Weight loss and a change in bowel habit
PLAB 2 practice station

The task

You are a doctor in a GP surgery. Mr Suresh Menon, aged 67, has come because he has lost weight and his bowels have changed. He is alone. Take a focused history. Then explain to him what you think needs to happen next and why, answering his questions, and tell him what to do if things change. There is no need to examine him. The examiner will not take part in the conversation.

What this station tests

• A faecal immunochemical test guides referral: 10 micrograms of haemoglobin per gram of faeces or more means a suspected cancer pathway referral.
• Ask directly about blood; patients may hold it back and blame piles.
• Family history and anaemia symptoms add weight to the concern.
• Avoid false reassurance while the cause is unknown.
• Safety-net for heavy bleeding, severe pain or faintness.
• A low result does not end the matter: safety-net, and do not delay referral if strong clinical concern continues.

Sources for the clinical content

• NICE NG12: Suspected cancer: recognition and referral
• NICE HTG690: Quantitative faecal immunochemical testing to guide colorectal cancer pathway referral in primary care

An original practice scenario with invented patients. Not an exam question.

Practise next

• Severe headache since yesterday
• Chest tightness that comes and goes
• Breathlessness and cough in a long-term smoker
• Lower abdominal pain in a young woman
• Low mood and poor sleep