Welcome Young Doctor,
You are about to start PLAB 1 sample questions metabolic medicine
It has a total of 56 Questions.
GOOD LUCK!!
1.
A 66 year old man attends your clinic for a review following some blood tests. You note from his monitoring bloods that his sodium levels have dropped to 130 mmol/l since starting a new medication. Which ONE of the following medications is MOST LIKELY to be the cause?
2.
A 16 year old teenager attends your clinic complaining of intermittent episodes of skin yellowing, which seem worse after exercising. He states he feels well otherwise and has no other symptoms. A review of his blood test results a week later shows normal liver function tests with a mildly raised bilirubin. The FBC and clotting screen is all normal. What is the MOST LIKELY diagnosis?
3.
A 40 year old man with a background of Type 1 Diabetes attends A&E as he has been vomiting for 9 hours. On examination he is clinically dehydrated with a blood pressure of 92/60mmHg and he has a blood glucose measurement of 18mmol/l. What is the next most appropriate initial investigation?
4.
Which ONE of the following drugs is NOT a cause for hyponatraemia?
5.
Which of the following is a complication of Vitamin B12 deficiency?
6.
What is the MOST COMMON cause of hypercalcaemia?
7.
Which ONE of the following is NOT a known sign/symptom of anaemia?
8.
A 34 year old lady attends your clinic for the results of her blood tests, following a 3 month history of tiredness. The abnormal results are shown below. She has no other symptoms and is otherwise well.
Hb:Â 99 g/L
MVC:Â 90 femtolitres
Ferritin:Â 5Â micrograms/L
What is the MOST APPROPRIATE management?
9.
A 56 year old man with a QRISK2 score today of 18% would like to know if he can take any medications to lower his risk of cardiovascular disease. He has a history of active liver cirrhosis. You note from his records that he also has hypercholesterolaemia. Which ONE of the following could be offered?
10.
A 45 year old male comes in for some advice. His recent blood tests including vitamin D and calcium were normal. He would like to know what dose of vitamin D tablets he can buy over the counter to help prevent vitamin D deficiency What is the correct daily dose for vitamin D tablets used to PREVENT vitamin D deficiency?
11.
A 52 year old female attends your clinic following a routine blood test for tiredness. You note from her results that the only abnormality is a raised corrected calcium level of 3.50 mmol/L . She has no symptoms or history of note otherwise. What is the most appropriate management option?
12.
A 52 year old male patient who has worked for the last 24 years in a battery recycling factory has been complaining of a chronic cough for the past 8 years. He has recently been diagnosed with Stage 3 CKD. What heavy metal poisoning is most likely in this patient?
13.
A 21 year old man attends your clinic complaining of a change in appearance in his tongue (see below). What is this MOST LIKELY to be?
14.
Which is the MOST accurate definition of hypercalcaemia?
15.
A 50 year old man attends your clinic following a new diagnosis of Vitamin B12 deficiency. He would like to know which foods contain Vitamin B12. Which ONE of the following foods is a good source of Vitamin B12?
16.
A 56 year old man attends your clinic following some recent blood tests for his cholesterol. He is fit and well. He has never smoked. You note that his QRISK2 score today is 12%. What is the MOST APPROPRIATE management option?
17.
A 5 year old boy is brought into your clinic by his father, who is concerned about a gradual progression in the shape of his legs (see below). The father has also noticed that his son finds it difficult to climb stairs. What is the MOST LIKELY diagnosis?
18.
A 36 year old man attends your clinic with some concerns about his cholesterol. He had some blood tests done last week and is here for a review. In which ONE of the following scenarios, would you not suspect familial hypercholesterolaemia?
19.
Which ONE of the following features is NOT seen in phenylketonuria?
20.
Which ONE of the following is MOST LIKELY to be caused by Cushing's syndrome?
21.
A 65 year old male with metastatic lung cancer is admitted to hospital following the blood test results below.
Corrected Calcium:Â 3.75 mmol/L (Raised)
What is the MOST APPROPRIATE management?
22.
A 50 year old male attends your clinic following a 3 month history of feeling tired. Which ONE of the following would NOT be considered a red flag?
23.
A 65 year old man attends your clinic with a 2 week history of a cough. Following a full assessment you decide to offer antibiotics for a lower respiratory tract infection. You note from his records that he is on Atorvastatin 20mg. Which ONE of the following antibiotics should be avoided?
24.
Which ONE of the following tests is MOST LIKELY to test for Wilson's disease?
25.
A 45 year old man has become increasingly tired and lethargic over the past six months. His wife comments that he looks tanned even in the winter months. His serum ferritin and transferrin levels are significantly raised, but his haemoglobin is normal. Which is the SINGLE MOST likely diagnosis?
26.
Intrinisc Factor antibodies are associated with which condition?
27.
A 58 year old lady with a background of osteoporosis attends your clinic wanting some advice. She is keen to increase the dairy in her diet, but is unsure how much to consume. What is the recommended daily intake of calcium per day for a healthy adult?
28.
At what Hyponatraemia threshold would you admit a patient to hospital immediately?
29.
A 52 year old female with a history of metastatic breast cancer attends your clinic with a 2 week history of fatigue, muscle weakness, palpitations and feeling low. You suspect this may be hypercalcaemia. What is the MOST LIKELY feature that may be seen on an ECG?
30.
A 48 year old female attends your clinic following a routine blood test for muscle weakness. You note the following from her blood results:
Corrected Calcium:Â 2.75 mmol/L (Raised)
Parathyroid hormone:Â Raised
Renal Function:Â Normal
What is the MOST LIKELY diagnosis?Â
31.
A 28 year old lady attends the emergency department with a 6 hour history of abdominal pain. A detailed history reveals that she has recently been taking large amounts of paracetamol for backache over the last 3 days. On examination, you note; mild jaundice, right upper quadrant tenderness and hepatomegaly. What is the most appropriate management?
32.
A 34 year old lady attends your clinic for the results of her blood tests, following a 3 month history of tiredness. She is diagnosed with iron deficiency anaemia and started on iron supplementation. After how long should her haemoglobin levels be re-checked following initiation of iron treatment?
33.
A 30 year old lady attends your clinic following initiation of iron supplementation for iron deficiency anaemia. She states that she has noticed some side effects since starting treatment. Which ONE of the following is unlikely to be due to the iron supplementation?
34.
A 28 year old man attends your clinic complaining of a 6 week history of tiredness. Which ONE of the following would you NOT request on an initial blood test, to investigate his symptoms?
35.
A 32 year old male with Crohn's Disease attends your clinic with a 2 month history of feeling tired. He has been reading on the internet that Vitamin B12 deficiency may be a cause. In which part of the gut is Vitamin B12 absorbed?
36.
A 54 year old fit and well man with a QRISK2 score of 15% is offered statins to lower his cardiovascular risk. He would like to know if he needs any blood tests doing in the future. How often should his liver function tests be checked after initiation of a statin?
37.
A 70 year old lady attends your clinic following a long admission in hospital for chronic hyponatraemia. Which ONE of the following is NOT a known complication of hyponatraemia?
38.
Which ONE of the following is MOST LIKELY to be caused by diarrhoea?
39.
A 34 year old lady attends your clinic for the results of her blood tests, following a 3 month history of tiredness. She is diagnosed with iron deficiency anaemia and started on iron supplementation. How long should her iron supplementation be continued for?
40.
At what threshold would you diagnose Hyponatraemia?
41.
At what thereshold of fasting triglycerides levels does the risk of cardiovascular disease increase?
42.
Which ONE of the following is MOST LIKELY caused by milk-alkali syndrome? Select ONE option only.
43.
A 61 year old lady who has been a heavy smoker since the age of 20 is diagnosed with a small cell lung cancer. What serum electrolyte findings will confirm the presence of SIADH?
44.
Which of the following foods contain the highest levels of Vitamin D?
45.
A 42 year old man attends your clinic asking for a review of his hands (see below). He states that his father who was born in Nigeria died at the age of 45. What is the most likely diagnosis?
46.
Which ONE of the following statements about Vitamin D-resistant rickets is true? Select ONE option only.
47.
A 15 year old teenager attends your clinic with her mother. Her mother states that she has taken drugs from her medical cabinet in an attempt to commit suicide, but does not know what was taken. Her mother states that she was recently started on treatment for a heart attack. The teenager complains of ringing in her ears, severe abdominal pain, nausea and has a respiratory rate of 28. What is the most likely cause of her overdose?
48.
A 68 year old man attends your clinic following a recent blood test result. You note that his corrected calcium has come back as 3.15 mmol/l on 2 separate occasions. Which ONE of the following drugs has MOST LIKELY caused this rise?
49.
A 65 year old lady with Chronic Kidney Disease Stage 5 has been accepted for dialysis, 3 times per week. She attends your clinic as she is keen to avoid foods high in potassium. Which ONE of the following foods is high in pottasium? Select ONE option only.
50.
A 22 year old male smoker attends your clinic for a routine review of his epilepsy. He is on sodium valproate. At the end of the consultation you start counselling him on smoking cessation, when he starts to develop jerking of all his limbs and loses consciousness. What is the MOST appropriate investigation to do at that moment in time?
51.
A 35 year old lady attends your clinic for a medication review. You note that she is on iron supplementation for iron deficiency anaemia. Which ONE of the following can reduce the absorption of iron?
52.
A 44 year old female is found to have a raised triglyceride level of 16 mmol/l after a recent routine blood test. She is a non-smoker and drinks around 6 units of alcohol spread throughout the week. Her blood pressure today is 126/80. Which ONE of the following is a cause of hypertriglyceridaemia? Select ONE option only.
53.
Which hormone is known to regulate serum sodium levels?
54.
A 55 year old diabetic lady is brought to the emergency department by her husband. She complains of a 3 day history of abdominal pain and nausea. On examination you notice a fruity odour when she talks and she also appears breathless. Her blood glucose is 17.4 mmol/L and her blood ketone levels are 5 mmol/L.
Normal ABG values:
pH:Â 7.35-7.45
pCO2:Â 4.5-6.0 kPa
pO2:Â 10-14 kPa
HCO3:Â 22-26 mEq/L
What is the arterial blood gas (ABG) likely to show in this scenario?Â
55.
A 55 year old female attends your clinic with a 4 week history of ataxia, mild confusion and paraesthesia in both her arms. You note from her records that she was recently treated for a folic acid deficiency. What is the MOST LIKELY cause of her symptoms?
56.
A 68 year old man with a history of metastatic prostate cancer attends your clinic following a 2 week history of polyuria and polydipsia. What is the MOST LIKELY cause of his symptoms?
Add a Comment