AUGUST 2024 PLAB 1 Recalls*

1) child with Molluscum contagiosum (pic. given). Management?

- Reassure

2) Schizophrenic patient, on resperidone developed stiffness, cog wheel rigidity.

Management?
- Procyclidine

3) Child with Measles rash (pic. given). Management?

- No treatment/Reassure

4) while examining a 3-month old baby with significant reduction in growth

percentile, doctor observed a bruise on the baby's head. Mother replied that
while changing his nappy he rolled over from the sofa and fell down. Next
action?
- Involve Safeguarding
- Admit and get hematology work
- Discharge and ask for follow up

5) s/s of hypothyroidism + LFT values supporting the same given. Management?

- Levothyroxine

6) 15-year female with s/s of depression. Management?

-Fluoxetine
7) Post-delivery hallucination, delusion. She feels that she can eradicate global
hunger. Diagnosis?
- Perpetual psychosis

8) s/s of low mood and mania given. Diagnosis?

-Bipolar affective disorder

9) ? Middle aged female with feeling of guilt for parking ticket fine that occurred
20 years back. she was repeatedly asking same questions during interview with
doctor. Diagnosis?
-Depressive disorder
(Other option: schizophrenia)

10) female patient swelling in breast ? Fibroadenoma. Best Investigation?

- Core biopsy
(Other options: FNAC)

11) case of type 1 diabetes. On short acting insulin and long acting insulin at
night. Morning, Afternoon and evening Blood sugar values given for last 5-7
days. There were only increased morning blood sugar levels before breakfast
whereas for rest of the day reading were normal. Management?
-Increase the dose of long acting insulin at night

12)Patient was prescribed any macrolide (like erythromycin) while he was on

simvastatin. Action?
- Withhold simvastatin

13) Patient on ? Diuretic presented with a headache and confusion. Cause?

- Hyponatremia

14) ECG provided with tall tented T waves. Diagnosis?

- Hyperkalemia

15) patient with s/s of nephrotic syndrome. Most definitive diagnosis method?
-Renal biopsy

16) s/s of inferior venacava syndromes given. Diagnosis?

Renal cell carcinoma

17)Female with family h/o cervical ca wants reversible contraceptive methods.

Most appropriate contraceptive to reduce risk of cervical ca ?
- Condoms

18) Elderly man with 5 days’ history of atrial fibrillation. Management?

-Bisoprolol

19) T2DM with HTN…… Next action?

- Continue Amlodipine and add Ramipril.

20) Man with arrhythmia with unstable vitals. ECG given. Management ?
- DC cardioversion

21) Patient with projectile vomitings. K/c/o gastric carcinoma and planned for
gastrectomy. Best method to provide nutrition now?
TPN
(Other options: NG Tube. Jejunostomy)

22)Nerves involved in herpes zoster opthalmicus ?

-Trigeminal ophthalmic

23) structure pierced between mid axillary line and ASIS during Laparoscopic
surgery
-External oblique aponeurosis and internal oblique

24) diplopia while looking on the right. Cause?

-Right abducen nerve palsy

25) The population of 2,50,000 have a disease among 250 people over a period
of 5 years. How many people would have disease annually per 5 lakh
population?
-100

26) 46y/f planned for hysterectomy due to fibroid uterus. Smokes 10

cigarettes/day. BMI 29. VTE prophylaxis for her?
- LMWH

(other options enoxaprin, dabigatran, warfarin)

27) patient with s/s of lung carcinoma. Initial investigation?

- Chest X-Ray
28) COPD patient presented with breathlessness. He was nebulized with
salbutamol and IV hydrocortisone given. But there’s still respiratory acidosis on
ABG. Management?
- NIV
- intubate
- Aminophylline
- MgSo4
-

29) Female pregnant and her husband suffers from hemochromatosis. What are
the chances that her unborn child will be affected with this disease?
- Male 50% Female 50%

30) Patient who had advance directive for DNACPR. But her daughter wants to
get CPR done.
- Discuss the ICU team decision with family

31)GP saw a man driving a car who had history of alcoholic seizures and was
advised not to true. Next action?
-Check hospital records for further seizures (means record of his last seizure to
be checked before raising a complaint to DVLA)

32) Marathon runners suffer rhabsomylosis. Cause of raised CK in blood?

- Myoglobin

33) patient with s/s of temporal arteritis. Most definitive diagnosis?

-Temporal artery biopsy
34)patient with s/s of compartment syndrome. Action?
-Remove the cast and inspect

35) patient with swelling PIP joint of index finger. Pic given. H/o stiffness in same
joint.
-Osteoarthritis

36) patient had a cast applied for fracture. After few hours developed severe
pain over that area. Cast removed but still severe pain. Most appropriate
Action?
- Measure intracompartmental pressure
(Other options: Inj. Morphine)

37) Stroke patient with AF. Prophylaxis drug?

-Edoxaban

38) Patient who is nurse by profession. Feeling anxious……. well dressed, has
good family support, maintained good eye contact during conversation.
Management?
- Counselling
- CBT
-

39)A 70-Year-old, history of urge incontinence, frequency. She wets herself

occasionally No evidence of UTI. Not worsened by cough. Which is the most
appropriate?
-Anticholinergics
Other options: Pelvic floor exercise, Antibiotics, Hormone replacement

40. Drug A and B given to two different groups over 5 years. 2018-2023. What
type of study?
-Randomized controlled trial

41) patient with urge incontinence and had h/o SVT. Management?
- Mirabegron (other option was tolterodine)

42)patient with the history of recurrent vertigo. Last only a few seconds.
Aggravates with movements.
-BPPV

43I) Child with s/s of orbital cellulitis. Management ?

-IV antibiotics

44) 10-month baby chocked. Parents asking for a first aid method if it occurs
again?
- Lie on the lap and back slap

45) child Scream…. Brief tensing and jerking spells… Child didn't turn blue.
- infantile spasm
- Breath hold spell

46) COPD patient. Acute Dyspnea. Management?

-FiO2 with 24%

47) In a RCT 2% patient left in the treatment group where as 25% left in the
placebo group after 3 months. What is it called?
-Blinding revealed to the researchers

48)patient on lithium. Last dose taken at 20:00. When to do blood lithium levels?
-At 8:00 am

49) ? young child with multiple vomiting and mass in RUQ. Results in?
- Metabolic alkalosis

50) Asthmatic child in emergency department. Which sign/symptoms most

dangerous?
-Drowsiness

51) patient with s/s of Trigeminal neuralgia. Management ?

-Carbamazapine

52) male patient with hyperprolactinemia. ? Infertility ?erectile dysfunction. MRI

show pituitary adenoma. Management ?
-Cabergoline

53) patient with s/s of hyperthyroidism. Lab values given. Management?

-Carbimazole
54) patient in the emergency department with the past multiple h/o overdoing
of PCM. Now asking for alcohol de-addiction. Has recently increased alcohol
intake since 1 week.
-Refer to Alcohol and drug team
Other option: Refer to psychiatry liasin

55) women with post delivery had no menstruation since 5 months. She is
exclusively breastfeeding her child. Next action?
- Reassure
(Other options: Get Hormone profile done, ultrasound etc)

56) patient with h/o URTI. Following which he started having chest pain.
Relieved by leaning forward. Diagnosis?
-Pericarditis

57) Patient undergone ERCP few days back, now c/o fever, jaundice, pain
abdomen. Diagnosis?
-Ascending Cholangitis

58) ~45 Year on routine check found to have abnormally raised bilirubin.
Otherwise asymptotic. Diagnosis?
- Gilbert syndrome

59) patient on mood stabliser. His skin disease got aggravated. Pic given and
diagnosis asked.
-Psoriasis

60) patient with trauma over the knee. Xray given. Diagnosis?
- Patella fracture

61) person with active syphillis lesion. Investigation?

-Viral culture

62) s/s of leptospirosis given. Investigation?

- Blood and urine culture

63) patient with s/s of bells palsy. Treatment to be added ?

-Prednisolone

64)patient with blurring of vision since 3 days. Redness. Irregular and dilated
pupil. Hazy cornea.
- Glaucoma
- Anterior uveitis

65) Few days post MI patient presented with s/s of shock (Bp ? 85/60), pan
systolic murmur. Diagnosis?
- Ventricular septal rupture

66) Mother suffering from congenital deafness is concerned for his ?3 month
baby hearing capacity. Investigation
- Brain evoked response
- Brain audiometry response

67)14 month child milestones given. Mother worried about his milestones that
he is unable to walk.
- Reassure and ask to revisit after 4 months

69) pregnant with a normal bp @ 10th week visit. Now 26 weeks with Bp
160/100. Significant proteinurea. Diagnosis ?
-Preeclampsia

70) T2DM patient with CKD and High BMI. Raised blood glucose levels. Next drug
to be added?
- Sitagliptin
- Pioglitazone

71)which is the biggest risk factor for ectopic pregnancy among the given risk
factors ?
-Chlamydia infection

72) 60-year-old man planned for Hernia surgery or Hip replacement surgery. Pre
op Investigation?
- FBC (other options: ECG, CXR, no investigation)

73) croup child with acute Dyspnea and stridor. Management?

- Nebulise with adrenaline
(Other option: Nebulize with budesonide)

74) There was a staff member at the care home threatening the patient. What
would you do?
- Raise safeguarding concern
-Confront her
75) alcoholic patient with withdrawal symptoms. Management
-Chlordiazepoxide

76) patient with both folate and b12 deficiency. Which treatment will you begin?
-Vitamin B12
(Treat b12 before folate)

77) ? type 1 diabetic patient or ? hypothyroidism. What type of anemia would

he be suffering from?
-B12

78)5 year child with h/o recurrent UTI. USG Normal. Next investigation?
-DMSA
(Other option was VCUG)

79) 19-year female patient with recurrent fainting episodes and has weakness.
Her potassium levels are 2.2. Management?
-Potassium supplement

80) old man with decreased vision. Unable to recognise faces and colours.
Diagnosis?
-Age related macular degeneration

81) A patient known case oh HTN and T2DM was on sitagliptin and rampirl. On
follow up his BP was 138/82 and hba1c was 50. Additional treatment?
Options:
Metformin
Furosemide
Calcium channel blocker
Dapaglifzolin

82) Patient c/o chronic cough and 1 table spoon of purulent sputum per day.
Xray shows increased bronchovascular markings. Diagnosis?
- COPD
(Other options: Acute bronchitis, Bronchiectasis)

83) patient on ?? multiple drugs. Cause of increased platelets?

- Prednisolone

84) patient with s/s of Cushing syndrome (stria on abdomen). Investigation?

-Urinary cortisol

85) child with writing issues (Dysgraphia). He was advised of computer typing to
help him in his problem. Whom child should be referred to?
-Occupational therapist

86) Patient with s/s of Gout. Most definitive diagnosis?

- Joint Aspiration

87) The patient had taken metoclopramide. Now c/o extrapyramidal symptoms.
Management?
- Procyclidine
88) hypertensive, ?alcoholic, overweight patient with erectile dysfunction. Most
appropriate Management
-Sildenafil
(Other options: advise weight reduction)

89) patient with s/s of obstructive jaundice, lab values given. significant weight
loss (5 kg over 3 months). Diagnosis?
- CA head of pancreas

90) patient with lung carcinoma. Investigation?

- Bronchoscopy

91) Elderly patient? Alcoholic with epigastric pain. Investigation?

- OesophagoGastroDuodenoscopy

92) patient c/o dysphagia with hot liquids. H/o antacids. Cause?
- Benign oesophageal structure

93) patient with behind the ear redness, swelling, pain (Mastoiditis). Most
appropriate action?
-IV ceftriaxone
(Other option: CT Scan)

94) palliative patient with pleural effusion. Management?

-Pleural aspiration
95) patient with urine retention and supra pubic palpable massage.
Management?
- Urethral catheter

96) patient with alcohol, gambling, addiction issue. Which neurotransmitter is

involved?
- Dopamine

97) New mother c/o pain in thumb when lifting baby. Diagnosis?
- De Quervain's tenosynovitis

98) Pregnant lady with s/s of Carpal Tunnel syndrome. Which Nerve compressed
and at which level?
- Median nerve at Wrist
(Other options median nerve at elbow, radial nerve at Wrist/elbow, ulnar nerve
at Wrist/elbow)

99) c/o unable to dorsiflex foot. ?? Injury ?? Pain near knee ?? Which Nerve is
involved?
Peroneal nerve

100) Patient with knee injury. Valgus stress test positive? Which ligament of
knee is injured?
- Medial collateral ligament

101) elderly patient with s/s of diverticulitis. Most likely outcome?

- Complete recovery
102) Parkinson Patient with acute agitation. punched the hospital staff.
Management?
- Lorazepam

103) palliative patient with disturbing respiratory secretions. He also had a

stroke a few days back n is unconscious but agitated. Most appropriate
treatment?
Glycopyranium
(Another option: Morphine)

104) Patient with typical s/s of HUS. Anuria since 3 days and Hb 60. Most
appropriate Management?
- Hemodialysis
(Other option: PRBC transfusion)

105) patient s/s of intestinal obstruction. Investigation?

- Abdominal X ray

106) Patient with CKD stage 4 had high serum calcium levels and normal PTH
level. Cause?
- Primary Hyperthyroidism
- vitamin D deficiency
- Pseudohypoparathyroidism

107) 60-year Hypertensive patient on Ace inhibitor. He was also on amlodipine

but he stopped it because he has developed B/L lower limb edema. His BP is
elevated. Which medicine to add ?
- Diuretic (other options: ARB)
108) Patient of Depression with MI. Which anti-depressant to be given?
-Sertraline

109) Epileptic patient on sodium valproate. Most appropriate reversible method

of contraceptive for her?
-Depot provera

110) calculate NNT of the drug.

- 2.5

111)s/s of dissecting aneurysm. Investigation?

CT aorta
(Other options: TEE)

112) chronic unilateral nasal discharge with ?supraorbital pain. Investigation?

- CT Head
- xray sinuses
- Flexible nasal endoscopy

113) patient planned for elective surgery. After giving General anesthesia
surgery team realised that the patient previously gave written consent for a
different surgical method but later on he discussed and changed it to something
else but the team didn't take written consent for that. Most appropriate ction ?
- Cancel surgery and inform the patient (and take new consent)

114) post op patient, developed respiratory depression, RR 6/min, b/l

constricted pupils. Treatment?
- IV Naloxone

115) Patient collapsed in the park. Brought to the emergency department. His
GCS was 11. Blood sugar 2.2. Management?
I/V 20% Glucose
(Other options IM glucagon, Oral Glucose)

116) patient with s/s of mumps. Developed complications like testicular pain etc
(i.e. Orchitis). Treatment?
- Ibuprofen

117) patient with cocaine toxicity. Treatment ?

- Benzodiazipine

118) Post op delivery patient developed seizure. She also has a high BP. Most
appropriate Management?
- MgS04

119) patient with single large red oval shape patch along with widespread red
rash over back (pic given). Diagnosis?
- Pityriasis Rosea

120) pregnant lady got Ultrasound done. No fetal cardiac activity seen. CRL
5mm. Next action?
- Repeat scan after 1 week.

121) First trimester pregnant lady with s/s of hyperthyroidism. Treatment?

- PTU
122) Pregnant lady taking olazapine. Most possible side effect?
- GDM (other option: cleft lip or palate, miscarriage)

123) Patient with hematuria and hemoptysis. Diagnosis?

- Good pasture syndrome

124) Post URTi patient with vertigo, hearing loss and neurological deficit
(involving some cranial nerve)
Diagnosis?
- Acoustic neuroma (other option: Labyrinthitis)

125) Patient with vertical diplopia. Involvement of which muscle?

- Superior oblique muscle

126) Patient with s/s of tension pneumothorax. Trachea diverted towards left.
Absent breath sounds on right side. Next action?
- Insert Needle into the Rt 2nd intercostal space.

127) child’s milestones were given. Asked normal or abnormal?

- Normal

128) parents already have a child suffering from cystic fibrosis. Now they are
worried and want to know how many chances that their next kid will be affected
by cystic fibrosis?
- 1:2
129) grandfather wants to know the chances of him being a carrier of xxxx as his
grandson is recently diagnosed with xxxx.
- 25%

130) patient with pain in multiple muscular parts of her body. Also associated
tenderness. Feeling fatigue. Diagnosis?
- Fibromyalgia (other option: myalgic encephalomyelitis)

131) Female with c/o dysmenorrhea. Management?

-Mefenamic acid

132)Patient k/c/o gastric ulcer. Presented with s/s of perforated gastric ulcer.
Where will the fluid go?
- Lesser sac

133) frank hematuria with unilateral flank mass present. Diagnosis?

- Renal cancer

134) patient with complaint of gross hematuria. Investigation?

- Flexible Cystoscopy

135) Patient suffering from severe epilepsy and had ?brain damage. He is in ICU.
?? Oh ventilator. Doctors think that attempting CPR won't be beneficial for him
but her sister wants the team to attempt CPR if required. Action?
- Explain to her sister about about DNACPR
(Other option is to arrange a meeting with the patient's family members to
discuss DNACPR)
136) Man with urinary incontinence using pads for the same has developed rash
around perianal area. Management?
- Urinary Catheter
(Other options: pelvic exercise, anti cholinergics)

137) female patient with s/s (possibly abscess due to PID). Investigation?
- USG
(Other options : CT Abdomen, xray)

138) patient with history of radical orchiectomy. Now presented with swelling
below the inguinal ligament.
- Femoral hernia
(Other options: Inguinal hernia, Incisional hernia)

139) 16-year boy with testicular pain since 3 hours. Similar episode last week.
Most appropriate Management?
- Urgent Surgical exploration.

140) Woman had hip replacement surgery 3 days back now presented with
breathlessness. RR-30, low BP 86/?59, RR-110. ABG- Resp. Alkalosis, normal
temperature. Asked for the most definitive diagnosis

- X-ray
- Pulse oximetry
- CTPA

141) child with perianal itch. More at night. Management?

- Mebendazole
142) Histopath finding of testicular carcinoma given "..... presence of cartilage".
Diagnosis?
- Teratoma

143) first trimester pregnant with UTI. Treatment?

-Nitrofurantoin (other options: Trimethoprim)

144) Cancer patient with increased calcium, s/s of hypercalcemia present. IV

fluid started. Next most appropriate management?
-Bisphosphonate

145) Patient was on multiple drugs like psychiatry, hypertensive, anti lipidemic
statin. He c/o muscle pain. Which drug is the most likely cause of his muscle
pain?
- Statin
(Other option: SSRI)

146) post trauma red hot knee. Most appropriate investigation?

- MRI

147) 6-year child with pain due to burn. Most appropriate treatment?
- Intranasal fentanyl
(Other options: PCM, NSAID, Codeine, Rectal Diazepam)

148) Patient planned for elective surgery. Most important reason to defer/post
pone surgery?
- H/O recent M.I.
149) Middle aged female with RUQ small firm lump in breast. Mammography
normal 2 months back. Most appropriate action?
- Urgent referral (other option: repeat mammogram)

150) patient with acute onset of dyspnea, restlessness, anxiety. ABG values pH
Increased, Pao2 decreased, Paco2 increased. Diagnosis?
- Pulmonary embolism

151) S/s of Gullein Barre syndrome given. What's the findings of this disease?
- Demyelination of peripheral nerves

152) Patient with s/s of osteoarthritis of xxxxx joint. Xray shows osteophytes.
Management?
- Physiotherapy (other option: steroid injection ?intra articular)

153) Young patient with prolonged QTc syndrome. ECG findings given. Cause?
- Ventricular tachyarrhythmia

154) Young patient c/o pain and unable to bear weight. Unable to dorsiflex foot
while applying pressure over the calf region. Cause?
- Achilles tendon rupture

155) Palliative patient ?cancer patient had ? bony pains. Doctor increased the
dose of morphine to relieve his pain. But few ?hours after increasing the dose,
patient passed away. What it is called?
- Doctrine of Double effect
156) Patient had symptoms of nausea and epigastric pain after eating
Doxycycline. Best way to reduce his symptoms?
- Advise him to take medicine after meals
(Other options: prescribe antacids, prescribe antiemetics)

157) patient with Histopath findings s/o villious atrophy with lymphocytes
present. Diagnosis?
-Celiac disease

158) 3.5 month child with fever 38.5. Next action?

- Start antibiotics and admit for septic work up

159) Alzheimer/Dementia patient hit a car with poll while driving. His son is
worried for him. Most appropriate action?
- Advise him to Stop Driving and inform DVLA

160) Patient had a knife injury on his arm. He tells he received this injury while
having assault with her wife. He asked you not to inform the police. Most
appropriate action?
- Contact her wife
- Tell him that you have to inform the police
- Do what he says
- Refer to relationship and counselling unit

161) middle aged man, sexually active c/onpain in testis. Management?

- Antibiotic
- urethral swab test
- USG Scrotum

162) A 25yr old woman, 8 weeks pregnant with persistent vomiting for 2 weeks,
dehydrated and deranged electrolyte

- HVS
- Pelvic scan
- Serum amylase
- Beta Hcg

163) Post menopausal women with symptoms ??Hot flushes etc. Management?
- HRT

164) patient had URTI few days back. Following which he developed Fever,
cough, SOB. His CXR revealed B/L cavitations. Causative organism ?
- Staphylococcus aureus

165) patient with Hyperkalemia (K 6.0). Most appropriate action?

- ECG

166) 6 weeks pregnant. Small leakage of fluid. USG reveals - Empty uterus and
Free fluid in pouch of douglas. Diagnosis?
- Ectopic pregnancy

167) Elderly patient with s/s of musical ear. Investigation?

- Audiogram/Audiometry
168) Elderly patient hospitalised. Since 2 days having hallucinations.
- Delirium

169) Elderly patient with progressive dementia since 2 years. Diagnosis?

- Alzheimer

170) patient with s/s of anemia. PBF shows hypersegmented neutrophils.

Diagnosis?
- Vitamin B12 deficiency

171) Afrocarribean patient Hypertensive. Which medicine to be added ?

- CCB

172) Male patient with gynecomastia and has normal testis. Nothing abnormal
during the testicular examination. Next action?
- TFT

173)

* still open for updates

• I am grateful to all the doctors who shared questions and answers in WhatsApp
groups, which greatly helped me in preparing for the recalls.

Additionally, I have tried my best to recall and improve the content from
memory, though I acknowledge that errors may still be present.
Please feel free to suggest improvements or add any necessary addendums to
the recalls. You can reply with question number, I will modify and repost the
updated version of this file.

Best wishes to all the doctors preparing for PLAB/UKMLA.

Ver. 8.0

Prepared with collective efforts of all doctors appeared for 8/8/24

UKMLA/PLAB 1 exam