SAMSON CLINICAL COURSES
PLAB 2 COURSE
DAY 2
Edited NOVEMBER 2022
COMPLETE, CORRECTED AND UPDATED NOTES FROM THE 16-
DAY ACADEMY COURSE.
IMPORTANT NOTE
,This is a complete, corrected and updated manual for the Samson Academy/Genius
Class 16-day course. It contains all the missing information in the manuals that are
usually given out as well as updated information on the current scenarios.
At the end of the Notes are links to more than 300 free videos of some of the most
common PLAB 2 scenarios including Interpersonal skills, all prescription scenarios, and
the most recent scenarios.
DAY 2:
History Taking Part 1
1. Palpitations (108)
2. Hyperthyroidism:
• Weight loss - (44)
• Tremors and sweaty hands (98)
3. Benign prostatic hypertrophy with UTI (8)
4. Urinary Incontinence (428)
5. Back pain:
• Back sprain (204)
• Back pain - prostate cancer pain management (1)
• Traumatic back pain (161)
• Back pain (renal colic) (19)
6. Constipation:
• Post hemiarthroplasty constipation (53)
• Constipation with nurse (106)
7. Shortness of breath:
• Pulmonary embolism scenario A (168)
• Pulmonary embolism scenario B (238)
• Pneumonia in elderly (179)
• Pneumocystis Carinii pneumonia scenario B (263)
• Acute COPD (212)
8. Headache:
• Migraine (235)
• Subarachnoid haemorrhage (72)
• Giant cell arteritis (132)
• Tension headache (193)
9. Hypothyroidism:
• Weight gain (147)
• Tiredness (128
10.Wheeze:
• Asthma first presentation - (scenario A and scenario B) (74)
11. Cough:
• Pneumocystis Carinii pneumonia scenario A (66)
• Tuberculosis (119)
,• Pneumonia
• Mesothelioma / Tuberculosis (56)
• Pneumonia in 72 year old (276)
• Pneumonia from a nursing home (275)
• Pneumonia in a traveller (107)
12. Anaemia:
• Iron deficiency anaemia with weight loss (187)
• Iron deficiency anaemia in a vegetarian
• Vitamin B12 deficiency (177)
• Thalassemia (199)
,DAY 2
1. PALPITATIONS
Nature of Palpitations
● Can you tell me what you mean by palpitations?
● Do you have an awareness of your heart racing?
● Can you tell me what you mean by fluttering feeling?
● Do you have an experience of thumping in the chest?
● Are the palpitations fast or slow?
● Do you have an experience of pounding in the chest?
● Do you have an experience like you're skipping some beats?
● Did you have a feeling that everything stopped for a moment?
● Can you tap for me on this table how fast your palpitations are?
FODPARA of Palpitations
F – Frequency:
● How often do you experience palpitations?
O – Onset:
● How did the palpitations start the first time? Suddenly or gradually?
D – Duration:
● When did the palpitations start?
● How long have you had the palpitations for?
● How long do the palpitations last? How do the palpitations stop?
P – Progression:
● Are the palpitations becoming more frequent?
A – Aggravating factors:
, ● Anything which makes it worse or anything which brings it on (if intermittent symp-
toms)?
● Does exercise make it worse?
● Does stress make it worse?
● Does drinking alcohol make it worse?
● Does drinking coffee or tea make it worse?
R – Relieving factors:
● Anything which makes it better?
● Does sitting help with the palpitations?
● Does holding your breath help with the palpitations?
A – Associations = Differential Diagnosis
Note: Ventricular ectopic beats disappear with exercise whereas AF remains the same.
If they’re having palpitations at the moment, ask to tap on the table
Differential Diagnosis:
Always think of DDs in terms of Emergency/common/and cancer
Ask about 3 DDs depending on the context
● Hyperthyroidism (oligomenorrhoea, heat intolerance, palpitations, weight loss, diar-
rhoea, tremors, palpitations)
● Medications (salbutamol inhalers)
● Hypoglycaemia (history of diabetes)
● Anxiety/panic attack (shortness of breath, chest pain, perioral paraesthesia, gener-
alised chest pains, previous episodes of similar symptoms)
● Arrhythmia (history of angina or myocardial infarction, hypertension or heart failure)
● Pheochromocytoma (intermittent abdominal pain, diarrhoea, episodic symptoms of
headaches, high blood pressure, panic attacks)
● Anaemia (light-headedness, weakness, tiredness, patient could be on aspirin or
NSAIDs for a long period of time)
● Drug abuse (IV drug abuse)
PLAB 2 COURSE
DAY 2
Edited NOVEMBER 2022
COMPLETE, CORRECTED AND UPDATED NOTES FROM THE 16-
DAY ACADEMY COURSE.
IMPORTANT NOTE
,This is a complete, corrected and updated manual for the Samson Academy/Genius
Class 16-day course. It contains all the missing information in the manuals that are
usually given out as well as updated information on the current scenarios.
At the end of the Notes are links to more than 300 free videos of some of the most
common PLAB 2 scenarios including Interpersonal skills, all prescription scenarios, and
the most recent scenarios.
DAY 2:
History Taking Part 1
1. Palpitations (108)
2. Hyperthyroidism:
• Weight loss - (44)
• Tremors and sweaty hands (98)
3. Benign prostatic hypertrophy with UTI (8)
4. Urinary Incontinence (428)
5. Back pain:
• Back sprain (204)
• Back pain - prostate cancer pain management (1)
• Traumatic back pain (161)
• Back pain (renal colic) (19)
6. Constipation:
• Post hemiarthroplasty constipation (53)
• Constipation with nurse (106)
7. Shortness of breath:
• Pulmonary embolism scenario A (168)
• Pulmonary embolism scenario B (238)
• Pneumonia in elderly (179)
• Pneumocystis Carinii pneumonia scenario B (263)
• Acute COPD (212)
8. Headache:
• Migraine (235)
• Subarachnoid haemorrhage (72)
• Giant cell arteritis (132)
• Tension headache (193)
9. Hypothyroidism:
• Weight gain (147)
• Tiredness (128
10.Wheeze:
• Asthma first presentation - (scenario A and scenario B) (74)
11. Cough:
• Pneumocystis Carinii pneumonia scenario A (66)
• Tuberculosis (119)
,• Pneumonia
• Mesothelioma / Tuberculosis (56)
• Pneumonia in 72 year old (276)
• Pneumonia from a nursing home (275)
• Pneumonia in a traveller (107)
12. Anaemia:
• Iron deficiency anaemia with weight loss (187)
• Iron deficiency anaemia in a vegetarian
• Vitamin B12 deficiency (177)
• Thalassemia (199)
,DAY 2
1. PALPITATIONS
Nature of Palpitations
● Can you tell me what you mean by palpitations?
● Do you have an awareness of your heart racing?
● Can you tell me what you mean by fluttering feeling?
● Do you have an experience of thumping in the chest?
● Are the palpitations fast or slow?
● Do you have an experience of pounding in the chest?
● Do you have an experience like you're skipping some beats?
● Did you have a feeling that everything stopped for a moment?
● Can you tap for me on this table how fast your palpitations are?
FODPARA of Palpitations
F – Frequency:
● How often do you experience palpitations?
O – Onset:
● How did the palpitations start the first time? Suddenly or gradually?
D – Duration:
● When did the palpitations start?
● How long have you had the palpitations for?
● How long do the palpitations last? How do the palpitations stop?
P – Progression:
● Are the palpitations becoming more frequent?
A – Aggravating factors:
, ● Anything which makes it worse or anything which brings it on (if intermittent symp-
toms)?
● Does exercise make it worse?
● Does stress make it worse?
● Does drinking alcohol make it worse?
● Does drinking coffee or tea make it worse?
R – Relieving factors:
● Anything which makes it better?
● Does sitting help with the palpitations?
● Does holding your breath help with the palpitations?
A – Associations = Differential Diagnosis
Note: Ventricular ectopic beats disappear with exercise whereas AF remains the same.
If they’re having palpitations at the moment, ask to tap on the table
Differential Diagnosis:
Always think of DDs in terms of Emergency/common/and cancer
Ask about 3 DDs depending on the context
● Hyperthyroidism (oligomenorrhoea, heat intolerance, palpitations, weight loss, diar-
rhoea, tremors, palpitations)
● Medications (salbutamol inhalers)
● Hypoglycaemia (history of diabetes)
● Anxiety/panic attack (shortness of breath, chest pain, perioral paraesthesia, gener-
alised chest pains, previous episodes of similar symptoms)
● Arrhythmia (history of angina or myocardial infarction, hypertension or heart failure)
● Pheochromocytoma (intermittent abdominal pain, diarrhoea, episodic symptoms of
headaches, high blood pressure, panic attacks)
● Anaemia (light-headedness, weakness, tiredness, patient could be on aspirin or
NSAIDs for a long period of time)
● Drug abuse (IV drug abuse)
