ans:Anorexia nervosa

    Two separate questions but same sumptoms and just places different
    A. Tuberculosis
    B. Lymphoma
    C. Brucellosis

    43.. An 18-year-old boy has come back from ?????after working in a farm there & now has fever with splenomegaly
    Brucellosis

    44.Woman returned from U.S now had night sweats and splenomegaly….lymphoma

    A patient has indirect inguinal hernia...which is the anatomical landmark...which differentiate the indirect inguinal hernia from the direct one....?
    a- Superficial inguinal ring
    b- Deep inguinal ring.......... (the answer ).......
    c- Pubic tubercle.......
    d- Mid-point of inguinal ligament

    A 53 years old man was admitted to the hospital for investigations of hemoptysis. 3 days after admission he developed alternating state of consciousness, ataxic gait and some visual problems.
    What is the most appropriate management of this patient?
    a. Acomprosate
    b. Chlordiazepoxide
    c. Diazepam
    d. High potency vitamins
    e. Disulfiram
    Ans: B.

    In a second day postnatal rounds pt is concered that her son as she is deaf------ ( ans)
    Other options were I do not know who bring these options all I remember is reassurance was there.
    1.Tuning fork.
    2.Startle Reflux
    3.Pure tone audiogram,
    4.Auditory Brain stem Response.
    5.Distracting Test.
    Ans: 4

    A 21 years old female in her first pregnancy at 38 weeks was brought to the emergency with a generalized tonic clonic seizure. Mgso4 given again fits.
    What is the single most important immediate management of this patient?
    a. IV MgSO4 repeat
    b. IV diazepam
    c. Immediate c section
    d. IV phenytoin
    e. IV lorazepam
    Ans: A
    A 53 years old female presents with an acute painful hot knee joint. She is a known case of rheumatoid arthritis. On examination, the knee is red, tender and swollen. The hamstring muscles are in spasm. Her temperature is 38.5 C and blood pressure is 120/80 mm Hg.
    What is the single best NEXT investigation? ( repeated )

    a. Joint aspiration for cytology and culture and sensitivity
    b. Join aspiration for positively birefrengent crystals
    c. Joint aspiration for negatively birefringent crystals
    d. Blood culture
    e. Serum uric acid
    Ans: A


    A 53 years old man presents with a long standing history of a 1cm lesion on his arm. It has started bleeding on touching.
    What is the most likely diagnosis? ( Repeated )
    a. Basal cell carcinoma
    b. Kaposi’s sarcoma
    c. Malignant melanoma
    d. Squamous cell carcinoma
    e. Kerathoacanthoma
    Ans: D
  6. A 15 years old boy presents with sudden onset of testicular pain. There is no history of trauma. He has a temperature of 38.5 C and right testes is swollen and tender.
    what is the diagnosis?
    a. torsion
    Ans: Torsion

    mask face….anti psychotic

    A 2 years old girl has frequency and pain burning micturation. She has some supra pubic tenderness.
    Which one of the following is the most appropriate initial investigation for this patient?
    a. Supra pubic aspiration of urine for C/S
    b. clean catch of urine for C/S
    c. USG
    d. IVU
    e. Micturating cystourethrogram
    Ans: clean catch urine

    meningitis??? headache,rash,fever
    Ans: lumbar puncture/ct

    7 years old boy presents with epistaxis of two hour duration. The bleeding has been controlled. His investigations are as follows:
    Platelets 210,000
    PT 13 seconds
    APTT 42 seconds
    Bleeding time: Normal

    Which one of the following is the most likely diagnosis?

    a. Hemophilia
    b. Vonwilibrand disease
    c. Idiopathic thrombocytopenic purpura
    d. Vitamin k deficiency
    e. Liver disease

    Ans: A

    child brought to A&E with cut in knee and sprained her left wrist.. which analgesia as she is asthmatic..------ ans: PARACETAMOL


    husband azzospermia
    Test to be done
    a.prolactin
    b.LH
    c.testosterone
    d.serum fsh
    Ans: d

    nuclear medicine???

    boy with recurrent swollen joints and not able to participate in sports
    Ans: rheumatic factor/ASO titre


    Painless vision loss- CRAO


    flamed haemorrhages


    Man on warfarin posted for hemiclectomy

    Ans- Stop warfarin and start Heparin

    Pt had ataxia, vertigo and nystagmus. Site of lesion?

    8th nerve
    Auditory canal
    Cerebellum

    Ans: cerebellum


    a patient with alternating swings/episodes from elation and depression was under treatment and got better .want something to be continued so he can stay well.
    *anxiolytics
    * mood stabilizers
    * anti depressents
    * anti psychotics


    a child distressed with stridousbreathing R/R 40. fever unable to swallow saliva .what to do first
    *examinine throat
    * secure airwa
    *keep him lie flat...
    iv penicillin

    Ans:secure airway

    .A patient came in emergency who was stabbed in a neck has a BP of 60/0 pulse was >120 and distended neck veins? Wats diagnosis?
    a) Aortic Laceration
    b) Cardiac Tamponade


    man with painless haematuria and bld clots -answer cystoscopy

    breast milk jaundice…..???
    man fell down in the garden and 24hr ecg was taken which was normal
    Ans: echo/ct
    Patient hurt while playing rugby. Severe pain. On examination just redness and tym.mem normal
    Ans: paracetamol
    Answered budd chiari syndrome twice
    Child with mild dehydration
    Ans: iv fluids
    A lady post colostomy closure has a small swelling around the stoma. Management?
    a. Local exploration
    b. Exploratory laporotomy
    c. Open laparotomy
    d. Resuture
    Ans:
    25 year old man sticky eye for one day. No trauma, no foreign body
    Treatment?
    Ans: antibiotics topical

    Lady heroin addict wants to quit. Needs someone to motivate
    Ans: clinical psychologist/community mental health
    Answered biguanides???
    Answered asthma???
    60year old woman tiredness,skin tanned
    Ans: Na 120mmol/l,K5.9mmol/l
  7. A child takes his grandmother medicine, now Nausea Vomiting ..
    Digoxin?



    Dilated.

    Dilated pupils mean
    - anticholinergic substances
    - sympathomimetics.

    Tricyclic antidepressants overdose:

    dilated pupils, dry mouth, drowsiness, sinus tachycardia, urinary retention, increased tendon reflexes, and extensor plantar responses, a wide variety of cardiac dysrhythmias (prolongation of the QRS complex and the PR/QT intervals, etc).
  8. long term effect of fully treated meningitis in a boy?
    a. full recovery
    b. hearing impairment (answer?)


    Info "Meningitis - Complications" (NHS Choices)

    As hearing loss is the most common complication of meningitis, people recovering from the condition are usually given a hearing test to assess their hearing. The test should be carried out before you are discharged or within four weeks of being well enough to have the test.

    Children and young people should discuss the results of their hearing test with a paediatrician (a doctor who specialises in treating children). This should take place four to six weeks after you are discharged from hospital. If your hearing is severely affected, you may need cochlear implants (small devices inserted into your ear to improve your hearing).
  9. Psychiatric Disorders:
    Q: Lady reluctant to go outside, stays inside her House [Agoraphobia]
    Q : Man depressed due to his rituals of closing taps and locking doors [Obsessive Compulsive]
    Q: Lady who broke up with boyfriend, feeling depressed and worthless, what is next if untreated? [Suicide]
    Q:Lady eating in expensive hotels, and cleaning house till 3 am [Obsessive compulsive?]
    Q: middle aged man with lots of symptoms, but clinicaly fit with no signs [Hypochondrial?]
    Q: Lady who thinks to quit heroin addiction, needs help [refer to mental health team]


    1. it's no BudChiary, it was infection in post ERCP patient, budchiary is highly unlikely after ERCP, infections are common due to impacted stones. perforation does not cause fever/jaudice so quickly.
    2. sticky eyes RX Antibiotic Drops
    3. Man with testicular pain and Red inflamed scrotum has Infection (not torsion, in torsion scrotum is normal)
    4.In homosexual patient was Traponema pallidum testing by [detection on antibody titres? or scraping culture from lesions]
    5. a man on operation theature lost musle strength and sensation in 1st web space is Median Nerve [or radial]



    A woman taking COCP pills is on Amoxicillin tabs for a week. What advice would you give to the patient?
    A. Stop CoCp and continue amoxil
    B. use condom for one week
    C. Use condim for two weeks
    D. No precaution required


    also a question about the effect of emergensy contraception
    - no ovulation
    - no implantation
    - thickening of mucous or something like that
  10. Antibiotics such as amoxicillin, ampicillin, erythromycin and tetracycline affect the re-absorption of oestrogen. These antibiotics alter the gut flora and ethinyloestradiol is not conjugated. There is more ethinyloestradiol passed in the stool. Pregnancy and breakthrough bleeding can occur

    if any of course of broad-spectrum antibiotics is taken then the woman should continue to use the pill but should also use a barrier method whilst taking the antibiotics and for seven days after stopping. If these seven days extend to the pill-free period then omit this (2) (in the case of ED tablets the inactive ones should be omitted)

    if the antibacterial course exceeds 3 weeks, the bacterial flora develop antibacterial resistance and additional precautions become unnecessary unless a new antibacterial is prescribed (3) - therefore if a woman is already taking the combined oral contraceptive and commences prolonged antibiotic treatment then additional precautions are required for the first 3 weeks only
    additional precautions are also unnecessary if a woman starting a combined oral contraceptive has been on a course of antibacterial for 3 weeks or more

    in the case of acne vulgaris an alternative therapeutic option would be the prescribing of a form of contraception with additional treatment properties such as Dianette (R)

    the guidance above is based on the use of antibacterials that are not enzyme-inducers (e.g. rifampicin, rifabutin)
    rifampicin and rifabutin are such potent enzyme-inducing drugs that an alternative method of contraception (such as an IUD) is always recommended. Since enzyme activity does not return to normal for several weeks after stopping an enzyme-inducing drug, appropriate contraceptive measures are required for 4 to 8 weeks after stopping (3)
    Notes:

    FSRH guidance now no longer advises that additional precautions are required to maintain contraceptive efficacy when using antibiotics that are not enzyme inducers with combined hormonal methods for durations of 3 weeks or less. The only proviso would be that if the antibiotics (and/or the illness) caused vomiting or diarrhoea, then the usual additional precautions relating to these conditions should be observed
  11. 1. A BOY ASTHMATIC ON b2 short agonist inhaled and inhaled steroids n suddenly has a cough that wakes him up in the night and a severe wheeze whenever he excercises wht other medication will you add. leukotriene antagonist
    2. a woman presented wt pain, xray shows low density and sclerotic edges and she is on HRT, wht other wmedication will u add. BISPHOSPHONATE
    3. a child with pan systolic mumur that radiates to the axila. MITRAL REGURGITATION
    4. a patient suffering from copd, who has been well controlled, just developed a sudden breathlesnness, which is the immediate next important first line investigation chest xray
    5. a woman suffering from post menopauseal hot flushes , wht medication will u give oestrogen n progesterone
    6. a man presented wt severe gastric tenderness, a biopsy shows abnormal cell infrittration of the lamina propria, what is the most likely diagnisis, adenocarcinoma
    7. a pt bn properly treated for cin11 she is on coc, smokes 20g of cigarette in a day, went to b examined for an ovarian ca cos her aunty has bn diagnosed of ovarian ca, which of these is a poor prognostic factor, family hx
    8. a woman brough her child breathing wt abdominal msl,he has received o2, nebulized salbutamol n ipratromin, and she is flaring with intercoastal and subcoastal recession Hydrocortisone
    9. which of these shows that the child is in severe respiratory failure INTERCOSTAL AND SUBCOASTAL RECESSION
    10. :A PT HAS DIPLOPA, PAIN ON LOOKING, WITH MILD DILATION OD PUPILS , UNREACTIVE TO LIGHT, WHICH IS THE MAIN ORAGN INVOLVED occulomotor
    11. a pt presented wt loss of sensation on the maxillary size of the face with some skin rashes,what othere organ will be affected in this patient, CORNEA
    12. A CHILD WT BLEEDING FROM THE NOSE, with prolong apt WHT IS THE LIKELY DIAGNOSIS HEMOPHILIA
    13. A SWELLING THAT EXTENDED FROM THE MANDIBULAR SIDE OF THE FACE WHICH MOVES FREELY AND IS PAINLESSS, WHT IS THE MOST LIKELY DIAGNOSIS mandibular CA
    14. A PT WTH MEATTSTIC BREAST CANCER, PRESENTED WTH ALTERED SENSORIUM,SWELLING OF THE UPPER PART OF THE BODY AND THE NECK AND HAS BN ON ADVJUVANT, WHAT IS THE NEXT LINE OF MANAGENMCT, A IV DEXAMETHASONE, ETC
    15. A BREAST DISCHARGE FROM A SINGLE DUCT OF THE BREAST DUCT PAPILOMA
    16. a woman who presented wth recurrent breast discharge, purulent with an induration bte thw skin and the areola, what is the likely cause of this a fistula,
    17. woman wt fine well circumscribed lesion, mobile fibro adenoma
    18. a 37yr old man who presented wt frank hematurai, all other investigations are normal,,what next investigation will you do cystoscopy
    19. A AMN AFTER CROSS SITTING FOR A LONG TIME PRESENTED WT EVERSION OF THE FOOT, LOSS OF SENSATION AT THE SOLE OF THE BIG TOE AND WHAT NERVE IS RESPONSIBLE PERONEAL
    20. A MAN PRESENTED WTH 55 PERCENT BURN AND SEVERE CHEST PAIN, ON OGD, THERE WERE MULTIPLE ULCERS IN D DUODENUM, he was haemodynamically stable WHAT IS THE MANGAMENT oral ppi,
    21. A PREGANNT WOMAN WT A BP OF 160 / 90, WHAT IS THE DRUG OF CHOICE LABETALOL.
    22. MAN WT A CHLAMYDIAL INFECTION, WHAT OTHER COMPLICATION WILL HE HV, EPIIDYMOORCHITIS
    23. A YOUNG BOY PLKAYING A GAME OF RUGBY, WAS HIT BY THE BALL, ON EXAMINATION THE EAR WAS ERYTHEMATOUS, TYMPANIC MEMBERANE WAS NORMAL, NO HEARING LOSS, WHAT MEDIACTAION WIL U GIVE, a ANAGELSIC
    24. A GIRL HAS COME TO YOU FOR emergency contraception DESCRIBE THE MXM OF ACTION INHIBIT IMPLANTATION
    25. A WOMAN HAD A SURGERY FOR REMOVEAL OF A STONE 110HRS AGO WTH MRCP, POST ENDOCOPY WAS GOOD N NORMAL AND SHE PRESENTED WTH JAUNDICE, WAHT IS RESPONSIBLE FOR HER JAUNDICE, INFECTION
    26. A MAN ON ALCOHOL DEPENDENCE WHO HAS BN TAKING ALCOHOL FREQUENTLY PRESNTED WTH PERSISTENT ABD PAIN AND JAUNDICE THAT RADIATES TO THE BACK,,,WHAT IS THE SINGLE MOST CAUSE OF THIS ACUTE PANCREATIATIS
    27. A PT PRESNTED WT ATAXIA, NYSTAMUS N VERTIGO, WHERE IS THE LESION CEREBELLUM
    28. A PATIENT IS SEVERLY SICK, CAME WT RASH THAT DOES NT BALNCH, PHOTOBIA,HEADCHE AND NECK STIFFNES, WHAT IS THE NEXT LINE OF IMMEDIATE ACTION IV ANTIBIOTIC AND CT
    29. a pt wth high bp pressure and n hypokalemis?????conns?? CONNS
    30. A PATIENT WT PIGMENTATION OF THE BODY,HYPERK,HYPONATREMIA, WHAT METABOLIT DO YOU MEASURE, acth,
    31. lymphactic drainge of the tetis PARAORTIC
    32. a wman wt mesttastic brest cancer has severe vomiting n diarhoea, and then became confused, what is responsible for it ACUTE INTESTINAKL OBSTRUCTION
  12. after thiazide is calcium antagonist before ACE inhibitors

    from gp notebook

    hoosing antihypertensive drug treatment

    offer people aged 80 years and over the same antihypertensive drug treatment as people aged 55-80 years, taking into account any comorbidities
    Step 1 treatment

    Offer people aged under 55 years step 1 antihypertensive treatment with an angiotensin-converting enzyme (ACE) inhibitor or angiotensin-II receptor blocker (ARB). If an ACE inhibitor is prescribed and is not tolerated (for example, because of cough), offer a ARB. (Do not combine an ACE inhibitor with an ARB to treat hypertension.)

    Offer step 1 antihypertensive treatment with a calcium-channel blocker (CCB) to people aged over 55 years and to black people of African or Caribbean family origin of any age. If a CCB is not suitable, for example because of oedema or intolerance, or if there is evidence of heart failure or a high risk of heart failure, offer a thiazide-like diuretic E.g:
    chlortalidone (12.5-25.0 mg once daily) or indapamide (1.5 mg modified-release once daily or 2.5 mg once daily) in preference to a conventional thiazide diuretic such as bendroflumethiazide or hydrochlorothiazide
    those already having Rx with bendroflumethazide or hydrochlorothiazide & stable , continue Rx with the same.
    Step 2 treatment - If blood pressure is not controlled by step 1 treatment

    Offer with a CCB in combination with either an ACE inhibitor or ARB
    If a CCB is not suitable , offer a thiazide-like diuretic (CCB intolerance, or if there is evidence of heart failure or a high risk of heart failure).
    For black people of African or Caribbean family origin:
    Consider an ARB in preference to an ACE inhibitor, in combination with a CCB
    Step 3 treatment

    Before considering step 3 treatment
    review medication to ensure step 2 treatment is at optimal or best tolerated doses
    Combination of three drugs:
    ACE inhibitor or angiotensin II receptor blocker,
    Calcium-channel blocker
    And Thiazide-like diuretic should be used
  13. 1 A 40 year old woman who smokes 10 cigarettes a day has a greenish discharge from both breasts.
    What is the single most likely diagnosis?
    A. Duct ectasia
    B. Duct papilloma
    C. Fibrocystic disease of the breast
    D. Montod's disease (not sure if this is it, but the option began with an 'M')
    E.
    2. An 18 year old boy is brought to the emergence dept with a history of sudden severe testicular pain that has been for 3 hours. Urinalysis shows no glucose, protein of leukocytes and is negative for nitrites. There is no palpable ? ( this question ended like this, it was not complete).
    A.
    B. Haemangioma
    C. Testicular torsion
    D. Testicular tumour
    E. UTI
    3. A 15 year old girl has irregular menses ansd heavy menstrual bleeding.
    What is the most appropriate treatment?
    A. Combined oral contraceptive pill
    B. Progestion-only pill
    C. Levonorgestrel ? (There was something next to this but can't remember)
    D.
    E. Tranexamic acid
    4. A 36 year old woman presents at 34 weeks gestation. Hb- 106g/dL, MCV and MCHC are within normal range.
    What is the most appropriate management?
    A. Blood transfusion
    B. Ferrous sulphate
    C. Folic acid
    D.
    E.
    5 A 36 year old woman with hyperpigmentation of the buccal mucosa.....
    K= 3.2mmol/L, Na= 128mmol/L, Albumin - low....
    What is the most appropriate hormone to measure?
    A. Adrenaline
    B. Cortisol
    C. ACTH
    D. Renin
    6. Question about a lady with low aldosterone.
    What is the appropriate investigation?
    7. A 25 year old man has had an irritating sticky red eye for 12 hours.
    What is the most appropriate management?
    A. Antibiotic (topical)
    B. Antibiotic (oral)
    C. Pilocarpine drops
    D.
    E.
    7 A 30 year old man has sudden onset of eye pain with a dilated pupil.
    What is the management?
    A. Analgesia
    B. Analgesia and routine opthalmology referral
    C. Analgesia and urgent ophthalmology referral
    D.
    E. Reassure and send home.
    8. A 35 year old man with known alcohol dependence presents to the emergency dept with opthalmoplegia , ataxia and ......
    What is the most appropriate management?
    A. IV glucose
    B.
    C. Bolus of thiamine
    D. Vit B 12
    e
    9 Question about a lady with proptosis and some other eye symptoms.....
    What nerve is affected?
    A. Abducens
    B.
    C. Occulomotor
    D. Trochlear
    10. Another question of nerves - A patient has had his UL dangling over the operatin table and has loss of sensation in the first web space.
    What nerve is affected?
    A. Musculo-cutaneous nerve
    B. Radial nerve
    C.
    D. Ulnar nerve
    11. A 26 year old man was stabbed in the chest . RR 30/min. Breath sounds are audible on both sides. Percussion note is resonant.
    Neck veins are engorged and he is breathing with his accessory muscles.
    What is the most likely diagnosis?
    A.
    B. Cardiac tamponade
    C. Haemopneumothorax
    D. Simple pnemothorax
    E. Tension pneuothorax
    12. A 50 year old woman can't leave her house. As soon as she gets out, she has to rush back in. She will only go out if accompanied by her husband.
    A. Agoraphobia
    B. Depression
    C. Obsessive compulsive disorder
    D.
    E.
    13. A 32 year old woman has recurrent breast abscesses. The latest one was six weeks ago. There is an area of identation on the areola which is discharging pus..
    What is the single most likely diagnosis?
    A. Breast abscess
    B. Duct ectasia
    C.
  14. a question about young female with dysmenorrhea and irregular periods with no children
    1. Ocp
    2.levonorgestral iucd
    3.copper iucd
    4. tranexamic acid

    another 1 still: a 33 yr old woman with kids has menorrhagia and dysmenorhia . the same options as above.

    there was 1 of Alzheimer's and another 1 related to dementia; external ear infection; epiglottitis related q; breast milk jaundice; uncontrolled DM on diet and exercise so next step of management in a bmi 22 male; 2 consecutive rbs readings of 8 and 10mmol/l and bp of 130/85 and cholestrol of 5.1mmol/l and bmi 35so choice of drug was metformin and statin
  15. Neha Gupta

    Neha Gupta Active Member

    a boy asthmatic on b2 short agonist inhaled and inhaled steroids n suddenly has a cough that wakes him up in the night and a severe wheeze whenever he excercises wht other medication will you add. leukotriene antagonist
    2. a woman presented wt pain, xray shows low density and sclerotic edges and she is on hrt, wht other wmedication will u add. bisphosphonate
    3. a child with pan systolic mumur that radiates to the axila. mitral regurgitation
    4. a patient suffering from copd, who has been well controlled, just developed a sudden breathlesnness, which is the immediate next important first line investigation chest xray
    5. a woman suffering from post menopauseal hot flushes , wht medication will u give oestrogen n progesterone
    6. a man presented wt severe gastric tenderness, a biopsy shows abnormal cell infrittration of the lamina propria, what is the most likely diagnisis, adenocarcinoma
    7. a pt bn properly treated for cin11 she is on coc, smokes 20g of cigarette in a day, went to b examined for an ovarian ca cos her aunty has bn diagnosed of ovarian ca, which of these is a poor prognostic factor, family hx
    8. a woman brough her child breathing wt abdominal msl,he has received o2, nebulized salbutamol n ipratromin, and she is flaring with intercoastal and subcoastal recession hydrocortisone
    9. which of these shows that the child is in severe respiratory failure intercostal and subcoastal recession
    10. :a pt has diplopa, pain on looking, with mild dilation od pupils , unreactive to light, which is the main oragn involved occulomotor
    11. a pt presented wt loss of sensation on the maxillary size of the face with some skin rashes,what othere organ will be affected in this patient, cornea
    12. a child wt bleeding from the nose, with prolong apt wht is the likely diagnosis hemophilia
    13. a swelling that extended from the mandibular side of the face which moves freely and is painlesss, wht is the most likely diagnosis mandibular ca
    14. a pt wth meattstic breast cancer, presented wth altered sensorium,swelling of the upper part of the body and the neck and has bn on advjuvant, what is the next line of managenmct, a iv dexamethasone, etc
    15. a breast discharge from a single duct of the breast duct papiloma
    16. a woman who presented wth recurrent breast discharge, purulent with an induration bte thw skin and the areola, what is the likely cause of this a fistula,
    17. woman wt fine well circumscribed lesion, mobile fibro adenoma
    18. a 37yr old man who presented wt frank hematurai, all other investigations are normal,,what next investigation will you do cystoscopy
    19. a amn after cross sitting for a long time presented wt eversion of the foot, loss of sensation at the sole of the big toe and what nerve is responsible peroneal
    20. a man presented wth 55 percent burn and severe chest pain, on ogd, there were multiple ulcers in d duodenum, he was haemodynamically stable what is the mangament oral ppi,
    21. a pregannt woman wt a bp of 160 / 90, what is the drug of choice labetalol.
    22. man wt a chlamydial infection, what other complication will he hv, epiidymoorchitis
    23. a young boy plkaying a game of rugby, was hit by the ball, on examination the ear was erythematous, tympanic memberane was normal, no hearing loss, what mediactaion wil u give, a anagelsic
    24. a girl has come to you for emergency contraception describe the mxm of action inhibit implantation
    25. a woman had a surgery for removeal of a stone 110hrs ago wth mrcp, post endocopy was good n normal and she presented wth jaundice, waht is responsible for her jaundice, infection
    26. a man on alcohol dependence who has bn taking alcohol frequently presnted wth persistent abd pain and jaundice that radiates to the back,,,what is the single most cause of this acute pancreatiatis
    27. a pt presnted wt ataxia, nystamus n vertigo, where is the lesion cerebellum
    28. a patient is severly sick, came wt rash that does nt balnch, photobia,headche and neck stiffnes, what is the next line of immediate action iv antibiotic and ct
    29. a pt wth high bp pressure and n hypokalemis?????conns?? conns
    30. a patient wt pigmentation of the body,hyperk,hyponatremia, what metabolit do you measure, acth,
    31. lymphactic drainge of the tetis paraortic
    32. a wman wt mesttastic brest cancer has severe vomiting n diarhoea, and then became confused, what is responsible for it acute intestinakl obstruction
  16. Neha Gupta

    Neha Gupta Active Member

    Amniocentesis for sure

    Amniocentesis is usually carried out during weeks 15-20 of pregnancy. A needle is used to extract a sample of amniotic fluid, the fluid that surrounds the foetus (the developing baby) in the womb (uterus). Amniotic fluid contains cells shed from the foetus that can be examined and tested for a number of conditions.
  17. Neha Gupta

    Neha Gupta Active Member

    Mock Repeats in PLAB 0313.
    There were some mock questions in the exam, for some of them the questions and the options were the same, while for some the questions were rephrased in a different way but I think the options were still the same. I think these questions were in the exam either exactly like this or rephrased in a different way.

    1 A 30 year old woman was treated successfully for CIN2 two years ago. She was a heavy smoker, but stopped a few months ago. She was on oral contraceptives all these years but her partner now uses condoms. She is anxious as her anut died of ovarian cancer at the age of 48.
    What is the single factor that puts her at risk of ovarian cancer?
    A. Age
    B. Family history
    C. CIN2
    D. Smoking
    E. Oral contraceptives
    2. A 47 year old man has a temperature of 39.1 C and is delirious. He has developed blisters mainly on his trunk. He last travelled five months ago to Italy.
    What is the single most likely diagnosis?
    A. Acute pemphigoid
    B. Acute viral haemorrhagic fever
    C. Chicken pox
    D. Lyme disease
    E. Shigles
    3. A 38 year old woman is in her first pregnancy at 16 weeks gestation and is very anxious about the possibility of chromosomal abnormalities in her baby.
    What is the single best test to give a definitive diagnosis?
    A. Amniocentesis
    B. Chorionic villous sampling
    C. Maternal alphafetoprotein
    D. Nuchal fold thickness
    E. Parental karyotype
    4. A 30 year old woman has a painless lump in the outer aspect of her left breat. She has had a previous lump. Her grandmother had breast cancer at 70 years of age. She has a 1cmx1cm smooth, firm, discrete mobile lump in the outer quadrant of her left breast.
    What is the single most likely diagnosis?
    A. Breast abscess
    B. Breast carcinoma
    C. Breast cyst
    D. Fibroadenoma
    E. Sebaceous cyst
    5. A 19 year old man has had fever, neck stiffness and generalized rash for 12 hours. He is not on any medication. He has a temperature of 39.5 C. He has limitation of neck flexion and no lymphadenopathy. The rash is sparse and mainly on the trunk and looks slightly haemorrhagic, non-blanching on pressure.
    What is the single most likely diagnosis?
    A. Henoch-Scholein purpura
    B. Measles
    C. Idiopathic thrombocytopaenic purpura
    D. Meningococcal infection
    E. Chicken pox

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