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

Common surgical presentations and cancer pathways

10 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.

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  1. A 62-year-old woman has a new hard, irregular, fixed 2 cm breast lump. What is the correct pathway?
  2. A 70-year-old man presents with painless visible haematuria. What does NICE advise?
  3. A 50-year-old man has a painless left groin lump that appears on standing and straining and disappears on lying. It is non-tender with a cough impulse. What is the most likely diagnosis?
  4. An 80-year-old woman has a tense, tender, irreducible lump below and lateral to the pubic tubercle, with vomiting. What is the most likely diagnosis and action?
  5. A 66-year-old man has progressively worsening dysphagia for solids and has lost weight. What does NICE advise?
  6. A 25-year-old man with a deep, dirty cut to the hand needs suturing. What must be assessed about tetanus before closure?
  7. A 59-year-old man has an asymptomatic 5.8 cm infrarenal abdominal aortic aneurysm found on ultrasound. What is the appropriate management?
  8. A 35-year-old woman has a painful perianal abscess with fluctuance. Which treatment is appropriate?
  9. A 55-year-old woman with a history of gallstones has fever, a tender right upper quadrant and a positive Murphy sign. Ultrasound shows a thickened gallbladder wall with stones. What is the diagnosis?
  10. A 45-year-old man has sudden severe epigastric pain and a rigid abdomen. An erect chest X-ray shows free air under the diaphragm. What is the likely diagnosis?

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