PLAB 1 Past Papers: What Exists and What to Use Instead

Are there official PLAB 1 past papers?

No past papers are listed in the GMC's PLAB 1 guide. Its preparation pages point you to four things instead: a set of sample questions, the MLA content map, the Foundation Programme curriculum and Good medical practice.

What the GMC does provide

Sample questions. The GMC publishes a selection of 85 sample questions. It says they were accurate at the time of publishing (December 2024), are based on the MLA content map, and won’t be used in any live exam. They are the closest thing to an official paper.

The MLA content map. PLAB 1 meets the Medical Licensing Assessment requirements, so its questions are based on the MLA content map. The GMC says all the topics and skills needed to pass are covered in the content map, which makes it the best checklist for your revision.

The Foundation Programme curriculum. The content map matches the conditions that doctors starting the second year of UK Foundation Programme training typically face. That is the level PLAB 1 tests.

Good medical practice. You are expected to show the professional values in Good medical practice in the exam. The GMC offers interactive tools, Good medical practice in action and Welcome to UK practice, to test your knowledge of it.

The GMC also says you don’t need a course to pass. It doesn’t run courses, and it doesn’t endorse or monitor the quality of courses run by others.

What the real paper looks like

PLAB 1 is a written exam of 180 multiple-choice questions, which you answer in three hours. Each question starts with a short scenario, followed by a question with five possible answers, and you choose the right one.

It is an applied knowledge test. Questions relate to current best practice in the UK and to equipment routinely available in UK hospitals. They can cover any of the common, important or acute conditions seen by doctors in a Foundation Programme Year 2 (F2) role, and the management of long-term conditions seen in primary care.

Five PLAB 1 questions with answers

These come from the TopQbank PLAB 1 question bank, reviewed by licensed doctors. They follow the real format, but they are not real PLAB 1 questions.

Question 1 · Medicine

A 41-year-old woman develops fever, painful skin and rapidly spreading dusky macules 10 days after starting an antibiotic. She has extensive oral and ocular erosions; sheets of epidermis detach with gentle pressure and approximately 35% of body surface area is involved. She is tachycardic and clinically dehydrated. Toxic epidermal necrolysis is suspected. Which management step has the highest immediate priority?

A) Continue the suspected drug until skin biopsy confirms the diagnosis

B) Start high-dose oral antihistamine and discharge if itching improves

C) Stop the suspected culprit drug immediately and arrange urgent supportive care in an appropriate specialist setting

D) Apply topical antibiotics to all detached areas as definitive treatment

E) Delay fluid assessment because aggressive hydration worsens epidermal detachment

Correct answer: C) Stop the suspected culprit drug immediately and arrange urgent supportive care in an appropriate specialist setting. SJS/TEN requires immediate withdrawal of the suspected culprit medication and urgent specialist supportive management, including fluid, temperature, wound, pain, ocular and infection-related care. Extensive epidermal loss behaves physiologically like a major burn.

Question 2 · Obstetrics and gynaecology

A 29-year-old woman at approximately 7 weeks' gestation presents with unilateral pelvic pain and light vaginal bleeding. She is haemodynamically stable; transvaginal ultrasound shows no intrauterine pregnancy and a 24-mm right adnexal mass separate from the ovary. There is no fetal heartbeat; serum hCG is 1800 IU/L and she has no significant pain at present. She can return reliably for follow-up and has no contraindication to methotrexate. Which management option is most appropriate to consider?

A) Methotrexate treatment is an appropriate option after confirming suitability and excluding a viable intrauterine pregnancy

B) Expectant management is mandatory because hCG is below 2000 IU/L

C) Immediate salpingectomy is required for every visualised ectopic pregnancy

D) Uterine evacuation should be performed first to treat the adnexal pregnancy

E) Give methotrexate and discharge without serial hCG follow-up

Correct answer: A) Methotrexate treatment is an appropriate option after confirming suitability and excluding a viable intrauterine pregnancy. A stable woman with an unruptured small tubal ectopic pregnancy, no fetal cardiac activity, relatively low hCG and reliable follow-up may be suitable for medical treatment with methotrexate. Follow-up hCG monitoring is essential.

Question 3 · Psychiatry

An 81-year-old man with mild established dementia is admitted with a urinary infection. Over the next 24 hours he becomes intermittently agitated, inattentive and disorientated; at other times he is drowsy and barely engages. His daughter says his cognition was stable before admission and has never fluctuated this dramatically. The team is uncertain whether this represents progression of dementia or a superimposed acute disorder. Which interpretation and management principle is most appropriate?

A) Rapid dementia progression is most likely, so increase long-term dementia medication immediately

B) The distinction is unimportant because delirium and dementia are managed identically

C) The fluctuating acute change suggests delirium superimposed on dementia; identify and treat underlying causes and provide reorientation/supportive care

D) Start an antipsychotic routinely because agitation confirms behavioural symptoms of dementia

E) Perform formal cognitive testing and diagnose dementia progression if the score is lower than baseline

Correct answer: C) The fluctuating acute change suggests delirium superimposed on dementia; identify and treat underlying causes and provide reorientation/supportive care. An acute fluctuating disturbance of attention and cognition is characteristic of delirium, which commonly occurs on top of dementia during acute illness. NICE advises treating delirium first when the distinction is uncertain, including identifying underlying causes and using supportive reorientation measures.

Question 4 · Ethics and professional practice

A hospital doctor prescribes ten times the intended dose of an anticoagulant because of a decimal-point error. The patient receives one dose and develops a clinically significant bleed requiring treatment and prolonged admission. The error is recognised, the patient is now stable and the consultant asks how the team should communicate what happened. The patient has not yet been told that the prescription was incorrect. Which response best reflects the professional duty of candour?

A) Wait until the internal investigation identifies an individual to blame before speaking to the patient

B) Tell the family but not the patient because disclosure may cause distress

C) Avoid apologising because an apology constitutes a legal admission of negligence

D) Explain promptly what is known, apologise, describe the actual or potential consequences and next steps, and document/report the incident appropriately

E) Describe the bleed as an unavoidable complication without mentioning the medication error

Correct answer: D) Explain promptly what is known, apologise, describe the actual or potential consequences and next steps, and document/report the incident appropriately. When something has gone wrong and caused harm or distress, doctors should be open and honest with the patient, explain what is known, apologise, and explain what will be done. An apology is appropriate and does not by itself amount to an admission of legal liability.

Question 5 · Paediatrics

An 8-year-old girl has chronic diarrhoea, abdominal distension and poor weight gain. Coeliac disease is suspected and she continues to eat a normal gluten-containing diet. There is no known IgA deficiency. The GP requests first-line serological testing. Which tests should be requested first?

A) HLA-DQ2 testing alone

B) Faecal calprotectin alone

C) IgM rheumatoid factor

D) Total IgA and IgA tissue transglutaminase antibodies

E) Serum CA 19-9

Correct answer: D) Total IgA and IgA tissue transglutaminase antibodies. NICE recommends total IgA and IgA tissue transglutaminase antibodies as first-choice serological tests for coeliac disease in children. Children with positive serology should be referred to a paediatric gastroenterology specialist.

For four more, see PLAB 1 sample questions with answers. To plan your revision, read how long to study for PLAB 1, and practise full timed papers in the TopQbank PLAB 1 question bank.