Professional and Linguistic Assessments Board (PLAB) General Practice, Public Health and Primary Care Syllabus

General Practice, Public Health and Primary Care syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for General Practice, Public Health and Primary Care in Professional and Linguistic Assessments Board (PLAB), not a summary of it.

1. 1

   Common Primary Care Presentations

   4 topics

   • Dermatology in Primary Care
     • Eczema and psoriasis
     • Skin cancer recognition and referral
     • Common skin infections
   • Ear, Nose and Throat
     • Otitis media and externa
     • Tonsillitis and sore throat scoring
     • Vertigo and dizziness
   • Ophthalmology
     • Red eye differential
     • Acute visual loss
     • Glaucoma and diabetic retinopathy
   • Musculoskeletal Complaints
     • Osteoarthritis
     • Soft tissue injuries
2. 2

   Chronic Disease Management

   4 topics

   • Multimorbidity and Polypharmacy
     • Medication review principles
     • Deprescribing
   • Cardiovascular Risk Management
     • QRISK and statin therapy
     • Lifestyle modification
   • Frailty and Elderly Care
     • Falls assessment
     • Continence and pressure ulcers
   • Palliative and End of Life Care
     • Symptom control and syringe drivers
     • Advance care planning
3. 3

   Public Health and Prevention

   4 topics

   • Screening Programmes
     • National screening criteria
     • Cancer screening programmes
   • Health Promotion
     • Smoking cessation
     • Alcohol brief intervention
   • Infectious Disease Control
     • Notifiable diseases
     • Outbreak management and vaccination
   • Epidemiology and Statistics
     • Sensitivity, specificity and predictive values
     • Interpreting study results
4. 4

   Therapeutics and Prescribing

   4 topics

   • Safe Prescribing
     • Drug interactions and contraindications
     • Renal and hepatic dose adjustment
   • Antimicrobial Stewardship
     • Rational antibiotic use
     • Resistance and allergy
   • Adverse Drug Reactions
     • Recognition and yellow card reporting
     • Anaphylaxis management
   • Special Populations
     • Prescribing in pregnancy and breastfeeding
     • Prescribing in the elderly and children

General Practice, Public Health and Primary Care flashcards for Professional and Linguistic Assessments Board (PLAB)

21 of 53 cards from the General Practice, Public Health and Primary Care deck — real questions with worked answers.

1. In the 7-point checklist for assessing pigmented skin lesions, what are the three major features (each scoring 2 points)?

   Change in size, irregular shape (border), and irregular colour. Minor features (1 point each) are diameter $\geq 7\,\text{mm}$, inflammation, oozing/crusting, and change in sensation. A score $\geq 3$ warrants urgent referral.

2. What is the ABCDE rule used to identify a suspicious melanocytic lesion?

   Asymmetry, Border irregularity, Colour variation, Diameter $> 6\,\text{mm}$, and Evolving (change over time).

3. What is the first-line topical treatment for mild-to-moderate plaque psoriasis in primary care?

   A potent topical corticosteroid plus a vitamin D analogue (e.g. calcipotriol), applied once daily (often steroid in the morning, vitamin D analogue in the evening) for up to 4 weeks.

4. Describe the classic distribution and morphology distinguishing eczema from psoriasis.

   Eczema: ill-defined, itchy, erythematous lesions on flexor surfaces (antecubital/popliteal fossae). Psoriasis: well-demarcated salmon-pink plaques with silvery scale on extensor surfaces, scalp and natal cleft, often with nail pitting.

5. What organism causes most cases of impetigo and what is first-line management for localised non-bullous disease?

   Staphylococcus aureus (and Streptococcus pyogenes). First-line for localised non-bullous impetigo is topical hydrogen peroxide 1% cream; topical fusidic acid if unsuitable. Widespread/bullous disease needs oral flucloxacillin.

6. What are the typical features of acne severity used to guide treatment, and what is reserved for severe nodulocystic acne?

   Mild = open/closed comedones; moderate = inflammatory papules/pustules; severe = nodules, cysts and scarring. Severe nodulocystic or scarring acne unresponsive to therapy warrants referral for oral isotretinoin (specialist-only).

7. In acute otitis media in children, when are antibiotics indicated rather than watchful waiting?

   Most cases are self-limiting. Antibiotics (amoxicillin first-line) are offered if: systemically very unwell, symptoms $\geq 4$ days without improvement, age $< 2$ years with bilateral infection, otorrhoea (perforation), or immunocompromise.

8. What are the red-flag features of a sore throat / neck that suggest peritonsillar abscess (quinsy) requiring urgent referral?

   Severe unilateral throat pain, trismus (difficulty opening the mouth), 'hot potato' muffled voice, uvular deviation away from the affected side, and drooling.

9. What scoring tool helps decide on antibiotics for a sore throat, and what does a high score suggest?

   The FeverPAIN (or Centor) score. FeverPAIN: Fever, Purulence, Attend rapidly ($\leq 3$ days), severely Inflamed tonsils, No cough/coryza. A score of $4$–$5$ suggests $62$–$65\%$ streptococcal likelihood, supporting antibiotics (penicillin V).

10. What is the most common cause of vertigo seen in primary care and how is it diagnosed and treated?

    Benign paroxysmal positional vertigo (BPPV). Diagnosed with the Dix–Hallpike manoeuvre (provoking rotatory nystagmus); treated with the Epley repositioning manoeuvre.

11. How do you clinically distinguish BPPV, vestibular neuronitis and Ménière's disease?

    BPPV: brief (seconds) vertigo triggered by head position, no hearing loss/tinnitus. Vestibular neuronitis: acute prolonged (days) vertigo after viral illness, no hearing loss. Ménière's: recurrent episodes (minutes–hours) with vertigo, fluctuating sensorineural hearing loss, tinnitus and aural fullness.

12. What examination differentiates conductive from sensorineural hearing loss using tuning fork tests?

    Rinne and Weber. Conductive loss: Rinne negative (bone $>$ air) in affected ear, Weber lateralises to the affected ear. Sensorineural loss: Rinne positive (air $>$ bone) bilaterally, Weber lateralises to the normal ear.

13. A patient presents with a sudden painful red eye, hazy cornea, fixed mid-dilated pupil and haloes around lights. What is the diagnosis and immediate management?

    Acute angle-closure glaucoma. Emergency: lie patient flat, give pilocarpine drops, acetazolamide (oral/IV), topical beta-blocker, and urgent same-day ophthalmology referral for definitive laser iridotomy.

14. How do you distinguish anterior uveitis, acute angle-closure glaucoma and conjunctivitis by pupil and pain?

    Anterior uveitis: painful red eye, small/irregular pupil, photophobia. Angle-closure glaucoma: painful red eye, fixed mid-dilated oval pupil, haloes, nausea. Conjunctivitis: gritty/itchy not truly painful, normal pupil, discharge, vision normal.

15. What are the key differences between central retinal artery occlusion and central retinal vein occlusion on fundoscopy?

    CRAO: sudden painless complete vision loss, pale retina with a cherry-red spot, attenuated arteries. CRVO: variable vision loss, 'stormy sunset' fundus with widespread flame haemorrhages, dilated tortuous veins and cotton-wool spots.

16. What sight-threatening complication of giant cell arteritis must be excluded, and what is the immediate treatment before biopsy?

    Anterior ischaemic optic neuropathy causing irreversible blindness. Start high-dose oral prednisolone immediately (do not wait for temporal artery biopsy, which can be done within ~1–2 weeks).

17. In the Ottawa Ankle Rules, when is an ankle X-ray indicated?

    Pain in the malleolar zone PLUS either bony tenderness at the posterior edge/tip of the lateral or medial malleolus, OR inability to weight-bear (4 steps) both immediately and in the assessment room.

18. What are the cardinal features and first-line management of acute gout?

    Rapid-onset monoarthritis (often first MTP joint – podagra), red, hot, swollen, exquisitely tender; negatively birefringent needle-shaped urate crystals. First-line: NSAID or colchicine; oral steroids if both contraindicated. Allopurinol for urate-lowering once acute attack settles.

19. How does the joint pattern of rheumatoid arthritis differ from osteoarthritis?

    RA: symmetrical small-joint (MCP, PIP, wrist) polyarthritis, prolonged morning stiffness ($> 30$ min), worse with rest, spares DIP joints. OA: asymmetrical, weight-bearing/DIP joints, stiffness $< 30$ min, worse with activity, Heberden's (DIP) and Bouchard's (PIP) nodes.

20. What are the red flags in low back pain that suggest cauda equina syndrome?

    Bilateral sciatica, saddle anaesthesia, bladder/bowel dysfunction (urinary retention or incontinence), reduced anal tone, and erectile dysfunction. This is a surgical emergency requiring urgent MRI.

21. Define multimorbidity and explain why it matters for care planning.

    Multimorbidity is the co-existence of two or more long-term (chronic) health conditions in one person. It matters because it increases treatment burden, polypharmacy, risk of drug interactions, and reduced quality of life, requiring a patient-centred, goal-oriented approach rather than single-disease guidelines.

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