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PLAB January 2003

Author: sunny, Posted on Saturday, June 28 @ 00:29:40 IST by RxPG  

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PLAB Part 1

Theme 3. FRACTURES OF WRIST JOINT
a)x -ray of wrist scaphoid view
b)refer to ortho doctor immediately
c)bandage and discharge
d)isotope scan

12) pt had a fall -x ray showed displacement of the radia

++++++++++
12-B



Theme 4. RELATION TO OBESITY
a)obstuctive sleep apnoea
b)type 1 dm
c)type 2 dm
d)alcholol
e)cushings
f)hypothyroidism
g)Polycystic Ovary Disease

13) wt loss would help night sleep and this condition and improve family relations
14) wt loss would even help to stop the medications
15) stop of this would help in wt loss and vitamin deficiency
16) surgery in this condition in a female would help in wt loss and improve this condition
++++++++++++++++++++++
13-A
14-C (DIET )??
15-D
16-G (SINCE HE SPECIFIED THE GENDER ,OTHERWISE ADENOMA –CUSHINGS IS ALSO AN ANSWER)


Theme 5. DELAYED MILESTONE
a)fragile x syndrome
b)tay-sachs disease
c)bacterial meningitis
d)hypothyroidim
e)prematurity
f)duchennes muscular atrophy
g)Fetus alcohol syndrome

17) a 4 yrs old boy can write his name and draw a circle and square; he walks with a
lordosis and he cannot run.
1 boy of 3 yrs of age, has delayed milestones his uncle and brother also have this
condition
19) girl can sort out cube 4 9 and is 97 percentile for her weight, but her head
circumference is lower than normal
20) a six months old child, can smile, but has head lag.
21) child was normal but then delayed miletones after a fever

+++++++++++++++++++
17-F
18-A
19-CHUBBY WITH MICROCEPHALY ??COULD IT G ??
20-E? OR SOMETHING CAUSING HYPOTONIA??SUCH AS HYPOTHYROIDISM
21-C


Theme 6. PSYCHIATRIC MANAGEMENT HOW CAN YOU HELP THESE
PATIENTS
a)methadone
b)propanolol
c)diazepam
d)acomprosate

e)zopiclone
f)risperidone
g)amitryptilline


22). A girl has oral numbness and limb paraetheses after an argument with her friend
23) patient a heroin addict - now in ward in withdrawal wants u to help him
24) patient an alcholic now has been detoxified feel that he wants to remain off it but is
scare he may relapse
25) female with s-s of pain in chest; tightness ,feeling like dying and sinking feeling
,wants some medication for her condition.
26) patient has to go for an interview has sweaty palms and palpitations asks for your
help.
27) patient having restlessness, pacing up and down after death of her husband with
difficulty in falling asleep .

++++++++++++++++++++++++++++++++
22-TO BREATHE IN A CLOSED BAG ,,+/- ANXIOLYTIC SUCH AS DIAZEPAM -------( C )
23-A
24-D (CAN SOMEONE INDICATES SHARPLY WHEN TO USE DISULFIARM AND WHEN TO USE ACAMPROSATE)

25-C
26-C
27-G

Theme 7. DIAGNOSIS OF PSYCHIATRIC DISORDERS
a)Post-traumatic disorder
b)Post natal-psychosis
c)though -broadcasting ,
d)insertion ,
e)echo
f)Hallucination
g)Illusion
h)paranoid delusions
i)Judgement
j)Insight
k)low mood
l)flight of ideas

2 patient keeps on talking to you ..non stop and jumps from one topic to another
29) patient after the birth of her child feels sad and does not want to feed the baby
30) patient has the believe that his neighbour is planning an attack
31) a old woman has been admitted and feels that the staff of the hospital knows what she
is thinking all the time.
32) patient who lost her husband is sad now and avoids eye contact
33). A man has psychiatric problem and he knows that he need a treatment


++++++++++++++++++++++
28-L (PRESSURE OF SPEECH ) A FEATURE OF MANIA
29-K .POST NATAL DEPRESSION
30-H
31-C (PATHOGNOMONIC OF SCHIZOPHRENIA)
32-K (BEREAVMENT)
33-J (INDICATES A GOOD PROGNOSIS)

Theme 8 VOMITTING IN PREGNANCY
a)hyperemesis gravidum
b)hydatid form mole
c)cholecystitis

d)Chloecystic pregancy
e)Brain tumour
f)pre eclampsia
g)migraine

34) 12 weeks pregnant woman has been continuously vomiting , comes with a furred
tongue and signs of dehydration and uremia.
35) A 14 weeks pregnant woman comes to you with severe vomiting , u.s of uterus shows
absence of f.h.s. and the uterine is 18 weeks to date.
36) patient comes to u with severe vomitting ,diziness and photohobia. She is in the 34
week ,she tells you that she had these symptoms since 14 weeks and o/e her pulse rate is
60 /min
37) A pregnant woman had a nauseous and vomit since week 18 and these symptoms
have got worse since two weeks and she is anorexic, vomiting and slightly jaundice.

+++++++++++++++++++++
34-A
35-B (COMPLETE)
36-BRADYCARDIAC-RANGE PULSE TOGETHER WITJ S&S OF RAISED ICP I GUESS IT IS MORE LIKELY TO BE BRAIN TUMOUR THAN MIGARINE ..
37-I GUESS CHOICE {D} IS CHOLESTATSIS OF PREGNANCY IF NOT MY ANSWER WOULD BE { C } .


Theme 9. NERVE INJURY
a)axillary
b)musculocutaneous
c)radial
d)ulnar
e)common peroneal nerve
f)sciatic

3 patient has history of fracture shoulder now has decreased sensation on the lateral
aspect of the deltoid muscle
39) patient had fracture of fibula or at level of fibula and now lost his dorsreflex and
sensation loss on the lateral side of his low leg.
40) patient had fracture of medial epicondly and now come with decreased sensation of
5th and 4 th finger
41) patient has some fracture of humer and comes with s/s/ of wrist drop
42) old man had a fall and fracture or dislocation of hip now has weakness in his
hamstring.

+++++++++++++++++++++++++++++
38-A
39-E
40-B
41-C
42-F


Theme 10. PAIN RELIEF
a)allopurinol
b)radio therapy
c)TENS
d)i/m diamorphine
e)oral nsaids
f)paracetamol
g)prednisolone
h)physiotheraphy
I)home exercise
j)i/m steroids in joint

43) patient with ca prostate and now has 2 aries to back with severe pain , no nsaids,
morphine has helped ?wants to continue his work
44) patient with ca lung with 2 aries now has come with an unilateral swollen arm , all
other medications have failed ( i.e nsaids and morphine )
45) 50 yr old woman has come with painful shoulder joint and hip joint
46) 30 yr old busy executive has got pain on lateral aspect of thigh . he shows no
improvement with nsaids . x ray taken was normal
47) a man is on Fresmide and got pain in his joint

+++++++++++++++
43-B
44-IF AMPUTATION WAS THERE I WOULD HAVE CHOSEN IT ,BECAUSE ALL OTHERS ARE NOT HELPFUL FOR THIS KIND OF LYMPHOEDEMA .!!
45-G (PMR)
46- J (*NOT IM )
47-E

Theme 11. MECHANISM OF ABORTION
a)immunological
b)genetic
c)anatomical
d)endocrine
e)Drug-induced

48 ) patient having 6 abortions in mid trimester
49 ) patient having some problem with the deformed child (She married her cousin)
50) patient has recurrent abortions, is obese and hirsutism.

++++++++++++++++++

48-C (CERVICAL PROLAPSE)
49-B
50-D


Theme 12. INVESTIGATION OF LEG ULCERS
a)pyoderma gangeroneusm
b)bowens disese
c)venous stasis
d)arteriography
e)Melanoma biopsy

51) patient having pain on walking. His leg and foot are pale and with the 4 th and 5th
digit blackened
52) patient with diarrhoea and abdominal pain had a small round (with central necrotic
tissue)
53) female fat obese and having edema of leg now has a small ulcer on medial aspect of
her ankle.
54) 60 yrs old man with a pigmented skin lesion on his shin.

++++++++++++++++++++
51-D
52-A
53-C,TYPICAL SITE
54-E

Theme 13. HEAD PATHOLOGY
a)Intra-cerebral haematoma
b)brain stem injury
c)Extradual haematoma
d)Subdual haematoma (SDH)
e)acute SDH
f)Chronic SDH
g)vertibo basilar ischaemia
h)migraine
I)depressed fracture of skull
j)Sub-rchnoid Haemorrhage

55) motor cyclist with accident is brought to casualty with head injury. gcs is 3 and his
blood pressure is 180/100 and heart rate of 56/min and his pupil is dilated and sluggish to
light, no neurological sign except his plantars are going up.

56) young male 27 after a heavy bout of alcohol fell down on the road and then got up n
walked home . His wife found him on the floor and cannot rouse and has fluctuating
consciousness.
57) 67 yrs old man had recent falls, became agitated and confused.

5 A old lady has dizziness and vertigo and walking reeling to one side.

59) Female has come to a-e with vomiting and severe pain in the back of the head
60) patient hit on the head with a hammer, now comes with vomiting
61) a young man fell over and there is injury on his temple scalp (I think he is alert)
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
55-WELL THIS IS BRAIN STEM DEATH ,,THERE ARE NO CRANIAL REFLEXES ,I GUESS BABEMSKI IS NOT COUNTED ,-----------------(B)

56-E
57-D
58-G
59-J
60-A
61-C {LUCID INTERVAL)

Theme 14. DIAGNOSTIC TESTS ON LOSS OF VISON
a)MRI temporal lobe
b)MRI pituatory
c)MRI occipital lobe
d)Doppler carotid artery
e)ESR
f)MRI parietal lobe

62) patient comes with repeated h/o/ loss of vision in one eye and it improves after a few
hours
63) patient with bitemporal hemianopia and increaes in shoe size.
64) patient has come with vomiting and upper quadranopia (not sure of the full question )
65) patient having pain while brushing her hair and now comes with loss of vision in one
eye
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
62-D (TIAs) IF IT WAS MS IT WOULD TAKE MORE THAN FEW HOURS FOR THE OPTIC NEURITIS TO RESOLVE ,,RIGHT !!

63-B
64-A
65-E

Theme 15. MANAGEMENT OF INJURIES (THIS IS REALLY NEW )
a)laparatomy
b)refer to surgeon
c)admit and observe
d)give iv fluids 1 litre in 30 mins
e)iv fluids 2 litres in 30 mins

f)reassurance and send home

66) boy has come with injury by fall on handle of cycle and had got pain and tenderness
in left upper side of abdomen. u.s of spleen shows a small sized haematoma or infarct in
the splenic capsule

67) patient with being hit by a ball comes with severe pain in epigastrium

6 patient was stabbed in a fight and now comes with his omentum ( or omentocele
outside in the umblical area). His blood pressure is 110/70 and heart rate 80.

69) patient with h/o/ fall has come with tenderness in left side of abdomen and fracture of
2 right sided ribs. patient in shock

70) Patient had (some sort of injury), after 2 litres of fluid iv, his bp is low and hr higher.
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
66-B (I THINK HE WILL NEED SPLENECTOMY)
67-C
68-B
69-E ,,THEN URGENT LAPAROTOMY
70-A

Theme 16. MANAGEMENT investigation OF SEIZURES *(THIS ONE IS NEW TOO)

a)Start anti-convulsants
b)reassurance
c)anxiolytic treatment
d)vulvar surgery
e)EEG.
f)ECG
g)I.V. glucose

71) A 50 yrs old man had hemoptysis and cough for some time and now come with a first
fit.
72) 8 year old girl falls down in the assembly. She is pale and loss consciousness for 1
min. She often falls in dentist visit.
73) boy has period of breathholding spells where he becomes blue and loss
consciousness. This happens when he is separating from his parents.
74) 30 year old female has 2-3 episodes of falling down, she also has got a loud murmur
in inspiration
75) 50 yrs old woman has episodes of unconsciousness starting in the left thumb and then
going to whole body. she loses consciousness
76) A 10 yrs old boy behaves strangely (cannot remember exactly), and his teacher says
that he is not concentrating at the moment.
77) A young man has some kind of fit (it is a long Q), his heart rate drop down to 50/min
7 a young boy has fit, he is a DM, his blood glucose is 2mmol.
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
71-A

72-THIS IS DEFINITELY VASOVAGAL ATTACK ,,IF FOR LONG STANDING DURING WAITING ----REASSURE AND ADVICE HER TO SIT DOWN ,,IF DUE TO LONG WAITING IN GENERAL----HYPOGLYCAEMIA(ORAL SUGARS),,,IF DUE TO FEAR FROM THE DENTIST ----ANXIOLYTIC S ,I GUESS THE LATTER IS WHAT IS BEING ASKED FOR IN THIS PARTICULAR QUESTION ,WHAT DO YOU THINK ??


73-B {{{{BREATH HOLDING SPELLS ARE OF TWO MAIN TYPES ,,CYANOTIC (THE CHILD GETS BLUE)AS IN THIS QUESTION AND PALLID WHERE HE GETS PALE ,,,THE LATTER IS LESS BENIGN THAN THE FORMER AND IN EITHER YOU SHOULD EXCLUDE SEIZURE DISORDER FOR CYANOTIC ----REASSURE FOR PALLID WHO USUALLY GETS ASYSTOLE ATROPINE IS A CHOICE }}}MANAGED FROM/// NELSON ESSENTIALS OF PEDIATRICS 3RD Edn ,PAGE 490 t ...SO IF YOU ARGUE THAT AN EEG MUST BE DONE FIRST BEFORE REAASURING THE PAENTS ,THEN YOU WOULD BE RIGHT !

74-D (VALVULAR AND NOT VULVAR )
75-JACSONIAN MARCH ,,,{ E }

76-THIS IS ATD ,T.O.C IS METHYLPHENIDATE ,,NOW WHETHER THIS INCLUDES ANXIOLYTIC AS WELL ???OR MAY BE WE JUST NEED TO REASSURE AS IT IS AN OVERDIAGNOSIS IN THE UK TO SAY THAT A CHILD IS ABNORMALLY HYPERKINETIC ??

77-F
78-G


Theme 17. HAEMETEMESIS
a)malleroy weiss tear
b)alcholic cirrhosis
c)gastric erosion
d)peptic ulcer
e)duodenal ulcer

7 patient 55 has been drinking 15 units/ day now comes with massive hemetemesis
79) patient comes with massive hemesis after eating a lot and a bout of alcholol
80) patient suffering from Rheumatoid arthritis. comes with vomiting with streaks of
blood
81) a 50 years old manager had epigastric discomfort for some time and his stool is tarry.
He is otherwise normal.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++=
78-B
79-A
80-C
81-UGIB ,,BEST ANSWER I GUESS IS ( D )


any differences of opinion welcome



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