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PLAB Part 2
11/28/14, 10:25 PM
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name=Your_Account&op=userinfo&username=akanksha) Yeah! PLAB
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Long station, I should say! Try and wrap up things fast so that
you finish both parts of the question well within the time
provided. Always, finish the complete format for history taking. It
will always lead to the diagnosis. Dont stick to the first clue the
patient provides (for this station, was the Right Iliac Fossa).
Always expand further thinking of other possibilities depending on
the age of the patient and the nature of pain.
2nd Station:
Here was a patient just after a small attack of myocardial
infarction, ready for discharge. The question clearly stated that
the patient is OBESE and I was supposed to give him advice for
life style modifications.
Now, post MI life style modification is quite a common station and Related Links
usually we are supposed to counsel the patient on his food habits, GMC Website (http://www.gmc-uk.org)
smoking, alcohol, work, sex, driving as well as medications.
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*PLAB 2 Coaching (http://www.newlatitude.com)
However, as the question hinted directly at him being OBESE, I
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preferred to focus my counselling accordingly.
After introducing myself with the examiner and the patient and
investing some time over general questions to create a good
rapport, I went on to advise him regarding loosing weight. He
seemed reluctant to carry on with advices I gave him regarding
food modifications and daily exercise regimen. But all I was
supposed to do was to inform him of the benefits of following the
advices and then leave it upto him if he actually wanted to follow
or not. After a quick discussion over obesity, I switched over to
his smoking habits and drinking habits.
2. Never pester a patient that You SHOULD loose weight (or any
other advice). You can only suggest him of the best possible
options. Leave it on him to choose what he thinks best for him.
Why the simulator was showing reluctance on each n every
advice the candidates were giving him, was only because they
were testing if we know the art of suggesting the patient about
everything we want to, yet not forcing anything on them.
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3rd Station:
This was young lady recently diagnosed with Idiopathic epilepsy
and started on carbamezepine. She has come for follow up and
has poorly controlled fits. Talk to her and give relevant advice.
After initial formalities with the examiner and the patient, I
confirmed if she is actually being diagnosed with the condition
and prescribed a medicine. Asked her if she knows how to take it
and if she is actually complying with the directions of her
consultant and taking the medications regularly. Then she came
out with the real problem, that because she is working, she keeps
forgetting to take the medications. I offered her a couple of
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simple methods to help her with this 'forgetting issue' and told
her the importance of taking the medications regularly.
She also asked if we could change the medications, as the fits are
anyway not controlled. I advised her on this as well and also
ruled out other causes for uncontrolled fits (viz skipping meals,
less sleep, bright light, watching TV for long, loud music and the
rest).
I finished this one just at 4 30 bell and all three of us sat together
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5th station:
This was a teenager with recently diagnosed with asthma. The
question clearly said that the patient is not aware that he has
asthma. Tell him about the diagnosis and address his concerns.
ARTICLE TOOLS
This was a cool young guy called Sam. I started the main part of
station telling him the cause of his breathlessness and that we
think its asthma and asked him if he knew anything about the
condition. He said yes, but wanted to know more. I explained the PLAB Part 2 section (article-topic-5.html)
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basic mechanism of the disease and went ahead talking on
allergens and ways he could identify and avoid them. I went
further talking about the type of medications we would put him
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on. Also told him how important is to keep people informed about
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his condition. His main concern was if he would be able to play
hockey as he was joining the hockey team that summer. I told
him that we will have to see how u respond to the medications
and also, if exertion is a precipitating factor for him.
He was happy n convinced towards the end and I myself left the
cubicle satisfied.
6th Station:
Traditional station, and I did nothing more than what was taught
at the coaching centre. After confirming whum I was talking to
and introducing myself, I told the consultant about the patient's
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Then we sat and told her about the diagnosis and what exactly it
is. Asked her about her profession and stressed on the
importance of rest. Told her about the pain killers. Asked her that
further treatment would depend on how she responds to this and
we need to see her again in few weeks time to determine whats
best for her.
Short station! Finished quite ahead of time!
10th Station:
This was a middle aged man was posted for herniorapphy.
However, his routine investigations revealed Hb >8 mg/dl. Talk to
the patient and counsel why his surgery needs to be postponed.
This man was not quite happy with the postpontment of his
operation date. I explained about his low Hb, when he asked what
could have caused this. I then took a short history to rule out
causes for anemia in a middle aged man. He didnt give anything
positive in the history which could have explained the cause, so I
went further saying dat we wud need to do some investigations to
find out the cause of his anemia. and then he wanted to know what investigations. I quickly brushed on the investigations and
again stressed on the fact that his anemia needs to be corrected
before we can go on with his scheduled surgery. He was sorta
satisfied towards the end and I wrapped up by asking if he had
any more concerns.
11th Station:
Here was an anxious mother whose baby had a fall and got
unconscious. Take a short relevant history and discuss
management with the mother.
On reading the question, I wasnt really sure whether it was a
head injury station or a station on Non Accidental Injury. I went
ahead as usual and elicited the history ruling out the possibility of
both non accidental injury as well as head injury. Mother told me
dat her baby went 'floppy' after the fall. Next I went ahead with
the management part of the questions and discussed it with
mother.
In this sort of stations it is important that:
1. You carefully rule out non accidental injury.
2. If its head injury, do not forget to ADMIT the baby.
3. Ensure you are as gentle as possible as these simulators are
always tearful.
4. Read carefully, if the question requires you to discuss
management with the patient or with the examiner. One of my
friend lost this station as she went on to discuss management
with the examiner.
12th Station:
Here was a middle aged lady with complaints of diplopia. The
question clearly asked carry out relevant examination and DO
NOT TAKE ANY HISTORY.
Short station! I carried out the examination of III, IV and VI
nerve and complemented it with the examination of the V and VII
nerve as well. The patient clearly showed lateral rectus affection
(Right). I dunno if the question asked to discuss findings with the
examiner but he asked me the diagnosis and probable causes for
such a presentation at this age group. Could list only a couple of
causes when the bell rang and I went out with a relief.
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13th Station:
This was a manniquin station and we were supposed to do
venepuncture.
I went ahead like any other manniquin station. Everything went
fine till I introduced the needle and kept the vacutainer in position
- NO BLOOD!!! God damn! I could see clearly the channels in the
manniquin were connected with a bag full of some red fluid. I
tried advancing the needle tip a bit, but all in vain!! My vacutainer
was still empty. Gosh!!! am messing up with this station!!!
Decided to withdraw the needle and give a second try. Withdrew
the needle and discared it in the sharps bin, talked about
hemostasis and also the second try. Took a new set of needle n
swipes and went ahead again at a different site. Introduced the
needle, placed vacutainer in position --- but no blood means NO
BLOOD AGAIN!!!! 4 30 bell rang! I disposed off the needle,
removed tourniquet, talked abt hemostasis and told the examiner
that I would tell the patient that I could not complete the
procedure and would come later to try again. I also added, that if,
I would have completed the procedure, I would have labelled the
vacutainer appropriately and sent for investigations.
Thats it!!! Almost ran out of the cubicle at 5 'o' clock bell. :-|
14th Station:
This was Paediatric CPR. The universal precautions were taken
and cervical injury already ruled out. We just needed to go ahead
with the procedure. Went well and smooth!
15th Station:
This was REST!!!!!!!!!!! 6 minutes in a stretch!!!!! Good time to
sit back and relax!
16th Station:
This was again manniquin - Testicular Examination. The question
asked only to discuss findings with the examiner and nothing was
mentioned if we were also supposed to discuss the diagnosis.
There were two examiners in this station (the 2nd one was
observer, I suppose). I carried out with the examination and
described 2 swellings. Went ahead with the fluctuation test and
asked that I would like a torch and transilluminoscope to carry
out transillumination test. No translilluminoscope!! Only pen torch
was provided. So I asked If I could dim the lights and carry on
with the test. Instead of him saying, 'Assume doctor, its done',
the observer went ahead and switched off the light. I carried out
with the test and then discussed the findings. 4 30 bell rang and
then ........OVER!!!!
PLAB 2 over.... what a relief!!!
I was definitely anxious about my results especially after the way
I had messed up with the venepuncture station, but then thank
God that I passed! Still wonder what grade I got for that
station!!!
So good luck to all you folks taking plab 2 in near future. Its not a
difficult exam. Keep your cool and be confident, you will definitely
succeed!
Good Luck!
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4 (Excellent)
3(Good)
2(Good)
1(Bad)
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