# PLAB 1 Prevention and screening Questions: 10 Free Practice MCQs > 10 free PLAB 1 prevention and screening questions with answers and explanations, from a bank of 26 prevention and screening questions. Try them now, no… Canonical: https://medhub.one/practice/plab-1/prevention-and-screening Last updated: 2026-10-31 Prevention and screening questions test population logic at the level of one patient. The MLA content map expects you to know the UK screening programmes, the age ranges and the test used, and to explain false positives and overdiagnosis honestly. Vaccination schedules, smoking and alcohol advice, and cardiovascular risk assessment also appear, and the exam rewards the recommendation that matches the national programme. ## Where candidates lose marks * Screening outside the national age range or interval because the patient asked. * Confusing a screening test with a diagnostic test and acting on an unconfirmed result. * Missing the vaccination status and catch-up schedule in an adult or a child. * Offering a test that has no proven benefit instead of a programme with evidence. **Guideline to follow:** PLAB 1 follows the UK National Screening Committee programmes and NICE guidance on behaviour change, immunisation and cardiovascular risk assessment. Ten PLAB 1-style prevention and screening questions with the answer and the reasoning behind it. They come from the UK.med bank, which has 26 prevention and screening questions and many more across every topic. [Free timed mock exam](https://medhub.one/practice/plab-1/mock) 1. 1 / 10 A 52-year-old woman with no diagnosed cardiovascular disease and no current treatment for hypertension attends an NHS Health Check. She asks whether its main purpose is to find an illness she already has or to help prevent future illness. Which explanation best describes the programme's main purpose? Show answer **Answer: A.** Assess modifiable cardiovascular risk and support prevention **Why:** The NHS Health Check is a primary prevention programme for eligible adults aged 40 to 74 without known cardiovascular disease. It assesses modifiable risks and supports action to reduce the chance of future cardiovascular illness. It is not intended to diagnose every condition or replace care for established disease. * **B.** The Health Check is a prevention assessment, not a comprehensive diagnostic investigation for every chronic illness. * **C.** People with established chronic disease continue to need condition-specific care; the Health Check targets eligible people without known CVD. * **D.** Acute symptoms require assessment through appropriate clinical pathways, not a routine preventive Health Check. Sources: NHS Health Check programme, Department of Health and Social Care, 2022 2. 2 / 10 A 65-year-old man attends a screening clinic for an abdominal aortic aneurysm (AAA) ultrasound scan. The scan reveals an aortic diameter of 5.7 cm. According to the NHS AAA Screening Programme, what is the correct management pathway for this result? Show answer **Answer: D.** Refer to vascular surgery for assessment within 2 weeks **Why:** The NHS AAA Screening Programme invites men in their 65th year for a one-off screening ultrasound. Management is based on aortic diameter: (1) Normal (<3.0 cm): discharge. (2) Small (3.0-4.4 cm): annual scan. (3) Medium (4.5-5.4 cm): 3-monthly scan. (4) Large (>=5.5 cm): 2-week referral to vascular surgery. Patients with aneurysms should also be started on cardiovascular risk management (Atorvastatin, blood pressure control, smoking cessation). * **A.** 3-monthly scans are for medium aneurysms (4.5 to 5.4 cm). Since this is 5.7 cm (large), immediate referral for surgery is required. * **B.** 12-monthly scans are for small aneurysms (3.0 to 4.4 cm). * **C.** An aorta >= 3.0 cm is abnormal. Discharge is only for normal aortas (< 3.0 cm). Sources: NHS Abdominal Aortic Aneurysm Screening Programme guidelines 3. 3 / 10 A 58-year-old man has had two troublesome gout flares in the past year and is now symptom-free, three weeks after the latest flare settled. He had a myocardial infarction five years ago and has no chronic kidney disease. He wishes to start long-term urate-lowering treatment. Which is the most appropriate initial urate-lowering treatment? Show answer **Answer: B.** Start allopurinol 100 mg daily, then titrate against monthly serum urate **Why:** He has multiple troublesome flares and major cardiovascular disease, so NICE recommends offering urate-lowering therapy and allopurinol as first-line. Starting 100 mg daily and titrating with monthly serum urate measurements follows the treat-to-target approach. His flare has settled, and the recommended interval before starting treatment has elapsed. * **A.** Febuxostat can be a first-line option for some people, but NICE recommends allopurinol first-line in people with major cardiovascular disease. * **C.** Colchicine can prevent flares while urate-lowering treatment is started or titrated, but it does not lower serum urate. * **D.** Multiple or troublesome flares are an indication to offer urate-lowering treatment, so waiting for another flare is unnecessary. Sources: NICE NG219: Gout, recommendations 1.5.1, 1.5.4, 1.5.5 and 1.5.9 4. Like these? UK.med has a bank of 1999 questions, plus timed mock exams. Free to start: [App Store](https://apps.apple.com/app/id6760537451?utm%5Fsource=medhub.one&utm%5Fmedium=owned%5Fweb&utm%5Fcampaign=practice&utm%5Fcontent=plab-1) · [Google Play](https://play.google.com/store/apps/details?id=com.medicinahub.ukmed&utm%5Fsource=medhub.one&utm%5Fmedium=owned%5Fweb&utm%5Fcampaign=practice&utm%5Fcontent=plab-1) 5. 4 / 10 A 52-year-old woman with no known cardiovascular disease or diabetes receives an invitation to an NHS Health Check. She asks what the appointment is for. What is the main purpose of the NHS Health Check? Show answer **Answer: D.** To assess cardiovascular risk and support steps to reduce future risk **Why:** The NHS Health Check is offered to eligible adults aged 40 to 74 without known cardiovascular disease every 5 years. It assesses cardiovascular risk and supports steps to reduce future risk, such as healthier behaviour or appropriate referral and treatment. It is not a universal cancer screen or a substitute for disease-specific follow-up. * **A.** People with known cardiovascular disease are not the target group for this preventive risk assessment. * **B.** The NHS Health Check assesses cardiovascular and related health risks; it is not a universal cancer screening appointment. * **C.** The check can identify risks or prompt further assessment, but it does not itself diagnose every chronic disease. Sources: NHS Health Check programme: eligibility and frequency, Department of Health and Social Care, current guidance 6. 5 / 10 A 46-year-old woman receives a routine cervical screening report stating that high-risk HPV was detected. The reflex cytology sample is adequate and shows no abnormal cells. What does the report establish? Show answer **Answer: A.** High-risk HPV is present, with no cytological abnormality detected **Why:** The report confirms high-risk HPV detection and negative cytology. It does not prove CIN or cancer, but it does require follow-up within the screening programme. At a first HPV-positive, cytology-negative result, repeat screening is arranged at 12 months. * **B.** This screening report does not diagnose invasive cancer. * **C.** No abnormal cells were detected, so this result does not confirm high-grade CIN. * **D.** High-risk HPV was detected, so the result is not entirely negative and follow-up is required. Sources: NHS Cervical Screening Programme: Cervical screening care pathway, UKHSA, current guidance 7. 6 / 10 At a routine screening appointment, a 30-year-old woman with no cervical symptoms has a sample positive for hrHPV. The accompanying cytology report states that no dyskaryosis is identified. What is the best interpretation of the result? Show answer **Answer: C.** High-risk HPV is detected, with no dyskaryosis seen on cytology **Why:** A positive hrHPV result with negative cytology indicates that hrHPV is present but no dyskaryosis was detected. It does not diagnose CIN or cancer. A first result of this type is recalled for repeat testing at 12 months under the NHS programme. * **A.** No dyskaryosis is reported, and cytology alone would not prove a histological CIN grade. * **B.** The report is a screening result and contains no evidence confirming invasive cancer. * **D.** The screening test is not negative because hrHPV was detected, even though cytology is normal. Sources: NHS Cervical Screening Programme: laboratory HPV testing and cytology guidance, UKHSA, current pathway 8. 7 / 10 A 60-year-old man receives a package in the post containing a bowel cancer screening kit from the NHS Bowel Cancer Screening Programme. What is the primary screening test used, and what is the screening frequency for eligible adults aged 60 to 74 in the UK? Show answer **Answer: C.** Faecal Immunochemical Test (FIT); every 2 years **Why:** The NHS Bowel Cancer Screening Programme uses the home Faecal Immunochemical Test (FIT) kit, which is sent to men and women aged 60 to 74 every 2 years (in England, the programme is gradually expanding to invite people from age 50). Patients with a FIT result >= 120 mcg Hb/g (or threshold set by local program, typically 120 mcg/g) are referred for a colonoscopy. * **A.** The gFOBt has been replaced by the more accurate and user-friendly FIT test in the UK, and the screening interval is 2 years, not annual. * **B.** The one-off 'Bowel Scope' screening at age 55 has been decommissioned in the UK, and FIT is the primary screening modality. * **D.** Colonoscopy is a diagnostic investigation performed for abnormal screening FIT results or symptoms, not the primary routine home screening tool. Sources: NHS Bowel Cancer Screening Programme guidelines 9. 8 / 10 A 30-year-old woman has a first routine cervical screening result showing high-risk HPV with negative reflex cytology. She has no symptoms and no history of abnormal cervical screening. What follow-up should she be offered now? Show answer **Answer: B.** Repeat clinician-taken cervical screening in 12 months **Why:** High-risk HPV with negative cytology is followed by repeat screening in 12 months in the NHS Cervical Screening Programme. The purpose is to check whether HPV persists or cytological changes develop, not to treat the virus with antibiotics. If the repeat HPV test is negative, she can return to routine recall; persistent HPV or abnormal cytology leads to further follow-up or colposcopy. Immediate colposcopy is not the standard response to a first HPV-positive result with negative cytology. * **A.** With negative cytology at the first HPV-positive screen, immediate colposcopy is not the standard pathway. * **C.** Routine recall follows a negative repeat HPV test; an interim 12-month test is needed first. * **D.** Antibiotics do not treat HPV; follow-up is based on repeat HPV testing and cytology. Sources: NHS Cervical Screening Programme: Cervical screening care pathway, UKHSA, current guidance 10. 9 / 10 A 49-year-old man wakes with abrupt severe pain, warmth and swelling at the right first metatarsophalangeal joint. He has had two similar attacks before, has no fever or skin break, and has chronic kidney disease with an eGFR of 48 mL/min/1.73 m2. Which diagnosis best explains this abrupt monoarthritis? Show answer **Answer: B.** Acute gout affecting the first metatarsophalangeal joint **Why:** Rapid onset of severe pain, redness and swelling in the first MTP joint strongly suggests gout. NICE advises considering septic arthritis and other crystal or inflammatory arthritis in a painful red joint; fever absence alone does not exclude infection. If infection is suspected, urgent referral is needed. * **A.** Rheumatoid arthritis more often causes persistent inflammatory symptoms in multiple joints rather than a sudden isolated podagra. * **C.** Dactylitis and psoriasis history would support psoriatic arthritis, but neither is described; the sudden podagra pattern supports gout. * **D.** Osteoarthritis usually causes chronic mechanical pain and does not typically cause this abrupt, intensely inflamed joint. Sources: NICE NG219: Gout, diagnosis and management, 2022 11. 10 / 10 A 40-year-old man is offered an NHS Health Check. He understands it is a preventive assessment but says he does not want to attend. Which ethical principle should guide the GP’s response? Show answer **Answer: C.** Respect his informed decision to decline the voluntary check **Why:** An NHS Health Check is a voluntary preventive offer, not a compulsory intervention. After the GP explains the purpose of the assessment and answers any questions, a capacitous adult can decide whether to attend. Respect for autonomy means accepting an informed decision to decline, without pressure or penalty. Beneficence supports offering the check, but it does not justify booking it against the patient’s wishes. * **A.** Promoting health does not justify overriding a capacitous patient’s informed refusal. * **B.** Confidentiality protects personal information; it does not prevent the practice from inviting an eligible patient. * **D.** Declining the check does not incur a fee, and charging is not an ethical requirement. Sources: NICE NG197: Shared decision making; NHS Health Check programme guidance, current ## Explore the 1999-question bank in UK.med Timed practice, spaced repetition and AI clinical simulations that grade you like an examiner. Free to start. 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