PLAB 1 (GMC, international medical graduates) · Surgery and perioperative care

Perioperative care

9 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 9 questions

  1. A 70-year-old woman takes apixaban for atrial fibrillation and needs an elective hip replacement. Her eGFR is 80 mL/min. What is the usual perioperative plan?
  2. A patient on warfarin for a mechanical mitral valve needs surgery. Which approach is correct?
  3. A 66-year-old man with type 2 diabetes takes metformin and an SGLT2 inhibitor and is listed for elective surgery. What is the key consideration for the SGLT2 inhibitor?
  4. A woman is 5 days after a bowel resection. She has fever, tachycardia, worsening abdominal pain and faeculent fluid in the drain. What is the likely diagnosis and next step?
  5. A 68-year-old man develops a swollen, tender left calf 3 days after a hip replacement. His Wells score indicates DVT is likely. What is the next step?
  6. What is the main purpose of the WHO surgical safety checklist used in NHS theatres?
  7. A 74-year-old man has an eGFR of 20 mL/min and is prescribed enoxaparin 40 mg daily for VTE prophylaxis. What should the prescriber do?
  8. A patient is 2 days after major abdominal surgery and has a urine output of 200 mL over the last 24 hours, with a rising creatinine. Which first step is most appropriate?
  9. A man in recovery is hypoxic after a laparotomy. He is pale, tachycardic and the drain is empty, with a rigid distended abdomen. What is the most likely cause and action?

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