PLAB TRAINER PLAB 1 MOCK TEST: 12" June 2011 TIME ALLOWED: 3HRS SINGLE BEST ANSWER: ~ (sa 79 year old man, who is active, comes to you with complaint of swelling an on dorsiflexion of the leg. On examination, there is oedema + 3em increase i diameter of right calf comparing to the other side A. What is the cause? b)DVT ©) Popliteal cyst 4) Lymphoedema ©) DMD oor artery aneurysm , ‘Theme: Delirium Options: A. Hepatic failure H. Alcohol withdrawal B, Renal failure 1. Drug withdrawal C. Hypoxia J. Brain tumour D. Pellagra K. Subarachnoid FE, Wemickle-Korsakoff syndrome L. Dug intoxication F. Beriberi M. Brain abscess G. Hypoglycemia Instruction: For each presentation below, choose the SINGLE most likely cause from the above list of options. Each option may be used once, more than once, or not at all. 2. A 60 year old man presents with confusion, restlessness, and walks with a broad-based gait. On examination, he has nystagmus and bilateral lateral rectus palsies and smells alcohol 3. A40 year old man taking isoniazide for tuberculosis now presents with dexmatitis, diarrhoea, and dementia 4. A30 year old man presents with pinpoint pupils and delirium. He is noted to have nasal septal perforation. 5. A 35 year old man presents with| fev Se sien and He has a history of chronic sinusitis. On examination, he has asymmetrical pupils and rising blood pressure. “There are no external signs of head trauma.C myocardial infarction. His chest ield. f\ 6. A.55 year old man presents with seizures and hallucinations. He is tachycardic with Slow) blood pressure. He insists there are insects crawling, Redes hes eso or aigehotism, — ‘Theme: Cardiac disorders Options: A. Acute pericarditis B. Atrial thrombus Cardiac tamponade Heart block Left ventricular aneurysm. Left ventricular endocardial thrombus . Post-myocardial infarction (Dressler’s syndrome) . Right ventricular strain Ruptured interventricular septum Ruptured papillary muscle. . Ventricular arrhythmia 2 AS momo Instrueti From each patient described below, choose the SINGLE most likely explanation of the abnormal investigation results from the above list of options. Each option may be used once, more than once or not at all. 7. A 58 year old ge) pata Ae caer suffering an goute anterior wy shows a large globular shaped heart and clear lung 8. A.63 year old man continues to experience chest pain and has mild pyrexia two days after an acute myocardial infarction, His ECG showsttidespread ST elevation} with upward concavity. cor ete eee (ntinuous dneror chest pain, worse on inspiration and pyrexia GHe four weeks Mtera myocardial infarction. HisTeSR isrased, 3 10. A 60 year old woman x sEdes}> develops severe\left ventricular failure fpllowing myocardial infarction, Her ECG demonstratgs-afitral regurgitation, /A.55 year old man returns for routine follow ix weeks afte myocardial infarction. ( getySreathless jyhen walking uphill. His ECG shows ST-elevation in the anterior che: leads, ‘Theme: Skin lesions OptioA. Chicken pox G. Pemphigus vulgaris B. Bullous pemphigoid H. Erythema multiforme C. Pilyriasisvesicolor I. Henoch-Schoinleinpurpura D. Pilyriasis rosacea . Measles E, Steven Johnson syndrome Instructions: For each skin lesion, choose the single most appropriate diagnosis from the above list of options. Each option may be used once more than once or not at all. Dp (2 }terata patch: Solitary patch with peripheral sealing, most commonly found on the trunk. {| 13: Target lesions: Concent rings due toa cell medicated eutaneous Iymphoeytotoxie response. 14, Thick walled bullae, Immunofluorescences studies show linear staining of IgG along the B basement membrane Gq 15 Thin walled bullae, Immunofuorescence sues show intraeluar stining of Te within the epidermis (E16. Target lesion with extensive mucous membrane involvement. \_17- Umblciated vesicles, pustules and crass, Resh distribution is centripetal. Ac. 18. Koplik’s spot on the mucosa of the checks opposite the molar teeth, INGLE BEST ANSWER: = fix 0>4y,..¢ Lowa oad 2 otadng iines of the following results established a diagnosis of diabetes mellitus? ‘A. Asymtomatic patient with fasting glucose 7.9 mmol/L on one occasion X B. Symtomatic patient with fasting glucose 6.8 mmol/L on two occasions se C.Glysosuriattt « — Newer lye D. jane atic patient with random glucose 22.0 mmol/l on one occasion Symptomatic patient with random glucose 12.0 mmol/L on one oceasian Clam BEST ANSWER: gsyem Cass man presents with bitemporal hemianopia and spade like hands. What is 3 inte confirm the diagnosis? A. Barly momiing growth hormone B, Insulin tolerance test ©. ral glucose tolerance with growth hormone measurements