PLAB 2 Mock test feedback:: Symptomatic Differential Medicine-Suspected Dementia:: 2nd Attempt

Mock Date: 09/07/2025
Case 2:
Topic: Symptomatic Differential: Medicine
Case Name: Suspected Dementia
Action Items:
Practice and Review the case in the OSCE workbench:	Click Here
Watch the (Private) Mock Test Video Recording:	Click Here
Read the Case Blog:	Click Here
Additional Resources:	Click Here
Deep Dive into your (Private) performance below:
Scenario Summary:
You are an FY2 doctor in a GP clinic. Your patient, Mrs. Margaret Thompson, is a 65-year-old female who is concerned about potential dementia due to recent forgetfulness and her daughter's observations. She has a history of Type 2 diabetes managed with Metformin and a family history of Alzheimer's disease. Your task is to address her concerns, gather relevant information, and provide appropriate management and reassurance.
My Performance:
🔍Let’s Deep Dive into your performance:
The Domain-wise evaluation shows areas where you did well and others where you have room to grow.
A "Yes" means you covered that point effectively
A "Partial" indicates that you did some of it well but missed some key details.
A "No" means there was an important opportunity that wasn’t addressed.
Don’t worry if you see several areas marked "No" or "Partial"—this is common and simply highlights where you can focus your learning.
By reflecting on these areas and practising, you’ll be able to improve and feel more confident in your consultations. Remember, every bit of feedback is an opportunity to grow, and you’re on the right path by taking these steps.
Timestamps are provided to show exactly when during the consultation you covered or missed key points. Reviewing these can help you see how well you're managing your time and where you might need to be more efficient in addressing important areas.

Domain	Point	Timestamp	Response	Remarks
Data Gathering	Patient identifiers: Confirm full name and age	0:07	yes	You confirmed both her full name and age at the start. Well done.
Data Gathering	Confirm the reason for the visit and current symptoms: 'My daughter thinks I have dementia.'	0:20	yes	You clarified her reason for visit clearly by asking what brought her in. Good start.
Data Gathering	Explore presenting complaint comprehensively: Ask “Can you tell me more about what your daughter has noticed recently?”	0:32	yes	You asked exactly what her daughter noticed. Good approach here.
Data Gathering	Explore symptoms: Ask about memory issues, specific incidents, and frequency	1:03	yes	You explored memory issues with examples and frequency well.
Data Gathering	Ask about onset and progression: “When did these memory issues start, and have they been getting worse?”	1:33	yes	You asked when the problems started and whether they are worsening. Good.
Data Gathering	Assess cognitive function: Inquire about difficulty remembering new things, forgetting names, and significant dates	2:09	partial	You asked about remembering new things (2:09) and names (2:26), but missed asking about significant dates. Next time include questions like “Do you forget birthdays or anniversaries?” to complete cognitive screening.
Data Gathering	Evaluate daily functioning: Ask about getting lost, driving, and managing daily activities	4:22	partial	You asked about managing appointments but did not ask about getting lost or driving. For a full dementia assessment, please ask if she gets lost in familiar places or drives safely.
Data Gathering	Rule out reversible causes: Ask about recent infections such as UTIs or chest infections.	5:01	yes	You asked about infections including UTI. Good coverage.
Data Gathering	Rule out vascular dementia causes: Ask about past strokes, mini-strokes, or cardiovascular conditions.	6:04	partial	You asked about strokes (6:05) but did not ask about cardiovascular conditions. Next time, ask about hypertension, heart attacks, or high cholesterol.
Data Gathering	Mental health screening: Check for hallucinations and feelings of depression	4:40	yes	You checked both hallucinations and mood. Good.
Data Gathering	Medical and family history: Confirm past medical conditions, medications, and family history of dementia	5:15	yes	You covered medical, medication, and family history well.
Data Gathering	Social history: Inquire about living situation daily routines and diet and exercise	6:21	partial	You asked about her living situation (6:23) but did not ask about her daily routine, diet or exercise. Please include “Tell me about your typical day, what you usually eat and whether you exercise” for completeness.
Data Gathering	Perform MMSE orientation task: “Can you tell me today’s date, day of the week, and where we are right now?”	3:01	partial	You asked date and day but did not ask location. Next time, ask “Where are we right now?” as well for full orientation assessment.
Data Gathering	Perform MMSE registration task: Ask them to repeat three words: “Apple, Table, Penny.”	3:26	partial	You said “apple, penny, table” instead of the standard “apple, table, penny.” Please keep exact words consistent for validated scoring.
Data Gathering	Perform MMSE attention task: Ask them to spell “WORLD” backwards (D-L-R-O-W).	3:38	partial	You asked to spell WORLD backwards, but the patient answered “D, L, O, W, R, D” incorrectly. You did not correct or note the scoring. Next time ensure you mark errors clearly for assessment scoring.
Data Gathering	Perform MMSE recall task: Ask them to recall the three words you gave earlier (Apple, Table, Penny).	4:05	yes	You asked recall appropriately, though she only remembered one word.
Data Gathering	Perform MMSE language naming task: Show them a pen or watch and ask, “What is this?" Ask them to repeat the phrase, “No ifs, ands, or buts.”	-	no	You did not perform naming or phrase repetition tasks. Please include these for a full MMSE.
Management	Discuss findings: Summarise concerns and findings with the patient	6:37	yes	You summarised her memory concerns and explained mild impairment. Good approach.
Management	Reassure and educate: Explain memory issues and the significance of MMSE results. Explain possible differential diagnoses including dementia, depression, thyroid disorders, vitamin deficiencies, and medication side effects.	7:25	partial	You mentioned dementia and thyroid issues but did not mention depression, vitamin deficiencies, or medication side effects. Next time list these clearly to reassure and educate comprehensively.
Management	Reassure that memory issues can have many causes, not always dementia.	7:25	yes	You explained that memory issues can have other causes. Good.
Management	Arrange immediate blood tests: FBC, U&E, calcium, LFTs, thyroid function tests, Vitamin B12 and folate levels, and HbA1c.	7:51	partial	You mentioned thyroid and blood glucose but not FBC, U&E, calcium, LFTs, Vitamin B12, or folate. Next time specify all relevant tests.
Management	Plan routine referral to Memory Clinic for detailed cognitive assessment and possible neuroimaging.	7:12	yes	You referred her to memory clinic appropriately.
Management	Immediate advice: Avoid driving and provide memory aids	-	no	You did not advise her to avoid driving or use memory aids. Next time mention these to ensure safety and support.
Management	Advise lifestyle measures: maintain routine, use memory aids, adopt Mediterranean diet, regular walks, and social engagement.	-	no	You did not advise on routine, diet, or social engagement. Include these for holistic dementia care advice.
Management	Follow-up: Arrange follow-up appointment and provide contact for urgent concerns	-	no	You did not arrange a follow-up or provide safety net contact details. Please do so next time.
Management	Provide safety net advice: Seek urgent help if sudden worsening of confusion, hallucinations, significant behavioural changes, or getting lost occurs.	-	no	Safety netting was not done. Always mention when to seek urgent help.
Management	Leaflets and pamphlets: Provide written information on dementia and memory clinics	-	no	You did not offer written information. Next time provide leaflets for patient understanding.
Interpersonal Skills	Empathy and active listening: Show understanding and acknowledge feelings	1:03, 2:24, 4:35	yes	You showed good empathy multiple times. Continue this approach.
Interpersonal Skills	Clear communication: Use simple language and ensure understanding	throughout	yes	You used simple language throughout. Good.
Interpersonal Skills	Building rapport: Maintain eye contact and encourage questions	6:37	partial	You built rapport well but did not explicitly encourage her to ask questions about management. Try inviting her views before concluding.
Interpersonal Skills	Respect and sensitivity: Involve patient in decision-making and be sensitive to emotions	7:12	yes	You involved her in the memory clinic referral decision sensitively. Good.
Interpersonal Skills	Signposting: Guide the patient through the consultation process	2:00, 2:54	yes	You signposted transitions in questioning and assessment well.
Interpersonal Skills	Reassure: Offer hope for improvement with proper adjustments	7:25	yes	You reassured her that issues are manageable. Good closure.

Feedback Statements:	Needs Improvement
Consultation	Disorganised / unstructured consultation. Includes illogical and disordered approach to questioning. You did not demonstrate sufficiently the ability to follow a logical structure in your consultation. For example, your history taking may have appeared disjointed, with your line of questioning erratic and not following reasoned thinking. You may have undertaken practical tasks or examination in an illogical order that suggested you did not have a full grasp of the reason for completing them or a plan for the consultation.
Diagnosis	Does not make the correct working diagnosis or identify an appropriate range of differential possibilities.	✔️
Examination	Does not undertake physical examination competently, or use instruments proficiently.
Findings	Does not identify abnormal findings or results or fails to recognise their implications. You did not identify or recognise significant findings in the history, examination or data interpretation.
Issues	Does not recognise the issues or priorities in the consultation (for example, the patient’s key problem or the immediate management of an acutely ill patient). You did not recognise the key element of importance in the station. For example, giving health and lifestyle advice to an acutely ill patient.
Management	Does not develop a management plan reflecting current best practice, including follow up and safety netting.	✔️
Rapport	Does not appear to develop rapport or show sensitivity for the patient’s feelings and concerns, including use of stock phrases. You did not demonstrate sufficiently the ability to conduct a patient centred consultation. Perhaps you did not show appropriate empathy or sympathy, or understanding of the patient’s concerns. You may have used stock phrases that show that you were not sensitive to the patient as an individual, or failed to seek agreement to your management plan.
Listening	Does not make adequate use of verbal & non-verbal cues. Poor active listening skills. You did not demonstrate sufficiently that you were paying full attention to the patient’s agenda, beliefs and preferences. For example, you may have asked a series of questions but not listened to the answers and acted on them.
Language	Does not use language or explanations that are relevant and understandable to the patient, including not checking understanding. The examiner may have felt, for example, that you used medical jargon, or spoke too quickly for the patient to take in what you were saying.
Time	Shows poor time management. You showed poor time management, probably taking too long over some elements of the encounter at the expense of other, perhaps more important areas.	✔️

Data_gathering	Management	IPS
4	2	3