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JUNE 2017 PLAB 1 Recalls

Hello everyone!

After discussing the questions with my other study partners, I was able to recall more
than 195 questions from the June 2017 PLAB 1 exam. I have arranged them in this file
with the possible stem I could remember. I hope it is of help for the current and future

By the way, the highlighted parts are the questions either I made them wrong or am not
sure about the answers.

If you are going through the recalls, please keep us in your prayers and pray for our pass
in the exam

Afghan boy anonymous
1. Woman planning on pregnancy. When to check the ovulation day for a 32-day
2. A girl with cystic fibrosis. The parents ask the chances of the future children
getting affected. Key: 1:4
3. A baby vomiting, long stem with lab results. Hypokalemia was noticed. Key:
pyloric stenosis
4. The baby is hungry, vomiting. The lips were cracked. What is the immediate
investigation: Urea and electrolytes
5. Pyloric stenosis clinical feature, asking for abnormality: metabolic alkalosis
6. 5 years old with lesions on some were crusted and others were weeping.
chickenpox. Oral acyclovir
7. 20 years old patient comes with swelling of the parotid and now suffers from
orchitis. Management: Analgesia
8. Lateral cutaneous nerve of thigh
9. ERCP shows stone in a duct opening to second part of duodenum. What is the
duct called: Hepatopancreatic ampulla
10. Patient present with pain anterior to lateral malleolus. Key: Anterior talo-fibular
11. Sensation of the medial side of forearm, intrinsic muscles of the hand were
affected. Abduction of the fingers were also affected. Options were: Forearm
median nerve: others say T2 root
12. The patient could not close they eyes. Key is Facial nerve palsy
13. The patient presented with symptoms of Bells palsy two days after the onset. rx:
14. Paracetamol poisoning after 12 hours. Management: N acetyl cysteine
15. Second question: Paracetamol poisoning after 12 hours. Management: N acetyl
16. Patient comes with swelling in the scrotum which resolves on lying down. Asking
for diagnosis: Varicocele
17. A patient with a bluish swelling and bag of worms appearance on the scrotum.
What is investigation of choice: Ultrasound scan for varicocele
18. Patient in emergency, with symptoms of Asthma, drowsy and confused: Iv
Salbutamol infusion or neb salbutamol
19. Asthma: oral prednisolone, salbutamol n oxygen given: IV magnesium
20. Asthma, eczema: oral chlorpheniramine
21. Asthma, he is on SABA, inhaled steroids, exercise induced, nocturnal cough,
patient gets symptoms on mild exertion: theophylline?? LABA according to the
steps of a chronic asthma management
22. Asthma on SABA. Next step: inhaled steroids
23. Asthma, fracture, pain: paracetamol
24. Sick looking child, fever, drooling of saliva (typical picture of epiglottitis):
25. IM adrenaline for child, stridor
26. Dexamethasone for croup (bark like cough)
27. Girl 14, boyfriend 15, asking for COCP: reject, tell parents, call police. KEY: give
the pills and encourage to involve the parents
28. Mortality rate in a population of 250 million, 950000 had MI, 250000 died.
29. Absolute risk (10/1000 in treatment grp who died, 10/1000 in the non-treated
died) ??? relative risk 2??
30. A person brought his wife who left alcohol for a few days. Fearful, agitated,
anxiety: benzodiazepine
31. A married woman, depressed (thinks she has cancer like her husband), on TCA
for 3 weeks and there are signs of improvement, lost husband, now some weird
thoughts: continue TCA
32. Haloperidol injection for an agitated and violent schizophrenic patient
33. Parkinsonism clinical features of medicines. What is the underlying condition.
Key: schizophrenia
34. Celiac disease presents with biopsy taken from gut had lymphocytosis picture:
35. Arrhythmia picture, low blood pressure, palpitation (unstable so treat as SVT): DC
36. Brady Arrhythmia picture HEART RATE 35 cool peripheries and signs of
cardiogenic shock: amiodarone or atropine
37. Sertraline for post MI depression
38. Suicidal thoughts: no option of ECT so choose SSRI
39. Suicidal thoughts, depression: risk increases with: alcohol no option of previous
history of suicide
40. Patient with anxiety, long term treatment: fluoxetine
41. Agoraphobia picture
42. Bipolar picture
43. Patient on lithium has tremors n other side effects (like nausea n vomiting)
medication of lithium above 1000, side effects: lithium toxicity
44. 2 days old, deafness: brain evoked
45. Laryngeal ca picture: risk factor: cigarettes
46. Hematuria painless above 50: flexible cystoscopy
47. Flexible cystoscopy second question
48. Fever, rigors, south Africa: Malaria
49. Fever, confusion, travel: Malaria
50. Travel to Europe, now in UK: bloating, diarrhea: Giardia??? E-coli not in the
51. Maculopapular Rash, fever, Thailand: Dengue
52. Episodes of abdominal pain and increased amylase. All other investigations
normal. Options were alcohol, viral, bacterial? (maybe chronic pancreatitis)
53. Junior doctor, off, in a restaurant, sees a patients notes on one of the tables: call
the police, inform the restaurant owner, open note and call GP, take note back to
the hospital
54. Lady unconscious, suicidal note: treat the patient till your best, wait till she
recovers, calling relatives n taking consent
55. Post-mortem death due to asbestosis: coroner
56. Glaucoma case: measure Intraocular pressure
57. Anterior uveitis: irregular pupil
58. hypertensive retinopathy. Patient on nifedipine 150/90 blood pressure, dot n blot
hemorrhages and macular exudates
59. Lady on thyrotoxicosis symptoms with history of URTI: subacute thyroiditis
60. On Amlodipine, painless, bilateral ankle edema, no raised JVP: SE of Amlodipine
61. ACE Inhibitors and STATIN. DM patient with micro albuminuria, cholesterol
raised, blood glucose normal
62. IV drug abuser, Mid diastolic murmur, mitral valve problem: infective
63. PR normal, Long QT, in a child, fainting attacks since childhood: asystole no
complete heart block in options, V Fib, V tach
64. Old patient with Heart failure, syncope, reason: Stoke Adams or vasovagal?
65. Pneumonia, cough, on ACE i: Keep the medication or withdraw lisinopril
66. Harsh pan systolic, acyanotic: VSD
67. Fever, chest clear pain increases with respiration: pericarditis
68. Intercostal artery in chest drain
69. SVT ECG adenosine
70. Reflex anoxic seizure (temper tantrums, episode after a finger prick in a young
71. Reflex anoxic seizure: I choose tonic-clonic (teacher sees boy falling down n going
stiff but becomes normal soon)
72. RA medication, low MCV: anemia of chronic disease or chronic gi bleed
73. Driver, urticaria, non-sedative that doesnt disturb driving: ceterizine,
chlorpheniramine, steroid tablets, steroid cream
74. Alcohol dependency definitive: GGT or drinking alcohol the first thing in the
75. Tracheal deviation: tension Pneumothorax management
76. Subcapsular hematoma: observe in surgery
77. Cardiac tamponade:
78. TIA driving: 1 month
79. Over 35 years old patient, spoonful sputum of 18 months: COPD or bronchiectasis
80. COPD non-responsive to some treatments nebulizers, steroids. Options were
81. Flu plus bilateral cavitation: staph pneumonia
82. PCA of Morphine after gangrenous appendix
83. Patient controlled Codeine sulphate on oral, cannot tolerate: change to IV
84. Inferior MI, morphine route: IV
85. Antibiotics during induction of anesthesia
86. BCC
87. Melanoma: all ABCD GIVEN Depth of the cancer
88. Painless vulvar ulcers: none of the options fit the picture
89. Painful male ulcer: HSV
90. PID treatment: ofloxacin plus metro
91. Risk of ectopic: PID
92. Lung cancer: adrenal insufficiency
93. Lung cancer: SCC: hypercalcemia
94. Lung Cancer: SIADH
95. Prostate cancer treatment procedure: hyponatremia
96. Meningitis: ceftriaxone
97. Meningitis, neck stiffness, vomiting, headache, photophobia: ceftriaxone or Dexa
(million-dollar question)
98. Meningitis (no signs of raised ICP): LP
99. Meningitis CSF: gram positive diplococci: streptococcus
100. Intracranial pressure increased: Dexa
101. Diploic or cerebral veins: old man presented with confusion days later after a fall
Subdural hematoma
102. Pulmonary embolism: 5 days operation
103. Stony dull percussion with CXR showing fluid levels (Pleural effusion): pleural
104. During surgery sugars elevated what would u do? FBS after operation
105. Diabetes: stress hyperglycemia
106. Pneumonia follow up: chest x ray
107. Diabetes on gliclazide on operation what will u do: give insulin, dextrose and K or
stop OHA???
108. Fasting blood glucose taken once: repeat the test
109. Impaired glucose tolerance
110. Alcoholic Tremor, hypoglycemic blood glucose 3.5, Wernickes, confusion and
ataxia. Whats initial management: glucose or thiamine
111. Alcoholic withdrawal, what to add: thiamine
112. IV drug abuser, HB core antigen positive: HBV
113. Celiac lady with distension when she takes wheat: allergy to milk and white
114. Dilated Transverse colon symptoms of Ulcerative Colitis like bloody diarrhea: UC
115. Increase dysphagia to solids, definitive: endoscopy
116. Dysphagia, CA mid third esophagus: stenting
117. Recurrent epigastric pain, intermittent dysphagia to solids, nocturnal cough:
peptic esophagitis I.E GERD
118. 20 years old, OTC drugs, jaundice, total bilirubin increased, AST and ALT normal:
gilbert (no g6pd in options)
119. Secondary metastatic deposits in a female. Most probable primary site of cancer:
Breast cancer
120. Women with colles fractures: definitive: Dexa scan
121. Women with colles fractures third fracture in the last six months. Osteoporosis
suspected, initial: Hypercalcemia or DEXA
122. Thyrotoxicosis picture plus FBC shows decreased B12: investigation: TFT
123. Thyrotoxicosis picture. Asking for the reason for dementia and neuropathy: b12
124. HB 17.8 Polycythemia picture: hormone, erythropoietin
125. On warfarin, bleeding, INR 7: Prothrombin complex concentrate
126. Elective operation, HB 8.5: defer and investigate
127. 10 days old boy Viral gastroenteritis (hypo Na, hypo K, diarrhea and vomiting
128. Wife died, severe headache: Subarachnoid hemorrhage:
129. Subarachnoid hemorrhage:
130. On warfarin, on h: Subdural hemorrhage
131. Bruises on face or neck INR normal, coming from nursing home. Nonaccidental
injury in old
132. Permethrin for scabies
133. Frontotemporal dementia. Inappropriate words
134. Vascular dementia with history of previous MI and step wise deterioration
135. Cervical x ray c7-t1
136. Post-menopausal comes with Bleeding: US, diagnostic hysteroscopy, MOST APP
137. Infertile, dysmenorrhea, dyspareunia, (endometriosis picture). DEFINITIVE
138. PATIENT couldnt flex at PIP AND MCP: Flexor digitorum superficialis
139. 7 years old, Metal spikes, vaccination yes: antibiotics plus immunoglobulin. NO
140. Women 7-month menorrhagia: coagulation factor
141. Cerebellum symptoms: MRI of the brain
142. Intracerebral hemorrhage: CT brain
143. Breast cancer on radiotherapy: Hypercalcemia
144. Calcium treatment: IV infusion
145. A vasculitis picture with hematuria negative ANCA positive ANA: SLE
146. Sjogren treatment for dry eyes. artificial tears
147. Inflammatory Chronic breast cancer: intra epidermal spread of intra ductal Ca
148. Virchow nodes: gastric cancer
149. Post gastric perforation: lesser sac
150. Dribbling in an old man PSA 4.5: Benign Prostatic H
151. Stress incontinence: Pelvic exercise
152. Patient with pelvic fracture, on palpation bladder can be felt immediate
management: Urethral catheterization
153. Elderly patient, overflow diarrhea, constipation, fecal impaction and pain:
Phosphate enema
154. Proteinuria n edema, definitive diagnosis: Renal biopsy
155. Post streptococcal GN patient which will stop the progression i.e. proteinuria:
ACE inhibitor or steroid
156. Adult polycystic kidney: US
157. Family history of renal disease, hematuria in patient APKD: US
158. Burn and sooth: intubation
159. Status epilepticus: IV lorazepam
160. GCS 13 at hospital but rapidly decreased to 8: CT intubation at < or equal 8 but it
wasnt in the options
161. trigeminal neuralgia diagnosis
162. trigeminal neuralgia: Carbamazepine
163. trigeminal neuralgia: Carbamazepine side effect ataxia n nystagmus, dry mouth n
blah blah
164. PID not responding tubo-ovarian abscess: US
165. Anti-D after 72 hours
166. Women on 8-week bleeding, viability of pregnancy: trans vaginal US not CTG AS
ITS only done previa n abruptio
167. COCP for a young girl with irregular, menorrhagia
168. Diagnostic investigation for a murmur: ECHO
169. Initial treatment for fluid in a child with K 2.8: 0.45ns plus K less than 3 we give
oral less than 2.5 IV K no option for 0.9 N/S
170. Tamoxifen: vaginal bleeding
171. Patient hypertensive, hot flushes and night sweating: RX: hrt or clonidine
172. Recurrent miscarriages > 2: Aspirin and heparin
173. Inflammatory changes in cervix: Swab
174. OCD treatment: CBT
175. RTA, tachycardia, tachypnea, fractured 5-7 ribs: o2, analgesia n then surgeon
Intubate or analgesia? o2 not in the option
176. DMT1 on insulin develops hypoglycemia at 4 pm: reduce morning insulin dose
177. A patient, migraine for 10 years, presented with severe headache that is not
relieved easily, no neurological signs. Investigation: None or CT
178. Heart failure, gout treatment. Gout improved, heart failure worsened. Cause:
NSAIDS. I choose Colchicine
179. Child, sudden testicular torsion
180. Torsion: immediate referral for exploration
181. Anorexia nervosa CLEAR
182. Bulimia Nervosa CLEAR
183. HB decreased, bilirubin increased, spherocytosis on peripheral film: direct
COOMBS AKA direct antiglobulin testing
184. Low back pain after moving the house: give analgesics and keep the patient
185. after seeing accident patient loses his eyesight: Conversion disorder
186. Ascending paralysis i.e. Gullian Barre Syndrome what is the Pathology:
187. Heroin addict wants to quit. Key: Methadone
188. IV drug abuser, which valve will be affected. Key: tricuspid?
189. A picture of DKA asking for initial management. Key: Normal saline
190. Asperger or autism or ADHD?
191. Patient has depression and anxiety. Now has metabolic acidosis. Key: Aspirin
192. weakness of shoulders and ESR high with normal CPK maybe Polymyalgia
rheumatica. treatment? steroid
193. Unstable patient, BLOOD PRESSURE was low, pulsatile mass. Management:
increase the BLOOD PRESSURE (and then go for surgery)
194. unstable patient with low blood pressure 70/40: dc shock
195. Was there a question about a patient who had an incident with machines. His
employer sends him for investigation. All exams were normal. What is next? CT
MRI Reassurance?