PLAB · GMC

MRCP(UK)

MRCP Part 1Two best-of-five papers on clinical medicine and the clinical sciences
MRCP Part 2Two best-of-five papers on diagnosis, investigation and management, with ECGs, images and data

FRCPath · RCPath

FRCPath Histo Part 1Histopathology, cytopathology, autopsy practice and the basic sciences
FRCPath Histo Part 2Practical, case-based reporting over two days: slides, cytology, long cases, frozen sections, macros and OSPEs

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PLAB · GMC

MRCP(UK)

FRCPath · RCPath

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ExamAbout PLAB 1 on Exameds

Respiratory medicine

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Question 1 [1 mark]

A 68-year-old man with known COPD is brought to the emergency department with three days of worsening breathlessness and purulent sputum. The paramedics started oxygen at 15 L/min through a reservoir mask. He is drowsy, with a respiratory rate of 22/min, heart rate 104/min, bounding pulses and a flapping tremor. Oxygen saturation is 99% on the current oxygen.

What is the most appropriate initial action?

Give salbutamol nebulised using oxygen at 8 L/minStart non-invasive ventilation immediatelyGive intravenous doxapramChange to a 24% Venturi mask and titrate to a saturation of 88–92%Continue the current oxygen and take an arterial blood gas sample