PLAB TRAINER PLAB-1 MOCK TEST: 13™ JUNE 2011 ‘TIME ALLOWED: 3HRS ‘CORONARY ARTERY: Op -Acute marginal branch Left internal mammary artery Left anterior descending artery Septal branches ‘Obtuse marginal branches Circumflex artery ‘Left main stem (LMS). Posterior descending artery (PDA) Diagonal branch af (Right coronary artery” co: ‘The artery that runs in the ee iroove.” Ce w @a branch of the ental coronary artery that supplies the inferior portion the septum. > D> Ay ()the ants artery that supplies the anterior right ventricular wall. GS Othe artery that rns along the leftatriovenricular groove. LAC, — XK og ‘Dn 85% of the population this artery is the dominant artery Krom RDO D> Diagnosis of confusion Options: ‘A. Alzheimer’s disease J. Hyper pyrexia B. Anaemia K._—_Hypoglycaemia C. Carcinoamtosis L. — Hypomania D. Cerebral tumour M. Hypotension E. Delirium tremens N. Infection toxicity F. Delusional depression ©. Post ictal statae G. Drug toxicity P. Schizophrenia H. Electrolyte imbalance Q Subdural haematoma 1. Hear failure R. Temporal arteritis Instructions: For each patient described below, choose the SINGLE most likely cause from the above list of options, Bach option may be used once, more than once or not at all6. A 72 year old woman who had a repair of strangulated femoral hernia two days ago becomes noisy, aggressive and confused. She is a febrile, her full blood count is normal apart from a raised mean corpuscular volume (MCY). 7. A 40 year old chronic alcoholic who lives alone, brought into the A&E department having confused at home after a fall. He complains of a headache. 8..A 76 year old woman has become tired and confused following influenza like illness. She is also breathless with signs of consolidation of the left lung:base. 9. An 18 year old previously well student is in his first year at university. He has been brought to the A&E department in an agitated, deluded and disoriented state. (rp ‘50 year old man presents with a iGractible, confused and overactive. a 2S 2 fg Palpitations a Options: A. Atrial fibrillation E, Ventricular fibrillation B. Complete heart block F. Ventricular tachycardia CC. Supraventricular tachycardia G. _ Wenckebach phenomena D. Ventricular ectopics Instructions: For each patient described below, choose the Single most li from the above list of options, each option may be used once, more than once, or not at all ly underlying rhythm disturbance 1. A76 year old man is on the coronary care unit two days after an acute myocardial infarction. He Tells you that he had an episode of rapid pounding in the chest lasting for about a minute. He remains conscious throughout. 12. A 68 year old man on treatment for an irregular heart beat comes to the Accident and Emergency department. He has palpitations for the last three hours, On examination you find that his pulse is regular and is 154 beats/minute. Carotid sinus massage settle his pulse down to 80 beats/ minute. 13. A 70 year old womariVongstanding anxiefj\is seen in the out patients department. She complains ‘other heat skipping.a beat quite often, This particulary occurs when she is tying to get to sleep ‘The palpitations are never sustained. cs 28 years old man presents with a two hour history of rapid palpitations. He feels a little ight jeaded but is otherwise well. On examination his pulse is 170 beats/minute and egular, and his blood pressure is 100/68 mmHg. He has had two similar episodes in the past. _ Itching: Options: A. Atopic eczema G. Psoriasisv k + Lymphoma Primary biliary cirrhosis, B. Dermatitis herpetiformis H. Psychogenic itching C. Hyperthyroidism L. Scabies D. Lichen planus EB F. Instructions: For each presentation 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. 15. A sixty year old vagrant presents with generalized itching. There are widespread excoriation ‘marks on his trunk and arms with liner tracks around his wrists and around aT 16. A45 year old woman presents with pruritus. On examinations, she has skin pigmentation and investigation show a raised serum alkaline phosphotase and the presence of antinitochondrial antibodies. 17. A29 year old woman has developed an itchy scaly rash particularly over her wrist with fine white streaks overlying the lesion. Her nails have ridges and her buccal mucosa is fine with a lacy wl ~paliern, o 18. A 20 year old man complains of a regent onset of itching which has followed a viral infeetion. ‘There are numerous weals of al sizes on his skin particularly after he has scratched it. These can last for up to an hour. 19. A{60 year old mar) complains of tiredness, lethargy and itching that is severe éftera hot bath) He also has nocturia, polyuria and nausea and vomiting. Examination reveals pallor, pigmentation and generalized oedema. 20. A patient presents with a lid lag, bulging eyes, opthalmoplegia, and thyroid bruit. What CR, Thyroid finetion tests B. Eye sight . Tensilon test D.Uttraround —? Yo if onthirs, mechivad | 30 years old lady complaining of right ear deafness with deereased corneal reflex & past “nting. Acoustic analysis shows sensorineural deafness ‘What is the next most appropriate investigation to do? CT brain b- CP acoustic canal IRI brain d- MRI acoustic canal PET brain 4 ENE"