PLAB 1 (UK DOCTORS) EXAM
QUESTIONS AND 100% VERIFIED ANSWERS WITH
RATIONALES GRADED A+ LATEST
ALIGNED WITH UK MLA & GMC STANDARDS
Question 1
A 67-year-old man presents with sudden onset right-sided weakness and aphasia
that began 90 minutes ago. CT head shows no haemorrhage. BP is 165/95 mmHg.
He takes ramipril for hypertension.
What is the most appropriate next step?
A. Aspirin immediately
B. Lower blood pressure aggressively
C. Intravenous thrombolysis
D. Start clopidogrel
E. CT angiography in 24 hours
Correct Answer: C
Rationale: He is within the 4.5-hour window for thrombolysis, CT excludes
haemorrhage, and BP is acceptable. Thrombolysis should not be delayed.
Question 2
A 25-year-old woman presents with fever, sore throat, malaise, and cervical
lymphadenopathy. Blood tests show lymphocytosis with atypical lymphocytes.
Which additional finding is most likely?
A. Strawberry tongue
B. Raised anti-streptolysin O titre
C. Hepatosplenomegaly
D. Reduced platelets
E. Conjunctival injection
Correct Answer: C
,Rationale: Infectious mononucleosis commonly causes hepatosplenomegaly and
atypical lymphocytes.
Question 3
A 72-year-old woman with COPD presents with worsening breathlessness. ABG
shows: pH 7.30, PaCO₂ 8.0 kPa, PaO₂ 7.2 kPa on air.
What is the most appropriate management?
A. High-flow oxygen
B. Oral steroids only
C. Controlled oxygen via Venturi mask
D. Immediate intubation
E. Nebulised salbutamol only
Correct Answer: C
Rationale: This is type 2 respiratory failure. Controlled oxygen (target sats 88–
92%) prevents worsening hypercapnia.
Question 4
A 30-year-old woman presents with acute pelvic pain and vaginal bleeding.
Pregnancy test is positive. Ultrasound shows an empty uterus and a right adnexal
mass.
Most likely diagnosis?
A. Ovarian torsion
B. Threatened miscarriage
C. Ectopic pregnancy
D. Endometriosis
E. Pelvic inflammatory disease
Correct Answer: C
Rationale: Positive pregnancy test with empty uterus and adnexal mass is classic
for ectopic pregnancy.
,Question 5
A 55-year-old man with long-standing diabetes presents with numbness and
burning pain in both feet, worse at night.
Best initial pharmacological treatment?
A. Paracetamol
B. Ibuprofen
C. Amitriptyline
D. Codeine
E. Morphine
Correct Answer: C
Rationale: Neuropathic pain responds best to agents like amitriptyline, duloxetine,
or gabapentin.
Question 6
A 4-year-old child presents with barking cough, hoarseness, and inspiratory stridor.
Temperature is 37.8°C.
Most appropriate treatment?
A. Antibiotics
B. Nebulised salbutamol
C. Oral dexamethasone
D. Intubation
E. Humidified oxygen only
Correct Answer: C
Rationale: Viral croup is treated with corticosteroids; antibiotics are not indicated.
, Question 7
A 60-year-old man presents with painless jaundice, weight loss, and pale stools.
Examination reveals a palpable gallbladder.
Most likely diagnosis?
A. Gallstones
B. Pancreatic cancer
C. Acute hepatitis
D. Primary biliary cholangitis
E. Alcoholic liver disease
Correct Answer: B
Rationale: Courvoisier’s sign (palpable gallbladder with jaundice) suggests
malignant obstruction.
Question 8
A 28-year-old woman presents with fatigue, weight gain, constipation, and cold
intolerance. TSH is elevated, free T4 is low.
Most likely cause?
A. Graves’ disease
B. Subacute thyroiditis
C. Hashimoto’s thyroiditis
D. Pituitary adenoma
E. Iodine excess
Correct Answer: C
Rationale: Primary hypothyroidism with raised TSH is most commonly due to
autoimmune Hashimoto’s disease.
QUESTIONS AND 100% VERIFIED ANSWERS WITH
RATIONALES GRADED A+ LATEST
ALIGNED WITH UK MLA & GMC STANDARDS
Question 1
A 67-year-old man presents with sudden onset right-sided weakness and aphasia
that began 90 minutes ago. CT head shows no haemorrhage. BP is 165/95 mmHg.
He takes ramipril for hypertension.
What is the most appropriate next step?
A. Aspirin immediately
B. Lower blood pressure aggressively
C. Intravenous thrombolysis
D. Start clopidogrel
E. CT angiography in 24 hours
Correct Answer: C
Rationale: He is within the 4.5-hour window for thrombolysis, CT excludes
haemorrhage, and BP is acceptable. Thrombolysis should not be delayed.
Question 2
A 25-year-old woman presents with fever, sore throat, malaise, and cervical
lymphadenopathy. Blood tests show lymphocytosis with atypical lymphocytes.
Which additional finding is most likely?
A. Strawberry tongue
B. Raised anti-streptolysin O titre
C. Hepatosplenomegaly
D. Reduced platelets
E. Conjunctival injection
Correct Answer: C
,Rationale: Infectious mononucleosis commonly causes hepatosplenomegaly and
atypical lymphocytes.
Question 3
A 72-year-old woman with COPD presents with worsening breathlessness. ABG
shows: pH 7.30, PaCO₂ 8.0 kPa, PaO₂ 7.2 kPa on air.
What is the most appropriate management?
A. High-flow oxygen
B. Oral steroids only
C. Controlled oxygen via Venturi mask
D. Immediate intubation
E. Nebulised salbutamol only
Correct Answer: C
Rationale: This is type 2 respiratory failure. Controlled oxygen (target sats 88–
92%) prevents worsening hypercapnia.
Question 4
A 30-year-old woman presents with acute pelvic pain and vaginal bleeding.
Pregnancy test is positive. Ultrasound shows an empty uterus and a right adnexal
mass.
Most likely diagnosis?
A. Ovarian torsion
B. Threatened miscarriage
C. Ectopic pregnancy
D. Endometriosis
E. Pelvic inflammatory disease
Correct Answer: C
Rationale: Positive pregnancy test with empty uterus and adnexal mass is classic
for ectopic pregnancy.
,Question 5
A 55-year-old man with long-standing diabetes presents with numbness and
burning pain in both feet, worse at night.
Best initial pharmacological treatment?
A. Paracetamol
B. Ibuprofen
C. Amitriptyline
D. Codeine
E. Morphine
Correct Answer: C
Rationale: Neuropathic pain responds best to agents like amitriptyline, duloxetine,
or gabapentin.
Question 6
A 4-year-old child presents with barking cough, hoarseness, and inspiratory stridor.
Temperature is 37.8°C.
Most appropriate treatment?
A. Antibiotics
B. Nebulised salbutamol
C. Oral dexamethasone
D. Intubation
E. Humidified oxygen only
Correct Answer: C
Rationale: Viral croup is treated with corticosteroids; antibiotics are not indicated.
, Question 7
A 60-year-old man presents with painless jaundice, weight loss, and pale stools.
Examination reveals a palpable gallbladder.
Most likely diagnosis?
A. Gallstones
B. Pancreatic cancer
C. Acute hepatitis
D. Primary biliary cholangitis
E. Alcoholic liver disease
Correct Answer: B
Rationale: Courvoisier’s sign (palpable gallbladder with jaundice) suggests
malignant obstruction.
Question 8
A 28-year-old woman presents with fatigue, weight gain, constipation, and cold
intolerance. TSH is elevated, free T4 is low.
Most likely cause?
A. Graves’ disease
B. Subacute thyroiditis
C. Hashimoto’s thyroiditis
D. Pituitary adenoma
E. Iodine excess
Correct Answer: C
Rationale: Primary hypothyroidism with raised TSH is most commonly due to
autoimmune Hashimoto’s disease.
