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2001 July - PLAB-1 Paper July-2001 Diagnosis of shock...

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PLAB-1, Paper July-2001 Diagnosis of shock Options A Acute pancreatitis B Adrenal insufficiency C Anaphylaxis D Cardiac tamponade E Fat embolus F Myocardial infarction G Pulmonary collapse H Pulmonary embolus I Ruptured abdominal aortic Aneurysm J Ruptured spleen K Spinal cord transaction L Spinal shock M Staphylococcal sepsis N Tension Pneumothorax Instruction For each patient described below, choose the SINGLE most likely diagnosis from the above list of options. Each option may be used once, more than once, or not at all. 1. A 70-year-old man is admitted to the Accident and Emergency Department with a history of sudden onset of back pain for 34 hours and now has severe constant abdominal pain. On examination he is pale, sweating and restless. His pulse rate is 120 beats/minute. Blood pressure is 60 systolic mmHg. His abdomen is distended, tender and has a pulsatile mass present. 2. A 40-year-old woman comes to the Accident and Emergency Department with an inflamed index finger after a puncture wound from a rose thorn. She receives an injection of anti-tetanus immunoglobuin and is commenced on oral penicillin. Whilst the wound is being dressed, she complains of thirst, peri-oral itching and she has a skin rash. She then collapses. 3. A 37-year-old woman presents to the Accident and Emergency Department feeling unwell. Following her last period. She has had an offensive vaginal discharge. She routinely uses tampons. Examination reveals pallor, sweating, pulse rate is 130 beats/minute, blood pressure is 80/40 mm Hg. There is lower abdominal tenderness and vaginal examination reveals an offensive discharge. 4. A 16-year-old boy presents to the Accident and Emergency Department with upper abdominal and left shoulder tip pain, following a fall from a horse. On examination he is pale, sweating, pulse rate 110 beats/minute, blood pressure is 115/70 mmHg. He is tender in the left upper quadrant of the abdomen. 5. A 35-year-old woman has undergone open cholecystectomy for empyema of the gall bladder. She is a chronic asthmatic taking bronchodilators and oral prednisolone (15 mgs/day). Four hours post operatively she was noted to have pulse rate of 110 beats/minute & blood pressure is 90/46 mm Hg. No evidence of intra-abdominal bleeding and electrocardiogram (ECG) and chest x-ray are normal. Review of her treatment charts confirmed that she only had antibiotics to which she is not allergic, and deep venous thrombosis (DVT) prophylaxis. 1
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Paper July-2001 PLAB-1 Investigations into anaemia Options A. Alcohol history B. Blood urea concentration C. Dietary history D. Erythrocyte Sedimentation rate ESR E. Hemoglobin electrophoresis F. Malaria screen G. Menstrual history H. Schilling test I. Serum erythropoietin Concentration J. Serum folate concentration K.
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