PLAB 1 UK Clinical Guidelines & Prescribing Safety

Question 1

According to NICE guidelines, what is the first-line antihypertensive for a 65-year-old Caucasian man with no other comorbidities?

Accepted Answer

Calcium channel blocker (e.g., amlodipine)

Answer

ACE inhibitor (e.g., ramipril)

Answer

Thiazide-like diuretic (e.g., indapamide)

Answer

Beta-blocker (e.g., atenolol)

Question 2

According to NICE guidelines (NG28), which of the following patients with type 2 diabetes should be started on metformin as first-line therapy?

Accepted Answer

A patient with no contraindications to metformin and HbA1c above the agreed target

Answer

A patient with eGFR 25 ml/min/1.73m²

Answer

A patient with recurrent hypoglycaemia on other agents

Answer

A patient with type 1 diabetes

Question 3

According to the BNF and NICE, what is the recommended first-line treatment for uncomplicated lower urinary tract infection (UTI) in a non-pregnant woman?

Accepted Answer

Nitrofurantoin for 3 days (if eGFR >45) or trimethoprim for 3 days

Answer

Co-amoxiclav for 7 days

Answer

Ciprofloxacin for 5 days

Answer

Amoxicillin for 5 days

Question 4

A 72-year-old man has an acute exacerbation of COPD. Arterial blood gas shows: pH 7.29, PaCO2 8.5 kPa, PaO2 7.0 kPa, HCO3 26 mmol/L. His oxygen saturations are 82% on air. What is the target oxygen saturation for this patient according to BTS guidelines?

Accepted Answer

88–92%

Answer

98–100%

Answer

94–98%

Answer

96–98%

Question 5

According to NICE stroke guidelines, which antiplatelet regimen should be started within 24 hours of a confirmed ischaemic stroke (not thrombolysed)?

Accepted Answer

Dual antiplatelet therapy: aspirin 300mg for 2 weeks, then clopidogrel 75mg monotherapy

Answer

Clopidogrel 75mg daily for life

Answer

Anticoagulation with apixaban immediately

Answer

Aspirin 75mg indefinitely

Question 6

A 55-year-old man has had a myocardial infarction. According to NICE guidelines (NG185), which combination of medications should he be prescribed for secondary prevention?

Accepted Answer

Aspirin + P2Y12 inhibitor (e.g., ticagrelor) + high-intensity statin + ACE inhibitor + beta-blocker

Answer

Aspirin alone

Answer

Warfarin + statin + beta-blocker

Answer

Clopidogrel + statin only