PLAB 1 HIGH-YIELD REVISION NOTES (ALL SPECIALTIES)
CARDIOLOGY
- STEMI: Immediate aspirin + ticagrelor + PCI within 120 min (or thrombolysis if PCI unavailable).
- NSTEMI/UA: Fondaparinux + aspirin + clopidogrel, early angiography if high-risk.
- Heart failure: 1st-line ACEi + β-blocker, then spironolactone, then SGLT2 inhibitor.
- Aortic stenosis: Ejection systolic, radiates to carotids.
- AF: Rate control (β-blocker/diltiazem). Anticoagulate if CHADSVASc ≥ 2 (DOAC).
NEUROLOGY
- TIA: Aspirin 300 mg daily immediately.
- Stroke: CT head → alteplase if <4.5 h and no bleed.
- SAH: Sudden worst headache, CT ± LP after 12 h.
- Parkinson’s: Levodopa + carbidopa.
- MS: IV methylprednisolone for relapse.
- Myasthenia gravis: Pyridostigmine.
- Guillain–Barré: IVIg or plasma exchange.
HAEMATOLOGY
- Microcytic: Iron deficiency, thalassaemia.
- Megaloblastic: B12 or folate deficiency – correct B12 first.
- ITP: Prednisolone if <30 × 10■/L or bleeding.
- Sickle cell: Hydroxyurea for crises.
- Leukaemia: ALL (child + bone pain), CML (Philadelphia chromosome).
RESPIRATORY
- Asthma: SABA → ICS → LABA+ICS → ↑ICS or LTRA.
- COPD: LABA+LAMA → +ICS if eos >300.
- PE: CTPA, DOAC.
- Pneumonia: CURB-65; amoxicillin or co-amoxiclav+clarithromycin.
- TB: 2 months RIPE → 4 months RI.
- Sarcoidosis: Bilateral hilar lymphadenopathy.
ENDOCRINOLOGY
- DKA: Fluids + insulin + K■ when <5.5.
- HHS: Fluids first.
- Addison’s: Hydrocortisone + fludrocortisone.
- Cushing’s: Not suppressed by dexamethasone.
- Graves’: TSH-receptor antibodies.
- Hypothyroidism: Levothyroxine.
- Pheochromocytoma: α-block before β-block.
INFECTIOUS DISEASES
- Meningitis: Ceftriaxone + dexamethasone (add ampicillin if >50 y).
- Endocarditis: Blood cultures before abx.
- HIV PEP: ≤72 h, 3-drug regimen.
- Hepatitis B: HBsAg +, anti-HBc +, anti-HBs –.
- Malaria: P. falciparum → artemether–lumefantrine.
- Syphilis: Benzathine penicillin G.
RENAL
- AKI: ↑Cr ≥26 µmol/L in 48 h or urine <0.5 mL/kg/h >6 h.
- Nephrotic: Proteinuria >3.5 g/day, oedema, hypoalbuminaemia.
- Nephritic: Haematuria, HTN, mild proteinuria.
- Post-strep GN: Cola urine + low C3.
- ATN: Muddy brown casts.
- CKD: ACEi/ARB, control BP <130/80.
GASTROENTEROLOGY
- Upper GI bleed: ABC, IV PPI, endoscopy <24 h.
- UC: Continuous lesions, mesalazine.
- Crohn’s: Skip lesions, steroids → azathioprine.
- Coeliac: Anti-tTG IgA.
- Hepatic encephalopathy: Lactulose ± rifaximin.
- Gallstones: Female, fat, fertile, forty.
- Pancreatitis: ↑amylase/lipase >3× ULN.
OBSTETRICS & GYNAECOLOGY
- Ectopic: Shoulder-tip pain, lap salpingectomy.
- Pre-eclampsia: Labetalol + MgSO■ if severe.
- HELLP: Haemolysis, Elevated LFT, Low platelets.
- Placenta praevia: Painless bleed, no vaginal exam.
- Placental abruption: Painful bleed.
- PPH: Uterine massage + oxytocin.
- COC contraindications: Smoker >35, migraine w/ aura, VTE, breast CA.
- Copper IUD: Immediate effect, safe in breastfeeding.
PAEDIATRICS
- Croup: Dexamethasone.
- Epiglottitis: Intubate + ceftriaxone.
- Bronchiolitis: Supportive.
- Kawasaki: IV Ig + aspirin.
- Nephrotic (minimal change): Steroids.
- UTI <3 mo: Admit + IV cefotaxime.
- Milestones: Walk 12–15 mo, 2 words at 2 y.
PSYCHIATRY
- Depression: SSRI (sertraline).
- Bipolar: Lithium.
- Schizophrenia: Risperidone.
- GAD: CBT ± SSRI.
- OCD: CBT (exposure + response prevention) ± SSRI.
- Anorexia: ECG (QT prolongation).
- Alcohol withdrawal: Chlordiazepoxide + thiamine.
RHEUMATOLOGY / MSK
- RA: DMARD (methotrexate).
- SLE: ANA + dsDNA.
- Gout: NSAID/colchicine; allopurinol after flare.
- Ankylosing spondylitis: HLA-B27+.
- Osteoporosis: Alendronate.
- PMR: Prednisolone 15 mg.
OPHTHALMOLOGY
- Angle-closure glaucoma: Acetazolamide + pilocarpine.
- Uveitis: Topical steroids.
- CRAO: Sudden painless loss, cherry-red spot.
- Diabetic retinopathy: Neovascularisation.
- Temporal arteritis: High-dose steroids.
EMERGENCY / GENERAL SURGERY
- ABCDE first.
- Anaphylaxis: IM adrenaline 0.5 mg (1:1000).
- Tension pneumothorax: Needle 2nd ICS → chest drain.
- Appendicitis: RIF pain, rebound tenderness.
- Bowel obstruction: NG + fluids.
- AAA rupture: Immediate surgery.
- Shock: Hypovolaemic (↓CVP), Cardiogenic (↑CVP), Septic (↓SVR).