Final Year Viva Questions - Surgery Professional Exam 2012

Final Year Viva Questions - Surgery Professional Exam

Compiled by Class of 2012

SURGERY VIVA COMPONENETS
OSCE
2 short cases
2 Table vivas
One long case

Osce me full help hoti hai.Short cases me methods nahi dekhty but findings narrate kerny ke practice hon chaiye.Buy Sir Shahid's method notes from King's Photocopier and practice case presentation.Table viva me XRays and instruments pochty hain.Long case book se purhny ka time mil jata hai EXCEPT in W.S.W.

Compiled by Class of 2013


OSCE Questions:

xray air under diaphragm
ques: xray finding? causes of air under diaphragm? treatment?

allen's test pic ,name the test?
significance?
 
proctoscope
ques:parts of proctoscope, in which condition its use is contraindicated

 laryngoscope
identify?parts?

catgut
ques: 2 uses? half life?

prolene suture picidentify?
two suture whch r not absorble?

 babcock forceps
ques: 2 uses? its sterlization?

metabolic acidosis
ph pco2 and hco3 values were given
diagnosis? name comon surgcl cndtion asociated with it?
 
needle holder
ques: identify? its sterlization?

thyroglosal fistula pic
identify the pathology?
treatment?

 hydatid cyst scenario+CT scan
ques: diagnosis? 4 complications?

hydatid dsease pic
name the disese
organism?
scolicidal agents?
 
blood transfusion precautions and complications?

spinal anesthesia picin which vertebral spce given?
which anesthetic used?

midline verticl incision pic
ques: identify the incision? name five other incisions?

xray pic air fluid levels
identify?
findings?

 ercp with cbd stones
ques: what is dignosis? complicatins of ercp?

colorectal ca staging table:
u have to match the stage and findings given in cloumn

haemorrhoids scenario + pic
ques: diagnosis, treatment?

ca breast staging table:
match the stages

 pic showing marjolin ulcer
ques: diagnosis? investigation of choice?

varicose veins pic:
identify?
treatmnt?

gastric outlet obstruction
ques: which contrast study? what metabolic derangements? other investigations?

tetanus vacine pic:
route of adminstration?
organism?

 xray showing multiple air fluid levels
ques: xray findings? management?

 iv canula:
identify?
size?

ETT with cuff
tracheostomy tube
ques: uses? cmplications

orophyrangeal airway pic:
identify?
in which patients it s contraindicated?

burn scenario
ques: signs of inhalation injury? formulas for fluid replacement calculation

Important Short Cases:1.thyroid swelling
2.parotid swelling
3.breast lump
4.inguinal/incisional/umblical/paraumblical hernia
5.examine neurovascular system of lower limb
6.lip carcinoma
Short case thyroid...he didnt notice the examination or atleast it seemed so....asked to describe it n asked related questions like which swelling moves with tongue protusion etc...diagnosis...investigations...since it was a nodule so dont forget fnac...asked treatment of ca thyroid...procedure of thyroidectomy...asked name of incision too....then crushing intestinal clamp...how did u identify it...non crushing...where are they used ( non crushing is applied to that part which we want to preserve n crushing is applied to the part to be resected then resection bw them).
Short case thyroid What structures to save in thyroidectomy? Why? difference in clinical presentation of injury to external branch of superior laryngeal nerve n recurrent laryngeal nerve? surgeon is sure that he has saved parathyroid carefully but if still hypocalcemic tetany develops postoperatively then what is the cause?
what will u give to treat this? what else will u give apart from calcium gluconate to stimulate parathyroid gland?
follow up?

short case thyroid swelling one clinical finding and d/d of swelling midline neck that moves on swallowing.... puberty goiter investigstions?? treat?? goitrogen name any?? (chinese salt is goitrogenic)

Short Case parotid swelling describe...asked to examine different branches of facila nerve like zygometic temporal etc...what else would u like to examine...y to look inside mouth n related questions...your diagnosis ... complications of surgery (inj to facial nerve importantly)
Short Case parotid swelling surgical procedures on parotid swelling? what structure to save in parotidectomy? what r the landmarks of facial nerve during surgery? where it can be damaged? its branches? check marginal mandibular branch in a single command to this patient ? whats its function?
Short Case Parotid Swelling (perform fluctuation test, examine facial nerve, name the muscles which we examine in facial nerve examination, how to palpate deep lobe of parotid?, differential diagnosis of parotid swelling, how to diagnose it is parotid swelling or enlarged preauricular lymph nodes, drainage areas of preauricular lymph nodes, branches of facial nerve)
Short case  lump in breast..investigations n treatment optionz.. difrnc btwen fnac.tru cut.incisional n excisional biopsy...findings in biopsy reports?(grading n staging of CA plus tells abt hormonal receptors' presence or absence)...which drugs used fr hormonal theray?(tamoxifen n anastrazole)..complicationz of mastectomy

Short case: Lump in breast: what are your findings?2. what is puckering of skin? what are astley cooper ligaments? how will treat highly advanced and minimally advanced carcinoma of breast? which chemotherapy regime is used? what are taxanes?

Short Case :ulcer on lip- tel ur findings?
types of ulcers?
dif btween arterial n venous ulcers?
"JAHAN MUSHKIL LAGY MUJE ROK DENA"
whats ur diagnosis of this case?
management?

Short Case : Perianal Fistula (inspect, findings, why to use gloves for examination?, name common pathologies of perianal region)

Short case inguinal hernia describe dx treatment table viva xray findings intestinal obstruction causes of large gut obstruction

Short case : mass rt hypochondrium.. not moving with resp.. most likely colonic hepatic flexure mass.. confirmed by ultrasound to differentiate from gall bladder and liver mass.. n treatment rt hemicolectomy... whats hartmann procedure. .. pt symptoms in hypokalemia n hypernatremia....


TABLE VIVAS

table viva west external...identify ambu bag...its use...another use other than cpr..chest tube...site of insertion...triangle of safety...vicryl...its sterilization ( i said ethylene oxide n gama rays cz sir Uzair told us so as far as i remember...external agreed too) types of needle...i could remember round body n straight
table viva dr gondal..simple ask u to identify specimen n ask details about one

table viva dr.naqi..he ask yuu abt ur fav surgical procedure n ask details abt dt

 
LONG CASES

Long case west.....perianal sinus/fistula...i did exam n dre too....sir Sadaqat n external both took it together... took my history sheet n overviewed it while listening to history .etiology (abscess then others), wht wuld u like to know next( high or low)......whre is abscess formed( infecion of glands) where are thy found...opening(on dentate line)...other name of dentate line...investigations...proctoscopy...dye...(probe isnt used cz it may cause another false passage....didnt agree on fistulogram)...one treatment....fistulectomy...asked to show what i have examined n to show the opening of fistula....

long case..south surgery.dr,gondal.(case of post.op. laprotomy patient)..which incision used fr it?(advantages?) name skin sutures? describe the paramedian incision(All layers which r cut in sequence) y pseudocyst caled so? name true cysts? whtz sebaceous cyst? detail of endoscopic procedure of cystogastrostomy? normal urine output? normal sodium n potassium levelz? normal TLC count? how post. rectus sheath gets formed? why laporotomy called so? name other abdominal incisionz? (sir concentrates on ward cards a lot)
LONG CASE IN NORTH intestinal obs.
sir arshad chema asked me to tell ful history..then examination findings..then diagnosis.difrential diagnosis?whether it z of large gut or small gut?
which investigations u will perform?
what findings on Xray erect and Xray supine?
what is most common cause of intstnl obs in our country?
then he asked how will u prevent cancer?
what is screening?--muje smjhao screening kia oti h?
kch r btao
show me ward cards 
jaty jaty keh gy k u haven't define the screening well
OVERALL EASY VIVA..relax mahol..

long case: pt of ischaemic foot
sir cheema asked about diagnostic tests and clinicals signs and investigations etc. ask of amputation would be done? any other reconstructive operation? how is it diff from wet gangrene? asked about screening? and what would do in awarness programs against cancer in general

Long case in south surgery taken by dr gondal: corrosive intake: how will you manage the patient? what are different types of esophagectomy? advantages and disadvantages of each procedure? what will be the complications? ideal treatment of choice for strictures?

Long case south- retroperitoneal mass. dr godal asked me to do the whole abdominal examination...asked about the D/d n how to exclude the d/d to reach the diagnosis . investigatns u will perform? if colonic mass then hoe will u stage it n how will u treat it? APR n ant resection? treatmnt of colorectal Ca?

Long case north..hydrocele external asked to demonstrate transillumination test diffrential and treatment.classification of testicular tumors..plenty of time to prepare for viva

Long case. Varicose veins. . Elicit fegans test.. tredelenberg test ki interpretations.n trivex n vnus is something that sir wanted to hear.

Long Case (East)......Paraumbilical hernia (Presenting Complaint, Clinical tests, Causes, Most probable cause in your patient, how did you rule out other causes, Differential Diagnosis, Investigations, Complications, Signs of Strangulation, Treatment options, Steps of mesh repair, Steps of appendectomy)
long case ca head of pancreas dr naqi asked abt history and examination in detail will also ask to examine in front of him and then asked management in detail ....

long case dr sadaqat asked type of shock on perforation of gall bladder ...extrnal asked how to look for function of gall bladder(dont know its usg related thing) and do strip test( to confirm autoclaved instrument sterilized strips are used whether sterilized properly or not)

Compiled by Class of 2012

SURGERYY VIVA !!!!!!(24th jan,2013)--- i had my combo as --short case n table viva +OSCE in EAST SURGICAL and LONG CASE+TABLE Viva in SOuth....

1)OSCE---very easy...n again humain kaafi bta di thee pehlay hi....there were scenarios regarding burns,head n spinal trauma,,images of proctoscope n one pneumothorax ka X-ray,,silk suture,carpopedal spasm n one counselling station regarding thyroid surgery...

2)SHORT CASES--two short cases taken by DR.Bhutta n the external respectively....wid dr.bhutta,i had INCISIONAL HERNIA..dr.bhutta methods bohat ghaur say dekhtay hain so practice them all very well..askd me bout the treatment of incisional hernia..phir TABLE VIVA WITH DT.BHUTTA------peritonitis,,n its treatment,,tracheostomy tube n uski indications,n C.I's,,and SSI's....P.S=DR.BHUTTA WARD CARD KO BOHAT IMPORTANCE DAY RAHAY THAY....

SHORT CASE & TABLE VIVA WITH EXTERNAL---DIFFUSE THYROID ENLARGEMNT-----he didnt bothr to c the menthods...just askd me to name some surgical conditions in diffrent age groups,,cystic hygroma ki treatment,,parotid tumors,,ERCP ki Indications n C.I's n complicationsOVERALL BOTH OF THEM VR EXXXTREMMLY NICE AND EXTRNAL TOU HINT DAY DAY KAY VIVA LEH RAHAY THAY....

3)TABLE VIVA EITH DR.GONDAL----just looked at the ward card and was half satisfied...askd kay koi say OT procedure bta dou...i strtd wid lap-chole,,,CBD ruputre main kon c commenest late complication hoti hai ,,Bismuth classification and treatment of CBD stricturs accrding to it....

4)TABLE VIVA WITH EXTRNAL----he has specimens of --appendix,kidney,multinodular goiter and gall bladder...askd me to identify appendix,,how is it diffrnt from fallopian tube,,y perforation is maximum at the tip ofthe appendix n draw the blood supply of appendix

5)LONG CASE WITH DR.GONDAL----my case was pseudoanuerysm in an IV drug abusr.....he ws a post-op..with an open wound....he askd me definitions of aneurysm,,its classification,,treatment of pseudoanuerysm,,how is it diffrnt from treatment of aortic aneurysm,,,wt wud u do if u r untraind to perform a grafting procedure in a ruupturd anuerysm(ligate the feeding vessel),,wt wud b the disadvantages of it and how ud u test the femoral nerve..lastly askd me about the wound examination

6)LONG CASE WITH DR.YAAR MUHAMMAD(ASST.PROF SSW)....askd questions regarding history of PC....wt r the d/dz of inguinoscrotal swellings,,,wt r the risks of iV drug abuse, wt odr questions wud u ask him...

AGAIN OVERALL,,,DR.GONDAL N EXTRNAL WR NOT ASKING TUFF QUESTIONS....boht basic pooch rahay thy..infact dr.gondal tou kaaafi lamba viva leh rahay thay that gives u enuf margin for a decent score.....

goood luk!!!!

Jan 24 , 2013

OSCE NORTH

1.Calculate GCS of pt

2.managmnt of head trauma pt

3.intestinal obs x-ray finding..hw to treat it?

4.pnumothora x-ray..manage it

5.swelling face rt..D/D..manage it..dx?

6.inhalational injury signs plus parklands formula

7.spinal injury..treatment ..surg..manage.

8. Carpopedal spasm n its treatment

9. Council a patient for thyroidectectomy

10. chromic catgut uses n half life

11. proctoscope n obturator , it's sterlization

12. Endotracheal tube , name its parts and give uses

Sr Cheema..CVP line..HERNIA CASE

External parotid swelling D/D invs Managment INTESTINAL OBBS X-RAY ...T TUBE CHOLANGIOGRAM..CHest x-ray..

Long case DUODENAL PERFORATION

Table viva instruments proctoscope..babcoch..allis..Leheys forceps

south

LAPAROSCOPY K instruments jo kbhe na daikhay na sunay and viva started frm tht

name all instruments,and i thnk un k theatr mai koe instrument nhn raha ho ga :)

FNAC grading of brest lump

external x.ray gas under diaphragm,mediastinal shift,haemo/hydropneumothorax and all findings were in one x.ray bt he didnt agree wd anythng

incisional hrnia short case,treatment,after whch type of incision it z more comon

EAST LONG case, obstructive jaundice

check jaundice,tell findings,investigations,mst likely Dx,diagnostic investigation,courvoisers law and its basis,Whipples operation mai kia krtay hain,is ki mst comon complication kia ho ge or wts the comom complication if u anastomose jujunum wd pancreas

surgery viva : dunya ka sb se ganda dhaga kaunsa he ??

ans was STAINless steel . just to make ev1 know stainless steel z da worst suture ever.. (specially 4 da juniors ,if sbday asks) otherwise normallly n most of de time alll de questions were normal easy n typical... so dn wory

MARKS DISTRIBUTION FOR SURGERY

 30....internal assessment

30......osce

60+60 .........short cases

20+20......table viva

80.......long case

OSCE :

OSCE IN NORTH

straight artery forceps(uses n metthod of sterilization)

trocar (uses)

pic showing burst abdomen(causes,management)

pic showing paraumbilical hernia(managemnt)

pic showing ambu bag (uses) 

pic showing fracture shaft of femer(neurovascular complications n mangement)

scenario of blunt trauma liver (inv. of choice and management)

vicryl(type of suture,uses,absorbable or not?)

pic showing appendix(complications of the procedure)

1.scenario of blood transfusion reaction...diagnosis? initial mangemnt n further mngmnt

2.pyloric stenosis shown on barium swallow...enlist investigations to cnfrm this..

.3.scenario of patient wd tension pneumotorax who,after being intubated got surgical emphysema,,,enlist the diagnosis n mx of this

4.ERCP......wt do u see in the xray....what is the tx of choledocal stones

5.patient of TPN....questions were....calculate daily caloriescalculate BMIcomplications of TPN

6.proline suture what r the properties?how is it sterilizedenlist uses

7.babcocks forecepsenlist useshow is it sterilized?

8.scenario of patient given an IM inj n afterwards he develops pain redness and crepts in the deltoid region...enlist diagnosis...prevention...treatment

9.boy presents wd PAIN IN RIF....vomiting n aNOREXIA present...diagnose...mx ....what is the commonest tumour involving this organ?

10...scenario of pt who becomes tachypneic 3 days post op following bone fracture...diagnosis n t/m?ans is fat embolism.

OSCE surgery....

10 stations n 7 rest stations.3 minutes for each n 3 marks for each... 

station 1: photo of lapro trocar n canula.. identify.uses n complications

station 2: photo of non crushing intestinal clamp. identify n uses

station 3: photo of burst abdomen post op patient.. write causes

station 4: vicryl suture.. identify uses n sterilized by

station 5: photo of plastic tracheosotomy tube.. identify n uses n complications

station 6: photo of sigmoid colon growth ..identify n treatment option

station 7: scenario based RTA 17 yrs boy resuscitation plan n diagnosis

station 8: scenario breast lump 4 into 5 cm in outer quadrant in 45 yrs old lady.. stage n 1 treatment option

station 9: photo of xray abdomen multiple air fluid levels.. identify n management

station 10: photo of pneumohaemothorax.. identify n management

pnemonic to remember color of cannulas accoding to increase in G. oral......orange gardan(neck)....grey Wide chest.......white groin......green perineum.....pink bulk of thigh....blue yakee....yellow (i didnt get any clue)pawoo(foot)....purple

 Yellow 24 GBlue 22 GPink 20GGreen 18 GGrey 16 (minimum G that can b used in resusitation)Orange 14 GRate of blood flow is directly relatd to 4th power of radius and inversely to length of cannula

OSCE west as stated below.Short case 1 ganglion (west surgical ext)examination of hand.why swellings are called cystic.how do you elicit on ex that they are cystic?treatment?why do you give GA?why not LA?short case 2(lipoma)examine back.(internal west surgical)*d/d*why is it a lipoma?*swellings expansile on cough*meningomyelocele what is it*biopsy types of biopsy,what is trucut biopsy*what is liposarcoma*differences between benign and malignant*how will you investigate and treat lipoma.Table vivas (west surgical ext)Identify T tube.its usesI/V cannulaBarium swallow(stricture) causes management of benign stricturesETT tube its usesTable Viva (west surgical internal)Steps of thyroidectomy its complicationsidentify Aliss forceps.Table viva specimens prof gondalGB,Appendix,MNG,breast ca,hydatid cyst.lab findings for hydatid cyst what is casoni's test?

WEST OSCE 1.xray air under diaphragm2.xray communated fracture shaft femur3.instrument trocar4.hemostat5.ambu bag n mask6.pic of burst abdomen7.pic hrnia8.pic of gall bladder specimen9.vicryl10.scenario liver traumaSHORT CASES1.ganglion2.thyroid solitary nodule3.lumber hernia4.ca b

scenario of ruptured AAA n treatmnt,ERCP,needle holder uses,silk suture uses n properties,appendix specimen,counsel diabetic pt fr below knee amputation(verbal st),vericose pic+traetmnt,pneumothorax xray clinical signs?,intestinal obs scenario tretmnt...

VIVAS

Short Case: West, Long Case: North

Sir Haroon - viva begins with x-rays. intestinal obstruction, T-tube cholangiogram and barium swallow today. there was CBD dilation and gall stones in the T-tube cholangiogram. my viva revolved around management of obstructive jaundice and Rx of CBD stones. examination of thyroid swelling and indirect inguinal hernia. minimum treatment of a cold nodule (lobectomy, isthmectomy)

External - x-ray showing rib fracture and hemoperitoneum. Analgesia for this case? (nerve block) modes of surgical analgesia. Asked me to test movements at the neck. muscles and joints involved in neck movements?

Long Case: (external only) recurrent indirect incomplete inguinal hernia. incision? ring occlusion test. get above the swelling. describe any herniorrhaphy you've seen.

OSCE: spleen rupture mx, liver injury mx, photo of tuberculous cervical lymphadenopathy, needle holding forceps, vicryl, pneumothorax x-ray clinical signs?, barium swallow showing gastric outlet obstruction definitive investigation (endoscopy), below knee amputation in a diabetic patient counselling station, blood transfusion complications and prerequisites, gas gangrene mx,

Cheema Sb

Asking abt pulse oximeter again. And aik na aik sawal ATLS mese. Esp clinical signs of shock/airway obstruction etc. How wud u resuscitate shock pt, how wud u assess response, Trocar cannula: used in, advantages and disadvantages of lap. surgery, Post-splenectomy risks, OPSI, what vaccinesCase was mass Rif. Asked d/d and inv for one or two of the differentials. He opens up ward cards and does ask something out of it, so have it prepared

long case dr chema northbless him he keeps smiling no matter what u tell him lols. my case was of bilaterl inguinl hernias and incisionl hernia. he askd investigations, wat is natural histry of disease, natural history of inguinal hernia. featurs of strangulated hernia, then showd me barium swallow showing strictes in esophagus

north surgery:short case of MNG with external asked about findings,. laheys and kocher method.in table viva there was 3 way stopcock ,iv canula,intest clamp asked about uses.short case of CA breast with prof Cheema,findings ,management, staging.xray was of t tube cholangio,findings,indications,when t tube is removed. 

Breast Examinationasked me site of lump and how to check fixation with pec major,treatment and staging.TABLE VIVA:X Rays were there; mine was barium swallow, IVU, ERCP and erect abdominal X Ray.

Short case2:incisional hernia...Dr.Bhutta...what is cough test?,causes of incisional hernia,repair options,inguinal hernia repair,what is lichenstein,Shouldice and Darn repair,contents of inguinal canal...Table viva...instruments...Burette,NG,CVP line...uses of all...Table viva...X-ray...intestinal obs,management,uses of folley catheter...Table viva...Specimen...Breast...types of breast malignancies,recepters on tumor cells,HER 2 Neu stands for?,treatment options

~WITH S.ARSHAD CHEEMApt had solitary nodule thyroid,asked findings ,whats ur diagnosis ,if papillary how will u treat it,pulse oximeter ka mechanism of action (may be he wanted to know its physics) periampullary carcinoma of pancreas clinical presentation,investigations,treatment,showed me crushing intestinal clamp and asked wat it is ?will it crush ? said try to crush ur finger....then he took the instrument from me n put his own finger in the clamp...thanks God here my viva ended

Cheema SbAsking abt pulse oximeter again. And aik na aik sawal ATLS mese. Esp clinical signs of shock/airway obstruction etc. How wud u resuscitate shock pt, how wud u assess response, Trocar cannula: used in, advantages and disadvantages of lap. surgery, Post-splenectomy risks, OPSI, what vaccinesCase was mass Rif. Asked d/d and inv for one or two of the differentials. He opens up ward cards and does ask something out of it, so have it prepared

North Surg Unit: Short case: with sir cheema, breast exam, findings, wot invest. Identify the x-ray! Its was barium swalow..with strictures. Wot treatment! With external, instruments! Kochers ko kocherz kyun kehte hain? (lo g, koe b'tlao k hum b'tlayen kia :0 ) wotz kochers sign n maneovre. Then hernia exam. Hw 2 diff b/w hernia n lymph node. (u cn get above evry sweling excpt hernia)

 Kocher's forceps is named after theodor kocher .if thats what he wanted to ask...

Kocher manoeuvre is a surgical manoeuvre to expose structures in the retroperitoneum behind the duodenum and pancreas; for example to control hemorrhage from the vena cava inferior or to facilitate removal of a pancreatic tumour

 East Surg: löng cse with khwaja azem. Cholecystitis. Complictnz n cntra-indictnz ov cholecystectmy! Hez sucha nice person..(got 2 knw 4 the 1st eva tym) :pGud luck every1 :)

External:Case was Parotid CA. Then qs abt GB stones, clinical diff b/w biliary colic and acute cholecystitis, facial nerve branches, pes anserina

west surgerysir bhutta short case axillary lymph node swelling..findings,axillary dissection, how to palpate axilla, neo adjuvant therapy, table viva appendicectomy, towel clip, tissue holding forceps how they are sterilized.external short case ganglion..findings, diagnosis, treatment. table viva prolene.. uses, properties, chest xray cannon ball secondaries. other short cases were lipoma, thyroid, inguinoscrotal swelling.south surgerylong case appendicectomy post op. what are complications of appendicectomy, treatment of appendicular abcess, wats tumor of appendix (carcinoid)table viva specimens breast, appendix, thyroid, ascaris, table viva external asked from ward card lap chole ports, seton kia hota hai?

dr khawja: xray of small gut obstuction showing multiple air fliuid levels cause of smalll gut obstructuon. complications of mng, is mey konsa cancer hota hai? gut ke strangulation k kya consequences hoty hai?

West surgery...Short case 1:lump in breast...External...findings,stage the lump clinically,triple assessment,treatment options,breast conservation surgery,breast problems in lactating mothers.

table vviva in east surgery externalaskd me to identify prolene n silk dono k characters uses which 1 is better, monofilament konsa hota hai. examine axillary nerve, findings, causes of axillary nerve damage, agr pt emergency my aye wid fracture humerus u cant check movemnt, how will u assess injury 2 axillary nerve? check sensations. wat is septicemial its causes?

short case wid dr khawja: xray of small gut obstuction showing multiple air fliuid levels cause of smalll gut obstructuon. complications of mng, is mey konsa cancer hota hai? gut ke strangulation k kya consequences hoty hai?

KJ

asked about appendisectomy,complications.table viva with external, specimen was of MNG where is the upper lobe of gland in specimen.LONG CASE of varicose vein with external history,findings on legs,do trendelenburg test,tretment,which nerve run with long saphenous,pre op preparation of patient.best of lucck to all 

operative surgery being asked by KJ n external....thy have weird things like staplers used in haemorrhoidectomy n laproscopic weird instrumnts...bt if u cnt answer that they will jump to xray which is usually very easy...so kj is all luck esp for girls... ;p

Two table vivas in KJ ward ( pyloric stenosis X day askd by Kj) foley askd by EXTERNAL 

sir KJs short cases: bilateral painful parotid swelling in a middle aged ladypara umblical herniaganglionthyroid swellingnobdy sees u do the short cases there they just want the findings,DD,Rx

Gondal

TAble viva...Dr.Gondal,radical neck dissection,incision?,papillary ca treatment,follow up and management f recurrence. 

examine right axilla,examine neck(nodule),fungating cancer of L lump long case(DR NAQI N DR GONDAL both took seperately) 

TWO TABLE VIVAS IN SSW (EXTERNAL ASKD RENAL CA SPECIMEN) GONDAL ASKD GALL BLADDER N CHOLECYSTECTOMY>>>>>mainly unit two n four r chillllllllll>>>>>>

dr gondal had nothing except peanuts on his table n read ward cards n asked from one of the cases written on it...External had gross models like breat n RCC n galbladder.. Identify n name tumors.

how much volum or pressur of CO2 ?

ts 12-15 mm of Hg... if pressure is raised more than 20 mm then it leads to abdominal hypertension comprising blood supply of abdominal visceras!

Externals :

Long case...paraumblical hernia...External...examine the patient,treatment options,type of mesh repair in the patient,predisposing factors...differential diagnosis

External:Case was Parotid CA. Then qs abt GB stones, clinical diff b/w biliary colic and acute cholecystitis, facial nerve branches, pes anserina

askd me to identify prolene n silk dono k characters uses which 1 is better, monofilament konsa hota hai. examine axillary nerve, findings, causes of axillary nerve damage, agr pt emergency my aye wid fracture humerus u cant check movemnt, how will u assess injury 2 axillary nerve? check sensations. wat is septicemial its causes?

With Dr. ZafarSHORT CASE:Rt indirect inguinal hernia.why it is hernia? why not lymph node (mine was very bad with him)TABLE VIVA:instruments (i had never seen those instruments)So, it was again bad with him.

With external, instruments! Kochers ko kocherz kyun kehte hain? (lo g, koe b'tlao k hum b'tlayen kia :0 ) wotz kochers sign n maneovre. Then hernia exam. Hw 2 diff b/w hernia n lymph node. (u cn get above evry sweling excpt hernia) 

external was asking renal cell ca nd other tumors of kidney..nd where does transitional epithelium found?

dysphagia is an imp n rather a common long case found in our wards...diagnosis based on history n history n lesser on examination...so following questions can be memorized in the following way that can make it easy to remember...M...meals full or partialN...nature...(constant or intermittent)

O....onset(gradual or sudden)P....progression ( same/worse/better)p...pain present or notQ...quality ( of food which is associated eg solids or liquids)R....regurgitates or notS...settlement...meaning to point out where the food gets stuck..T...time since onset U....V...vomit or notW...weight loss... :)))

Table viva (external south surgical)what is pseudoaneurysm what are its causes and treatment?what is DVT?Its treatment for how long do you give heparinLong Viva dr gondal Indirect inguinal hernia

why is it a hernia?treatment optionswhatis richters and littres hernia?

SHORT CASE IN NORTH '''~WITH EXTERNAL pt had breast CA ,asked findings,staging,investigations,treatment,then showed specimen of mng n asked symptoms,treatment,complications of thyroidectomy,anatomy of recurrent laryngeal nerve,how will u identify n save it 

'''''''''TABLE VIVA IN EAST''''''~WITH EXTERNAL FROM SIMSprocedure of suprapubic systostomy in extreme detail....how will u differetiate between bladder n peritoneum,stray suture 

~WITH SIR KHAWAJA AZEEMshowed specimen of gangrenous appendix,asked its pathophysiology,complications 

''''''''''LONG CASE WITH EXTERNAL''''''''''pt has toxic diffuse goitre ,listened to history,demonstrate the positive findings in ur patient ,why diarrhoea occurs in hyperthyroidism,treatment with doses,how will u follow up ,what will u monitor while giving neomercazole (TLC),how will u cum to know that neomercazole is working or not ,why u dont operate n what wil happen if u operate ,how can the pt die on ot table ?

SOUTH SHORT CASE N WEST LONG CASE

as my short case was of cervical lymphadenopathy..sir cheema asked about its differentials....how will u investigatee.....if its because of tb how will u treat..name the drugs for how long....identify cvp line ,,,its uses.....how will u recognise shock...short case with external was of parotid,,,he listened to examination...its dd definite diagmosis investigations findings on fnac...then details of parotidectomy.almost everything...konsi artery preserve karte hen... n table viva me.t tube cholangiogram uspe points mark hue hue the us pe comment karna tha ...plus air under diaphgram,,..he asked me to mark diaghram n stomach on the xray....dilated cbd why<<stone treatment ...cholangiocarcinoma treat ment........long case was with dr,haroon.....he is very sweet...my long case was of appendicular mass,,,ochner sherren regime....when will u do appendicectomy in this case...treatmenet of appendicular abcess...steps of appendicectomy..in viva he asked to identify spleen(although he told me earlier ke left hypochondriun ka solid organ:P)splenomegaly ke causes portal htn ki manifestations...varices ki treatment....tracheostomy tube uses...suction drain uses.....

28th jan! south west combo!

osce: xray volulus. Rx? 2. Xray gas under diaphragm. Rx? 3. Xray of person with chest trauma..prolly hemothorax. Q indications of thoracotomy. 4. scenario of hydatid cyst . complications. 5.vicryl. properties? use? 6. CBD stone.question complications of ercp 7. picture of ulcer on site of 20 yr old burn. marjolin. diagnose n what investigation to confirm it. 8. scenario: tibial fracture 1 day back n now presents with ischemic calf signs. diagnose? how cud it be prevented. 9.gastric oultel obstruction barium. what metabolic changes occur. 10. xray of foreign body inhalation. threatment. 11.hemrhoids. picture. treatment. 12. tracheostomy tube pic. indications and complications 12. pic of midline abdominal incision. indication . write 5 more abdominal incisions. 13.picture of humbeys knife. use? 14.scenario of appendicular mass and it treatment. 15.?

short case: examine insisional hernia . peri umblical hernia . solitary nodule thyroid. submandibular gland. viva sir Gondal: xray t tube cholangiogram. 2 Double J stent in ureter. simple questions on CA thyroid. external: instruments n their sterlization. long case: CA breast. general questions abt staging treatment MRM sentinel lymph node biopsy etc. there were cases of hemrhoids testicular CA. fibroadenoma etc