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History Taking Stations Flashcards

6 cards from real PLAB 2 practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. During a PLAB 2 history taking station, a 45-year-old woman presents with chest pain. Which of the following is the most important question to ask first to differentiate cardiac from non-cardiac chest pain?

    Answer: Can you describe the character of the pain — is it a central, crushing or squeezing sensation, and does it radiate to the jaw, left arm, or back?

    Characterising the pain using SOCRATES (Site, Onset, Character, Radiation, Associations, Timing, Exacerbating/relieving factors, Severity) is essential. Central crushing pain radiating to the jaw or left arm suggests cardiac origin. This is the most discriminating initial question.

  2. A patient presents with a 3-month history of weight loss. In the OSCE history, which system-specific red flag questions should you prioritise?

    Answer: Screen for malignancy red flags across systems: night sweats, haemoptysis, change in bowel habit, haematuria, lumps, dysphagia, and post-menopausal bleeding

    Unexplained weight loss is a red flag for malignancy. A systematic review of cancer-related symptoms across all body systems is essential — respiratory, GI, urological, gynaecological, and haematological. Night sweats and fatigue also suggest lymphoma. This approach ensures no serious cause is missed.

  3. In a PLAB 2 station, a 28-year-old man presents with headache. You need to assess for red flags. Which combination of features would be most concerning for a serious underlying cause?

    Answer: Sudden-onset thunderclap headache, neck stiffness, photophobia, and fever

    Sudden-onset thunderclap headache with meningism (neck stiffness, photophobia) and fever suggests subarachnoid haemorrhage or meningitis — both are life-threatening emergencies. These red flags mandate immediate investigation and should never be dismissed.

  4. During a history station, the patient mentions they drink alcohol. According to UK screening guidelines, which validated tool should you use to assess alcohol use?

    Answer: Use the AUDIT-C (Alcohol Use Disorders Identification Test) or full AUDIT questionnaire

    The AUDIT-C (first 3 questions of AUDIT) or full AUDIT (10 questions) is the validated screening tool for alcohol misuse recommended by NICE. It assesses consumption, dependence symptoms, and harmful consequences. A score of 8+ on full AUDIT suggests harmful or hazardous drinking.

  5. A patient presents to a PLAB 2 station with symptoms of depression. Which validated screening tool should you use to assess severity?

    Answer: PHQ-9 (Patient Health Questionnaire-9)

    The PHQ-9 is the validated screening and severity assessment tool for depression recommended by NICE. Scores range from 0-27: 5-9 (mild), 10-14 (moderate), 15-19 (moderately severe), 20-27 (severe). It also includes a question about suicidal ideation which must always be explored further.

  6. In a paediatric history station, a mother brings her 18-month-old child who has had a fever and is not feeding well. Which question is most important for assessing severity in a febrile child?

    Answer: Has the child had a non-blanching rash, reduced consciousness, or is unusually drowsy or unresponsive — features of meningococcal disease?

    In a febrile child, the NICE traffic light system prioritises red flag features: non-blanching rash, reduced consciousness, neck stiffness, bulging fontanelle, seizures, and signs of meningococcal disease. These features indicate a life-threatening condition requiring immediate action.