PLAB 2 OSCE MASTERY EXAM
QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+ LATEST
COMPLETE CLINICAL CIRCUITS ALIGNED WITH GMC STANDARDS
Station 1 – Chest Pain in A&E
Scenario
A 54-year-old man presents with central chest pain for 45 minutes, radiating to the
left arm, associated with nausea and sweating.
Task
Take a focused history and explain your immediate management.
Expected Actions
Rapid symptom analysis (SOCRATES)
Identify red flags
Initiate emergency management
Communicate urgency calmly
Model Answer (Summary)
Suspect acute coronary syndrome
Immediate ABCDE assessment
Administer oxygen only if hypoxic, give aspirin 300 mg, obtain ECG, IV
access, bloods
Escalate to senior and cardiology
Rationale
Time-critical chest pain with autonomic symptoms strongly suggests myocardial
infarction. Early aspirin and ECG reduce mortality and guide urgent reperfusion.
,Station 2 – Breaking Bad News (New Cancer Diagnosis)
Scenario
A 62-year-old woman has biopsy-confirmed colorectal cancer.
Task
Explain the diagnosis and next steps.
Expected Actions
Use SPIKES structure
Assess patient understanding
Allow silence and emotional response
Avoid jargon
Model Answer (Summary)
Ask what the patient already knows
Deliver diagnosis clearly and compassionately
Reassure ongoing support and MDT involvement
Rationale
Patient-centred communication and emotional support are core GMC competencies
and reduce psychological harm.
Station 3 – Confused Elderly Patient on the Ward
Scenario
An 82-year-old man becomes acutely confused overnight.
Task
Assess and outline management.
Expected Actions
Identify delirium
Search for reversible causes
, Ensure safety
Model Answer (Summary)
Acute onset → delirium
Check infection, electrolytes, hypoxia, medications
Treat cause, avoid restraints, involve family
Rationale
Delirium is a medical emergency; addressing triggers prevents morbidity and
mortality.
Station 4 – Consent for Lumbar Puncture
Scenario
A 28-year-old man requires lumbar puncture for suspected meningitis.
Task
Obtain informed consent.
Expected Actions
Explain indication, risks, benefits
Check capacity
Answer questions
Model Answer (Summary)
Explain headache, bleeding, infection risks
Emphasise diagnostic importance
Confirm understanding and voluntary agreement
Rationale
Valid consent requires capacity, information, and voluntariness.
, Station 5 – Acute Asthma Exacerbation
Scenario
A 19-year-old woman with wheeze, RR 30, PEFR 45%.
Task
Manage the patient.
Expected Actions
Assess severity
Initiate treatment
Escalate appropriately
Model Answer (Summary)
Give oxygen, nebulised salbutamol, oral steroids
Monitor PEFR and response
Prepare for escalation
Rationale
Early aggressive treatment prevents respiratory failure.
Station 6 – Telephone Consultation: Child with Fever
Scenario
Mother calls about a 2-year-old with fever.
Task
Conduct safe telephone triage.
Expected Actions
Red flag screening
Safety-netting
Clear advice
QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+ LATEST
COMPLETE CLINICAL CIRCUITS ALIGNED WITH GMC STANDARDS
Station 1 – Chest Pain in A&E
Scenario
A 54-year-old man presents with central chest pain for 45 minutes, radiating to the
left arm, associated with nausea and sweating.
Task
Take a focused history and explain your immediate management.
Expected Actions
Rapid symptom analysis (SOCRATES)
Identify red flags
Initiate emergency management
Communicate urgency calmly
Model Answer (Summary)
Suspect acute coronary syndrome
Immediate ABCDE assessment
Administer oxygen only if hypoxic, give aspirin 300 mg, obtain ECG, IV
access, bloods
Escalate to senior and cardiology
Rationale
Time-critical chest pain with autonomic symptoms strongly suggests myocardial
infarction. Early aspirin and ECG reduce mortality and guide urgent reperfusion.
,Station 2 – Breaking Bad News (New Cancer Diagnosis)
Scenario
A 62-year-old woman has biopsy-confirmed colorectal cancer.
Task
Explain the diagnosis and next steps.
Expected Actions
Use SPIKES structure
Assess patient understanding
Allow silence and emotional response
Avoid jargon
Model Answer (Summary)
Ask what the patient already knows
Deliver diagnosis clearly and compassionately
Reassure ongoing support and MDT involvement
Rationale
Patient-centred communication and emotional support are core GMC competencies
and reduce psychological harm.
Station 3 – Confused Elderly Patient on the Ward
Scenario
An 82-year-old man becomes acutely confused overnight.
Task
Assess and outline management.
Expected Actions
Identify delirium
Search for reversible causes
, Ensure safety
Model Answer (Summary)
Acute onset → delirium
Check infection, electrolytes, hypoxia, medications
Treat cause, avoid restraints, involve family
Rationale
Delirium is a medical emergency; addressing triggers prevents morbidity and
mortality.
Station 4 – Consent for Lumbar Puncture
Scenario
A 28-year-old man requires lumbar puncture for suspected meningitis.
Task
Obtain informed consent.
Expected Actions
Explain indication, risks, benefits
Check capacity
Answer questions
Model Answer (Summary)
Explain headache, bleeding, infection risks
Emphasise diagnostic importance
Confirm understanding and voluntary agreement
Rationale
Valid consent requires capacity, information, and voluntariness.
, Station 5 – Acute Asthma Exacerbation
Scenario
A 19-year-old woman with wheeze, RR 30, PEFR 45%.
Task
Manage the patient.
Expected Actions
Assess severity
Initiate treatment
Escalate appropriately
Model Answer (Summary)
Give oxygen, nebulised salbutamol, oral steroids
Monitor PEFR and response
Prepare for escalation
Rationale
Early aggressive treatment prevents respiratory failure.
Station 6 – Telephone Consultation: Child with Fever
Scenario
Mother calls about a 2-year-old with fever.
Task
Conduct safe telephone triage.
Expected Actions
Red flag screening
Safety-netting
Clear advice
