High Yield Points for PLAB by Clinchers

These are the High Yield Points for for PLAB by Clinchers






Rheumatology: 

  • Hot, painful, swollen joint +/- fever= septic arthritis= Ix: aspirtion = Rx: FLUCLOXACILIN
  • Young man, lower back pain = ankylosing apondylitis = Ix: x-ray sacroiliac joint
  • Polyarteritis nodusa – necrotising vasculitis – cause aneurysm / thrombitis of medium sized arteries – leads to infarct, Rx: Systemic Steroids, M>f, ass. With Hep-B
  • Arterial occlusion + HTN, Female = Takayasu arteritis (big vessel vasculitis),
  • Child = Kawasaki
  • A joint pain with ear pinna plaque = gout (raised uric acid level)
  • Pt. with progressive relapsing remitting arthritis = RA
  • Intermittent severe arthritis with symptoms free interval = Gout
  • Arthritis with pitted finger nail = psoriatic arthritis
  • Young man with lower back pain = ankylosing spondylitis
  • Lower back pain with paravertebral shadow = TB of vertebra
  • Elderly mand with lumbar back pain + enlarged vertebra = pagets
  • Septic arthritis Ix : joint aspiration ???
  • RA Ix : Rh factor
  • Reiter’s syndrome Ix : chlamydial IgA
  • Thiazide diuretics raises uric acid level = Gout
  • Arthritis following travelling history(india, spain, Thailand) usually Reiters synd
  • Schirmer test +ve in sjogren synd
  • Best Ix to Dx nerve compression = MRI
  • AS does not need any Ix as its Dx is clinical
  • Talengedtasia / Raynauds = Crest = Ix: Anti-centromial Ab
  • Female / pruiritis / raised Gamma GT = PBC = Ix: Anti-mitochondrail Ab
  • Rash on cheeks, photophobia = SLE = Ix: Anti-double Strand DNA Ab.
  • Pt. with thyroid with hashimoto = Anti-paroxy/thyroglobulin Ab
  • GCA Mx = Steroids
  • Diabetic retino pathy Mx = laser

Haematology: 

  • ITP initial Mx = Steroids
  • Very low ph with purura = ITP, Mx with predinsone, Ix: anti PLT antibody
  • Anemia with blood film showing target cells = thalassemia
  • Celiac disease will cause decreased folate anemia due to malabsorption
  • Rx with cyclophosphamide will cause aplastic anemia
  • Blood film showing immature cells = leukemia = confirm Dx by Bone Marrow Biopsy
  • Inherited anemia = pernicious (decreased vit-B12) + Haemophilia (coagulation defects)
  • HSP (Henoch Schonlein purpura) : abd pain, purpura on buttocks/thigh is allergic inflammation of blood vessel wall.
  • DIC due to sepsis
  • Phenytoin / Methotrexate reduces Serum folate level
  • Thalassemia/sickle cell Ix = electrophoresis
  • Anemai with sore tongue = decreased Vit-B12
  • Anemia + bruising + infection = aplastic anemia (leukemias well)
  • Easy bleeds, all tests are normal with family history = osler weber rendu synd
  • Easy bleeds, prolonged clotting time with family history = von willi brands
  • Male, pale, anemic with paresthesia = pernicious anemia = Ix: Ab against intrinsic factor
  • Post. Cricoids web with decreased Fe anemia = plummer Vinson synd

Infectious: 

    • Children usually have viral meningitis, Ix: CSF MCS => PCR
    • TB = wt. loss, african, night sweat
    • Brucellosis = Hx of Farm work, visit to MECCA
    • Lyme = Hx of forest walk, insect/tic bite
    • Malaria by plasmodium falciparum – severe intermittent fever, can cause cerebral malaria, Dx: LP-CSF
    • I/V Acyclovir for varicella zoster = elderly, decreased immune, opthalmic
    • Orla acyclovir for varicella zoster = mild surgery + in pregnancy
    • For typical chicken pox = no management
    • Varicella Ig for high risk exosure on moderate compromise e.g pregnancy
    • Cellulitis caused by strep.pyogenes
    • Mucoid urethral discharge = chlamydia
    • Purulent urethral discharge = GC
    • Thick blood film confirms malaria
    • Hep-B Ag confirms active disease
    • Dye industry workers have increased risk of renal cell Ca.
    • MRSA found in ward = test all medical staff
    • MRSA +ve staff should be Rx with Mupurocin nasal spray
    • Staphylococcus is coagulase +ve cocci
    • Pneumococcus is gram +ve diplococcic
    • TB meningitis Ix = ????????
    • Meningitis after URTI = Strep
    • Syncope with sweating = hypoglycemia
    • Meningitis with rash Tx = Blood culture
    • Meningitis with raised ICP no LP

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