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PLAB1 practice questions — 10 free

Professional and Linguistic Assessments Board Part 1 · every answer carries the reasoning, and why each other option fails.
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Tap an option to see the answer, the reasoning, and why the other three fail.

Question 1 of 10

A 64-year-old man has recently suffered from an MI and is on aspirin, atorvastatin and ramipril. He has been having trouble sleeping and has been losing weight for the past 4 months. He doesn't feel like doing anything he used to enjoy and has stopped socializing. He says he gets tired easily and can’t concentrate on anything. What is the most appropriate treatment?

Why C is correct

Depression is common among patients recovering from a myocardial infarction. Approximately 1 in 6 patients with MI experience major depression and at least twice as many as that have significant symptoms of depression soon after the event. Post -MI depression is an independent risk factor for increased mortality (as depression is clearly associated with poor compliance with risk-reducing recommendations). For treating this depression SSRIs are recommended as first line agent and among SSRIs Sertraline is the drug of choice for ischemic heart disease. Next choice is citalopram (as it is often related to torsades de pointes it is not 1st choice). If SSRI cannot be used Mirtazapine is recommended as next antidepressant

Question 2 of 10

An 83-year-old man with longstanding COPD has become progressively breathless over the last 2 years. He is on salbutamol, ipratropium, salmeterol, beclomethasone and theophylline. His FEV1<30%. What is the next appropriate management?

Why C is correct

Patient is progressively breathless with present FEV1 of <30%. So his respiratory deterioration indicates progressive respiratory failure for which he should be assessed for long term O2 therapy. Long-term oxygen therapy (LTOT) for more than 15 h/day improved mortality and morbidity in a well-defined group of patients with chronic obstructive pulmonary disease. Requirement of condition to proceed to LTOT is patient should be stable and on appropriate optimum therapy (as in given case) and having stopped smoking tobacco. Patient should be shown to have a PaO2 less than 7.3 kPa and/or a PaCO2 greater than 6 kPa on two occasions at least 3 weeks apart. FEV1 should be less than 1.5 litres, and there should be a less than 15% improvement in FEV1 after bronchodilators. Patients with a PaO2 between 7.3 and 8 kPa who have polycythaemia, right heart failure or pulmonary hypertension may gain benefit from LTOT

Question 3 of 10

A 79-year-old stumbled and sustained a minor head injury 2 weeks ago. He has become increasingly confused, drowsy and unsteady. He has a GCS of 13. He takes warfarin for Atrial fibrillation. What is the most likely diagnosis?

Why A is correct

In elderly head injury usually leads to subdural hematoma even if head injury is minor or trivial and extradural hematoma in elderly is extremely uncommon even in more severe head injury. Warfarin is also a risk factor for subdural hematoma from a minor trauma. Management: 1st line: Evacuation by barr hole craniostomy. 2nd line: Craniotomy if the clot is organized. Up to 3 weeks burrhole may be possible but longer than this clot is mostly organized and Flap craniotomy is usually required

Question 4 of 10

A 40-year-old woman presented with generalized itching and tiredness for few months. She gave a history of heavy menstrual periods. Examination: pallor. What is the single most likely causative factor?

Why B is correct

IDA is one of the causes of generalized pruritus. Heavy periods, pallor and tiredness further supports the diagnosis

Question 5 of 10

A 35-year-old male is bitterly annoyed with people around him. He thinks that people are putting ideas into his head. What is the single most likely diagnosis?

Why B is correct

Thought insertion is feeling as if one's thoughts are not one's own, but rather belong to someone else and have been inserted into one's mind. It is a common feature of schizophrenia

Question 6 of 10

A 7-year-old girl has been treated with penicillin after sore throat, fever and cough. Then she develops skin rash and itching. What is the most probable diagnosis?

Why D is correct

Common drugs causing erythma multiforme are: antibiotics (including, sulphonamides, penicillin), anticonvulsants (phenytoin,barbiturates), aspirin, antituberculoids, and allopurinol

Question 7 of 10

A 70-year-old man with lung cancer presents with a cough. He is already on codeine, steroid and salbutamol inhalers. What is the single most appropriate management?

Why C is correct

Nebulized NS loosens the phlem and help to expectorate it easily

Question 8 of 10

A young lady with cervical ectropion bleeds on touch. What is the most appropriate next investigation?

Why B is correct

Screening test cervical smear is only done in scheduled time and not in on demand basis. Also smear test is started at the age of 25 years. So if it is scheduled now then it can be the option otherwise Colposcopy should be done

Question 9 of 10

A 78-year-old male with diabetes mellitus and hypertension, had a fall and since then is unable to walk. He presents withdeformity and tenderness over the right hip area. X-Ray shows fracture of femur neck. What is the single mostassociated nerve injury?

Why D is correct

Sciatic nerve injury though may occur but may not be very common!

Question 10 of 10

A4-year-old boy with a febrile convulsion lasting eight minutes has been given IV lorazepam to control them. What is the single most likely serious side effect?

Why E is correct

Respiratory depression may occur following lorazepam administration

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