Shortness of breath and heart failure
PLAB pack: SBA + explanation
Theory
Theory 1: Station focus
Shortness of breath tests cardiopulmonary pattern recognition and first safe management.
- Onset, orthopnoea and exertional dyspnoea.
- JVP, crackles, oedema and oxygen saturation.
- Chest pain, fever or PE risk.
Theory 2: Reasoning path
Fluid overload signs point toward acute decompensated heart failure, but immediate severity must be assessed.
- Identify the immediate risk.
- Choose the safest first action.
- Explain why the distractors are weaker.
Theory 3: Expected output
The candidate should identify the likely diagnosis, start safe assessment and explain alternatives.
- ABCDE and oxygen saturation.
- Cardiac/respiratory exam findings.
- CXR/ECG/Bloods and escalation.
Vocabulary and model dialogue
Examiner: What finding points toward heart failure?
Candidate: The raised JVP, ankle swelling and basal crackles suggest fluid overload.
Examiner: What would you assess first?
Practice
Practice 1: Stem analysis
A 58-year-old man with type 2 diabetes has worsening breathlessness, ankle swelling, raised JVP and basal crackles.
Output: Age, timing, symptoms, vital risk and one missing question.Practice 2: First action
Choose the first safe action: ABCDE assessment, oxygen saturation, ECG/CXR/bloods and senior review.
Output: One action plus clinical reason.Practice 3: Differential
Compare Acute decompensated heart failure with two alternatives.
Output: Three-line differential table.Practice 4: Exam response
Explain the likely diagnosis and name two weaker alternatives.
Output: Diagnosis + alternative reasoning.Interactive tasks
Interactive 1: Red-flag sort
Sort findings from "Shortness of breath and heart failure" into urgent and non-urgent details.
Interactive 2: Distractor removal
Remove the least plausible option from: Community-acquired pneumonia, Pulmonary embolism, COPD exacerbation.
Interactive 3: Timed response
Give a 90-second exam answer using the station output steps.
Quiz
Fluid overload signs point to acute decompensated heart failure.
The safest answer addresses the immediate clinical risk first.
Exam documentation must record the detail that changes management.
Safe exams include patient understanding and escalation advice.
The station expects a short, defensible clinical chain.