Welcome to your PLAB 1 Score Predictor

Docty's PLAB Test Score Predictor consists of 25 questions covering all categories.
The test is in MCQ Format. Each question has 5 options. Please select the correct answer and go the next question.
You have 25 minutes to complete the test.
All the best!

1. A 65-year-old factory worker presents to the general practice feeling tired all the time. He has been like this for at least a few months. On further questioning he admits to a loss of appetite and just ‘not feeling right’. Clinical examination reveals a fullness in his left flank and a varicocele in the left side of the scrotum. What is the single most appropriate next investigation of choice?

B. Biopsy

E. Cystostomy

A. Ultrasound scan

C. CT thorax, abdomen and pelvis

D. Abdominal x-ray

2. A 19 year old girl comes to your clinic complaining of shortness of breath and wheezing. She reports that her symptoms get worse after exercise and it gets in the way of her daily activities. She has a history of eczema. What is the single most appropriate investigation to confirm the diagnosis?

C. Peak flow measurement

E. Spirometry and bronchodilator reversibility testing

D. Clinical findings are sufficient

A. Chest X ray

B. Eosinophil count

3. A 67-year-old man presents to the general practice clinic complaining of a left sided headache. He has noticed it come on over the past 2 days and says the area is very tender when he brushes over it with a comb. He usually wears spectacles, but his vision has become blurred on the affected side over the past few days. What is the single most appropriate diagnostic investigation of choice?

A. ESR

B. MRI

D. Temporal Artery Biopsy

C. Antinuclear Antibody

E. CRP

4. A 17 year old girl presents to A&E with severe pain in her abdomen. The pain began 5 hours ago and started in the centre of her tummy before moving to the right iliac fossa. She says that she has not eaten all day because she feels sick and has vomited three times. She has a temperature of 38.2°C, heart rate of 70 beats per minute and blood pressure of 120/80mmHg. Baseline bloods reveal the following: WCC: 12.0 (normal = 4.0-11.0) CRP 30 (normal = < 10) What is the single most appropriate step in management?

A. Regular paracetamol and as required oral morphine

B. Regular paracetamol, intravenous sodium chloride and as required oral morphine

C. Nil by mouth and intravenous fluids

E. Nil by mouth, intravenous fluids, analgesia and consideration for laparoscopic cholecystectomy

D. Nil by mouth, intravenous fluids, analgesia and consideration for laparoscopic appendectomy

5. A 33-year-old woman presents to the general practice clinic reporting that she feels constantly worried and tense about every day issues over the past 12 months. She currently works as a sales manager at a retail store, is performing well and is due for a promotion soon. She has two children both of whom are healthy. She reports that she finds it difficult to sleep well at night and is unable to concentrate as much at work. Her basic observations are all normal and physical examination is unremarkable. What is the single most likely diagnosis?

E. Post Traumatic Stress Disorder

B. Agoraphobia

D. Hyperthyroidism

C. Generalised Anxiety Disorder

A. Panic Disorder

6. A 26-year-old man presents to the general practice feeling fatigued. He has felt ‘funny’ for the past few days and has noticed that his urine is very dark compared to usual. Clinical examination reveals that he is jaundiced. His past medical history is unremarkable and he is usually fit and well. He has recently started taking malaria prophylaxis in preparation for a trip to Africa next week. What is the single most likely diagnosis?

D. Autoimmune Haemolytic Anaemia

A. Hereditary Spherocytosis

B. G6PD Deficiency

C. Thalassemia

E. Sickle Cell Disease

7. A 29-year-old woman presents to Accident and Emergency following an overdose. She has a coarse tremor, feels nauseous, has abdominal pain and diarrhea. She vomits twice while in A&E. Her medical notes reveal a past psychiatric history of bipolar affective disorder. What is the single most likely drug she overdosed on?

A. Aspirin

C. Olanzapine

B. Paracetamol

D. Clozapine

E. Lithium

8. A 9-year-old boy attends the general practice clinic with his mother who is worried about his lack of concentration. She describes how he often has episodes of ‘zoning out’, where he will stop all activity and stare into space. She describes how each episode lasts about 10 to 20 seconds. His teacher has complained that he seems to be daydreaming regularly in class. What is the single most likely diagnosis?

B. Hypoglycemia

D. Absence Seizure

A. Inattention Syndrome

C. Dyscognitive Focal Seizure

E. Cerebral Tumour

9. A 69-year-old woman presents to the general practice clinic complaining of vaginal bleeding over the past two months. She describes it as ‘spotting’ and is confused, as she underwent the menopause almost 10 years ago and has not had a period since then. An abdominal and pelvic examination are unremarkable. What is the single most likely diagnosis?

E. Cervical Ectropion

B. Ovarian Cancer

C. Cervical Cancer

D. Pelvic Inflammatory Disease

A. Endometrial Cancer

10. A 41-year-old man presents to the outpatients clinic complaining of a long standing cough with ‘lots of phlegm’. He is known to the clinic, as he has been under treatment for cystic fibrosis in the past. Clinical examination reveals coarse inspiratory and expiratory crackles and his fingers are clubbed. What is the single most appropriate diagnostic investigation of choice?

A. Chest x-ray

D. Spirometry

C. CT Chest

B. Bronchoscopy and biopsy

E. Arterial Blood Gas

11. A mother presents with her 4-month old baby to the general practice worried about a rash he has developed over his scalp. She says that it is causing flaking of his skin and is worried he may have a skin infection. On examination, a greasy rash with scales is present over the scalp. What is the single most appropriate next step in management?

E. Reassurance

A. Topical clindamycin cream

C. Topical benzoyl peroxide

D. 2% ketoconazole shampoo

B. Oral flucloxacillin

12. A 40-year-old Caucasian woman presents to the general practice complaining of feeling increasingly tired over the past year. During this time, she feels her mood has been lower, she has been losing hair and her periods have been more irregular than previously. Clinical examination reveals a diffuse, painless goitre with an irregular surface. Her latest blood results reveal the following: TSH 10, T4 6. What is the single most likely diagnosis?

D. Toxic adenoma

B. Iodine deficiency

A. Grave’s disease

C. Toxic multinodular goitre

E. Hashimoto’s thyroiditis

13. A 53-year-old man presents to the outpatient clinic for a review of his diabetic medication. He has a background of type 2 diabetes mellitus. He had been taking metformin twice daily since his diagnosis a year ago, however, he was unable to come even close to his target HbA1c. He was commenced on gliclazide three months ago. The gentleman reports that he has been getting frequent episodes of lethargy, sweating and shaking. He usually has a chocolate or cookie to calm his nerves and feels better afterwards. What is the single most appropriate next step in management?

A. Decrease dose of metformin

D. Check fasting plasma glucose

E. Add sitagliptin

C. Stop gliclazide

B. Stop metformin

14. A 72-year-old man visits Accident and Emergency complaining of palpitations for the past week. He has a blood pressure of 130/80 mmHg and a heart rate of 150 beats per minute. An ECG is performed and reveals an absence of P waves and an irregular rhythm. Rate control with a beta blocker has been decided upon. He has a background of type 2 diabetes mellitus. Which single drug is important in preventing the risk of stroke in this patient?

D. Apixaban

B. Tenecteplase

E. Ibuprofen

C. Aspirin

A. Clopidogrel

15. A 23-year-old woman presents to the clinic with a lump in her right breast. The lump has been present for at least a few months and has not changed in size. Clinical examination reveals the presence of a smooth, mobile and non-tender lump in the upper outer quadrant of the right breast. It is decided to perform imaging to rule out any sinister causes. What is the single most appropriate investigation of choice?

A. Mammogram

C. CT

B. MRI

E. X-ray

D. Ultrasound

16. A 59-year-old man takes warfarin once daily for atrial fibrillation. He visits his local anticoagulation clinic for an INR check today and his result comes back at 7.0. He feels fit and well and has experienced no bleeding symptoms. What is the single most appropriate step in management?

B. Stop warfarin, administer dried prothrombin complex and restart when INR < 5

E. Stop warfarin, administer vitamin K and start apixaban when INR < 5

D. Stop warfarin and start prophylactic low molecular weight heparin

C. Stop warfarin and re-start when INR < 5

A. Stop warfarin, administer vitamin K and restart when INR < 5

17. A 31-year-old obese woman presents to the general practice with a breast lump. Clinical examination reveals the presence of a painless and firm lump of the left breast with some overlying bruising which has largely faded. She was recently involved in a minor car accident a few weeks ago. She has no family history of note. What is the single most appropriate next step in management?

B. Reassurance

E. Ultrasound of the breast

D. Oral flucloxacillin for 5 days

A. Refer for triple assessment

C. Perform fine needle aspiration in the clinic and send for cytology

18. A 31-year-old woman recently had a smear test which showed mild dyskaryosis. An HPV test was subsequently carried out and came back negative for any high-risk types. Previous cervical smears were all normal. What is the single most appropriate management in this case?

B. Recall for a cervical smear in three months

A. Recall for a cervical smear in one year

C. Recall for a cervical smear in three years

D. Recall for a cervical smear in six months

E. Refer for colposcopy

19. A 50-year-old obese lady presents to the general practice clinic with a sore on her leg. She describes how she has noticed it slowly getting bigger over the past year. It is sometimes itchy and painful. Inspection of her right leg reveals a large, irregular and shallow area of abnormal tissue approximately 5cm above the lateral malleolus. There is discoloration and swelling of the surrounding normal skin. She has a background of type 2 diabetes mellitus. What is the single most likely diagnosis?

C. Neuropathic ulcer

D. Venous ulcer

B. Arterial ulcer

A. Cellulitis

E. Malignant melanoma

20. A 6-year-old boy presents to the general practice clinic with his mother, who complains that he is wetting the bed. His mother is stressed because she thinks it is starting to have a negative effect on his social life; he has had to miss sleepovers with his friends. She describes how he has never achieved continence. A general physical examination is unremarkable and the child is on the 50th centile for weight and height for their age. What is the single most appropriate next step in management?

B. Reassurance

C. Referral to Secondary Care

E. Vasopressin

D. Desmopressin

A. Enuresis Alarm

21. A 67-year-old man presents to Accident and Emergency with shortness of breath which has become worse over the past few days. He has a background of heart failure and takes ramipril, bisoprolol and furosemide at home. He has a temperature of 37.1, respiratory rate of 30, blood pressure of 130/80 mmHg and heart rate of 90 beats per minute. What is the single most appropriate step in management?

E. IV candesartan

C. Oral spironolactone

D. Oral losartan

A. Oral bendroflumethiazide

B. IV furosemide

22. A 36-year-old woman presents to the outpatient clinic complaining of a change in her hearing. She describes how she has noticed a gradual reduction in her ability to hear and her husband has to often speak loudly at home to get her attention. She is worried because her father has had trouble with his hearing and required a hearing aid in his fourth decade. What is the single most appropriate diagnostic investigation of choice?

E. Rinne’s test

A. CT head

D. Audiometry

B. Otoscopy

C. MRI head

23. A 44-year-old man presents to the general practice complaining that he has been having sudden episodes of the strange feeling that the room is spinning around him. They seem to occur in the mornings as he rolls over in bed and last no longer than 10 seconds. He has a background of hypercholesterolemia and type 2 diabetes mellitus. Cranial nerve and peripheral neurological examination are unremarkable. What is the single most appropriate next step in management?

D. Cyclizine

C. Dix-Hallpike maneuver

A. MRI head

E. Epley maneuver

B. CT head

24. A 65-year-old man presents to A&E after experiencing a 25-minute episode of vertigo, dysarthria and nystagmus. He is given treatment for a suspected diagnosis of a Transient Ischaemic Attack (TIA) and has a neurology review while in hospital. He currently takes ramipril and atorvastatin at home. Which single drug is most appropriate for secondary prevention of such an episode?

A. Clopidogrel 300mg daily

C. Rivaroxaban 20mg daily

B. Dalteparin sodium 5000 units daily

E. Aspirin 75mg daily

D. Warfarin 3mg

25. A 24-year-old man presents to the general practice clinic. He has had ‘funny bowel movements’ for many years, experiencing intermittent episodes of diarrhea, bloating and excessive flatulence. He describes his stools as ‘frothy’ and difficult to flush away. He has a background of type 1 diabetes mellitus. What is the single most appropriate next investigation of choice?

C. Sigmoidoscopy

E. Stool culture

A. Duodenal Biopsy

D. Serum tissue transglutaminase antibodies

B. Colonoscopy

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