PLAB 1 Sample Questions (With Answers)
Searching for PLAB 1 sample questions with answers? Here's the real exam format from the GMC, plus four full-length practice questions in that exact single-best-answer style — each with the correct answer and a full explanation.
PLAB 1 is a written exam made up of 180 multiple-choice questions, which candidates must answer within three hours. Each question opens with a short clinical scenario, followed by five possible answers — you choose the single best one. The exam covers the clinical knowledge expected of a doctor entering the second year of the UK's Foundation Programme, spanning medicine, surgery, obstetrics and gynaecology, paediatrics, and psychiatry.
Below are four practice questions in that same single-best-answer, five-option format — TopQbank's own original items, not real past PLAB 1 questions (the GMC publishes a small set of its own official samples separately, not a full retired-question bank).
Question 1
A 68-year-old man presents to the GP with a 3-month history of progressive dysphagia, initially to solids and now also to liquids, with associated weight loss of 6 kg. What is the most appropriate next investigation?
A) Barium swallow
B) Upper GI endoscopy
C) Trial of a proton pump inhibitor
D) CT chest and abdomen
E) Reassurance and review in 6 weeks
Correct answer: B) Upper GI endoscopy. Progressive dysphagia (solids then liquids) with weight loss in an older adult is a red-flag presentation for oesophageal malignancy and requires urgent upper GI endoscopy to directly visualize the oesophagus and obtain tissue for biopsy — not a trial of medical therapy or reassurance, which would delay diagnosis of a potentially serious and time-sensitive condition.
Question 2
A 24-year-old woman presents with a 2-day history of unilateral facial weakness affecting the forehead on the same side, with no other neurological deficits. What is the most likely diagnosis?
A) Ischaemic stroke
B) Bell’s palsy
C) Multiple sclerosis
D) Myasthenia gravis
E) Ramsay Hunt syndrome
Correct answer: B) Bell’s palsy. Bell's palsy is an idiopathic lower motor neuron facial nerve palsy that affects the forehead (unlike an upper motor neuron lesion from stroke, which spares forehead movement due to bilateral cortical innervation). The acute, isolated, unilateral presentation with forehead involvement and no other neurological deficits is classic for Bell's palsy rather than stroke or MS. Ramsay Hunt syndrome would be accompanied by a vesicular rash and ear pain, which aren't described here.
Question 3
A 45-year-old woman with a history of rheumatoid arthritis on long-term prednisolone presents with sudden-onset severe abdominal pain. On examination, her abdomen is rigid with generalized guarding. What is the most appropriate immediate management?
A) Oral analgesia and outpatient review
B) Urgent surgical assessment and erect chest X-ray
C) Increase the prednisolone dose
D) Reassurance, likely steroid-related dyspepsia
E) Outpatient ultrasound in one week
Correct answer: B) Urgent surgical assessment and erect chest X-ray. A rigid, guarded abdomen with sudden severe pain suggests peritonitis, possibly from a perforated viscus — a surgical emergency, and one that chronic steroid use can mask (blunting the usual inflammatory signs) or predispose to (via peptic ulceration). An erect chest X-ray can show free air under the diaphragm, and urgent surgical assessment should not be delayed for outpatient review.
Question 4
A 3-year-old girl is brought in with a 1-day history of fever and a barking cough, with mild inspiratory stridor at rest. She is alert, well-hydrated, and not in respiratory distress. What is the most appropriate initial management?
A) Immediate intubation
B) Oral dexamethasone
C) Nebulized salbutamol
D) Oral amoxicillin
E) Reassurance only, no treatment needed
Correct answer: B) Oral dexamethasone. This presentation is classic for croup (laryngotracheobronchitis) — barking cough, stridor, and fever in a young child. A single dose of oral dexamethasone is first-line management even for mild-to-moderate croup, shown to reduce symptom severity and the need for further intervention. Intubation is reserved for severe respiratory distress or impending failure, salbutamol targets bronchospasm (not the airway oedema of croup), and antibiotics are not indicated since croup is viral.
Study takeaway: since every PLAB 1 question opens with a short clinical vignette rather than an isolated fact recall, practice identifying the single most clinically urgent or most likely diagnosis from the scenario first, then work backward to the best-fitting option among five — and because the exam tests UK Foundation Year 2-level generalist knowledge specifically, prioritize breadth across medicine, surgery, O&G, paediatrics, and psychiatry over specialist depth in any one area.