Alcohol advice after raised liver blood tests
PLAB 2 practice station

The task

You are a doctor in a GP surgery. Mr Eoin Brennan, aged 49, a self-employed plasterer, has come for a review after blood tests showed raised liver enzymes. He is alone. Take a focused alcohol history, then advise him about his drinking and the options available. Agree a plan with him. You do not need to examine him. The examiner will not take part in the conversation.

What this station tests

• Convert drinks to units; people underestimate what they drink.
• Ask about past withdrawal: stopping suddenly can cause fits and delirium, and a history like this may need inpatient withdrawal.
• Use a motivational style; a lecture closes the conversation.
• Arrange supported treatment and a short follow up.
• Ask about driving: persistent alcohol misuse or dependence means the person must not drive and must tell DVLA.

Sources for the clinical content

• NICE CG115: Alcohol-use disorders: diagnosis and management
• NHS: Calculating alcohol units
• GOV.UK: Drug or alcohol misuse or dependence: assessing fitness to drive
• NICE NG50: Cirrhosis in over 16s

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

Practise next

• Starting a statin to lower heart disease risk
• Helping a smoker who wants to stop
• Choosing contraception when pills are forgotten
• Diet advice after a diabetes diagnosis
• A parent unsure about her son's measles vaccine