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UK MEDICAL ETHICS NOTES

Due to changes in the new plab exam, I would like to guide all prospective candidates to the best Medical Ethics notes, the bulk of the exam will be the same, you can however expect 10-20 questions to have an ethical element to them. Studying this material will ensure you have no problem dealing with them. Best of luck. I have put red exclamation marks next to the chapters most relevant for PLAB1, but it's probably wise to read the entire ethical curriculum.

1. Ethical Theories
2. UK legal framework
3. Professionalism!!!!
4. Consent and Confidentiality!!!!!!!
5. Child Health!!!!
6. Reproductive Medicine!!!
7. Public Health
8. Mental Health !!!
9. End of Life !!!
10. Medical Research Issues

NIDDM (564/1700)

A 45yo man with colon cancer now develops increased thirst, increased frequency in urination and weight loss. His fasting blood glucose=9mmol/L. what is the most appropriate management?
a. Oral hypoglycemic
b. Insulin long acting
c. Short acting insulin before meal
d. IV insulin
e. Subcutaneous insulin

ECG: wide QRS tachycardia (498/1700)

An ECG of an elderly lady who collapsed in the ED shows rapid ventricular rate of 220bpm,
QRS=140ms. What is the most probable dx?
a. Atrial fibrillation
b. VT
c. SVT
d. Mobitz type1 2nd degree heart block
e. Sinus tachycardia

ECG (439/1700)

A 72yo man is found to be not breathing in the CCU with the following rhythm. What is the most
likely dx?

a. SVT
b. VT
c. VF
d. Atrial fib
e. Atrial flutter

ECG (363/1700)

A 66yo man has the following ECG. What is the most appropriate next step in management?

a. Metoprolol
b. Digoxin
c. Carotid sinus massage
d. Adenosine
e. Amiodarone

Urinary Stone (931/1700)

A pt had passed a 4mm stone in his urine. He has a 3mm stone in the renal pelvis found on US.
What is the management?
a. ESWL
b. None
c. Dormier basket
d. Surgery
e. PCNL

Basketball Match, Player fell (936/1700)

During a basketball match, one of the players suddenly collapsed to the ground with coughing and SOB. What is the inv of choice?
a. CXR
b. CT
c. MRI
d. V/Q scan
e. CTPA

Progressive dyspnea, cough and mucopurulent sputum (903/1700)

A pt presents with progressive dyspnea. He complains of cough, wheeze and a table spoonful of
mucopurulent sputum for the last 18m. Spirometry has been done. FEV1/FVC=2.3/3.6. After taking salbutamol, the ratio=2.4/3.7. What is the most likely dx?

a. Chronic bronchitis
b. Asthma
c. Bronchiectasis
d. Lung fibrosis
e. Sarcoidosis

Fracture of femur, shock (899/1700)

A young male met with a RTA and is suspected to have a femur fx. His BP is 90/60mmHg. What is the next immediate action?

a. XR
b. IV fluids
c. Put leg splint
d. Send bloods for inv
e. US

Pain relief in a young asthmatic child (1496/1700)

A 4yo child comes with a sprain in his foot. Hx reveals that the child has had recurrent admissions to the hosp due to severe asthma. What is the most appropriate analgesic?

a. Diclofenac sodium
b. Ibuprofen
c. Paracetamol
d. Codeine

HUS vs TTP (1487/1700)

A middle aged lady presented with fever, altered sensorium, bleeding gums and jaundice. Labs: deranged renal function tests, normal PT/APTT, fragmented RBCs and low plts. What’s the most likely dx?

a. Cholesterol emboli
b. HUS
c. TTP
d. Hepatorenal syndrome
e. Sepsis

Hoarseness of Voice (1434/1700)

A 22yo man reports a 2d hx of hoarseness of voice. He denies any weight loss but he has been smoking for 4yrs. What is the single most appropriate inv?
a. None
b. Laryngoscopy
c. Bronchoscopy
d. BAL
e. CXR

Maxillary division of trigeminal (1312/1700)

A pt with vesicles in the maxillary divison of trigeminal nerve. Which area of mucus membrane will be involved?
a. Palate
b. Cheek
c. Cornea
d. Conjunctiva

Proptosis (1390/1700)

A 7yo boy presents with proptosis and periorbital edema. What is the immediate action that needs to be taken?
a. IV morphine and immediate ophthalmoscopy
b. IV morphine
c. Observation only