South Surgery Ward Test Guide

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OSCE Questions

1.A young boy comes with Hx of fever,vomiting and pain in right Iliac fossa.On exam,there's a palpable mass in RIF. Dx? appendicular  Rx? Conservative management.

2.A farmer comes with C/O mass Right Hypochonrdrium.Dx? Hydatid Cyst Rx ?

Medical : 1.Albendazole/mebendazol 2.PAIR

Surgical : 1.Deroofing of cyst and evacuation of contents 2.Excision of cyst 3.Liver resection

3.10y old boy with C/o cynosis & stridor. X-rays shows a round foreign body in trachea.Dx? Foreign body in trachea  Rx?

4.A poor quality picture of Stapplers.Use ? to close skin incision
(note by McFearless: The stapler pictured above is used for gastrointestinal anastomosis. )
Skin stapler is smaller in size and usually used for closing skin  as it is faster and easier than stitches. 

5.60 y old male C/O pain lower abdomen +vomiting.Xray shows Omega sign.
Dx? Sigmoid volvulus.
Rx?
1. Resuscitation with IV fluids and N.G decompression 

2.Sigmoidoscopy may untwist the gut and give temporary relief

3. If step 2 fails, laprotomy (read details from doggar)

6.Xray of air under the diaphragm, causes and management ?

1.resuscitate with iv fluids and NG decompression

2.Grams Repair
3.Peritoneal lavage

7.Name the incision shown below

It's umblicus sparing midline abdominal incision

Name five other abdominal incisions

1.Pfannenstial incision for c-section

2.kocher's incison for cholecystectomy

3.Rutherford Morrison's incision for appendectomy

4.Paramedian incision

5.Lanz incision for appendectomy

8.Name the instrument and give complications

It's Endotracheal tube.

9.A 30 y old pregnant woman presents with painless bleeding from a bluish mass coming out of rectum .Dx ? (hammerrhoids/rectal prolapse?)

10.Xray of hemo-pneumo thorax and management?

Note the absence of lung markings on lateral side of middle and upper zones of
Right lung.It is due to pneumothroax.And opacity over lower zone of Right lung due to
hemothorax.

Rx: 2 chest tubes may be preferred, with the tube draining the pneumothorax placed in a more superior and anterior position.

11.Man had a tibia fracture which was managed by closed reduction.Now the patient has developed calf tenderness.Dx: ? Acute limb ischemia or venous thrombosis. Management ?

12.Xray abdomen showing stones in gall bladder. (on Xray gall stones have radio-opaque margins and radio-lucent centers).Question was what are the causes of dilated CBD?

1.Stones in bile duct 2.Biliary strictures 3.peri-ampullary carcinoma

13.A clinical scenario of Marjolin Ulcer

14.Vicryl suture and properties

15.A girl with c/o vomiting and h/o corrosive intake.X-ray shows gastric outlet obstruction. Management? What is paradoxial aciduria ?

Short Cases:

Previous batches were given cases of MNG, abdominal hernia or varicose veins.Sir Imran says students should follow the protocol of mutual introduction and consent in short case too.Just make sure you ask the name of the patient.