PLAB 1 (GMC, international medical graduates) · Emergency and acute medicine

Cardiovascular, neurological and metabolic emergencies

12 practice questions, each with the answer and an explanation.

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Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 12 questions

  1. A 58-year-old man has chest pain and ST elevation in leads II, III and aVF 90 minutes after onset. A PCI centre can deliver primary PCI within 100 minutes. What is the preferred reperfusion strategy?
  2. A 66-year-old woman has a regular narrow-complex tachycardia at 180 per minute and is haemodynamically stable. Modified Valsalva has failed. What is the next step?
  3. A 72-year-old man has a heart rate of 38 per minute, blood pressure of 80/50 mmHg and new confusion. He is not in cardiac arrest. What is the first drug?
  4. A 55-year-old man has a broad-complex tachycardia at 190 per minute, blood pressure 70/40 mmHg and reduced consciousness. What is the immediate treatment?
  5. A 66-year-old woman has sudden left arm weakness and facial droop that began 2 hours ago. CT head shows no haemorrhage and she has no contraindication. What is the most appropriate treatment?
  6. A 59-year-old man was last seen well 14 hours ago and now has aphasia and right hemiparesis. CT angiography shows a left middle cerebral artery occlusion with salvageable tissue on perfusion imaging.…
  7. A 30-year-old man has had a tonic-clonic seizure for 12 minutes without recovery. A cannula is in place. Which is the correct first-line drug?
  8. A 40-year-old man with type 1 diabetes presents with vomiting, pH 7.1, glucose 28 mmol/L and ketones 5.5 mmol/L. Which insulin approach do UK guidelines recommend?
  9. A 70-year-old man on an ACE inhibitor has potassium of 7.2 mmol/L with peaked T waves and a widened QRS. What is the first treatment?
  10. A 25-year-old man found unconscious has a respiratory rate of 6 per minute and pinpoint pupils. Which drug is indicated?
  11. A woman presents after taking paracetamol tablets in a staggered overdose over 12 hours. What is the correct approach?
  12. A patient with suspected tricyclic antidepressant overdose has a widened QRS of 140 ms and a seizure. Which drug is indicated for the cardiac toxicity?

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