PLAB TRAINER PLAB 1 MOCK-TEST: 10 June 2011 TIME ALLOWED: 3HRS ‘Theme : Diagnostic test for lower limb ulceration Options: A. Arteriography F Biopsy pyoderma gangrenous B. Assess for alcoholism G. Biopsy for tuberculosis ” C. Assess for dermatitis artifact H. Plasma uric dtid D. Assess for venous stasis 1. Serum blood glucose concentration E. Biopsy for melanoma J. Treponema palladium test hacmogintination > Instructions: For each patient described below, choose the singlé most appropriate _ diagnostic test from the above list of options, each option may be tised once, more than once, or not at all. "ee = 1.A.60 year old man with a row year history of thirst, urinary frequency and weight loss presents with a deep painless uleer on the hee. 2. A 70 year old woman with chronic leg oedema presents with a 4 cm chronic ulcer over the medical malleolus of the ankle? 3. A 65 year old man presents a two weeks history of right leg pain at rest. His toes and distal foot are black with tilceration over the fifth toe. * 4. A 30 year old man with'a six month history of profuse bloody diarrhea presents with a chronic offensive lileet over the medial malleoulus of the ankle, ) 5. A 50 ear old man presents with a pigmented lesion on his shin with central ulceration. SINGLE BEST ANSWER 6. A 40 year old woman with breast cancer has back pain keeping her awake at night. For which she blames a gym session two weeks ago. She has difficulty climbing the stairs ‘There is tenderness over the right thoracic spine, She has diminished fine touch and ‘temperature sensation in her right foot. What is the SINGLE most appropriate investigation? A. Bone density seanB. CT scan of the head MRI of the spine 'D. Nuclear medicine(NM) bone scan E. Plain x-ray of the thoraco-lumbar spine SINGLE BEST ANSWER & JA 54 year old man with aleohol dependence has tremor and sweating three days ino it spital admission for a fractured femur. He is apprehensive and fearful ‘What is the SINGLE most appropriate treatment? aa \ tlen olenhali¢ wer A. Acamprosate ~ (Brentowinzepxite C. Disulfiram = — D, Lofexidine = — epi a® w/D . an 9 B. Procyclidine —f¥ Coq IOV a 0 SINGLE BEST ANSWER Y 8. A73 year old woman with skeletal’and brain metastases from breast cancer has worsening low back pain and blurring of vision. She has weakness of her legs, minimal knee and absent ankle tendon reflexes, a palpable bladder, power of 2/5 at the hip, 3/5 in the knee and ankle, and tendemess over the second liuhbar vertebra, There is reduced sensation in the peri She has been started on dexamethasone 16 mg daily. = What is the SINGLE moi likely cause of her weakness? A. Paraneoplastic neuropathy B. Progression of brain tumour . W, C. Prolapsed intervertebral disc at L2/L3 (©3) spinal cord compression E, Steroid induced myopathySINGLE BEST ANSWER housebound 78 year old man with severe chronic obstructive pulmonary disease has had ‘a gradual deterioration over recent months and is now breathless at rest, He is on maximal inhaled_medical therapy. Results show: pH: 7.36 L PaCO2: 5.9 kPa PaO2: 6.9kPa <) oil 7 < What is the SINGLE mos appropriation! ent? fe A. Aminophylline (oral) Va e B. Angiotensin converting enzyme (ACE) inhibitor (oral) C. Antibiotic (oral) aur. ven ) D. Oxygen — > : | & Steroid (oral) — add Vienna t ) ‘Theme : Causes of acute abdomen in younger women Options : A. Appendicitis G. Pneumonia B. Cholecystitis ey H. Pyelonephritis C. Constipation 1. Ruptured ectopic pregnancy D. Gastroenteritis J. Salpingitis E. Pancreatitis K. Ureteric colic F, Perforated peptic ulcer L. Urinary tract infection Instructions : For each patient described below, choose the SINGLE most likely diagnosis from the above list of options, Each option may be used once, more than once or not at al. QL 10. 4.17 year old woman has had lower abdominal pain for 12 hours. She has a temperature ‘of 37.8° C. She has tenderness with rebound in the right iliac fossa. E11. A 40 year old woman has had severe upper abdominal pain gadiating to the back and She is shocked with diffuse abdominal tenderness.