GENERAL SURGERY 2019-20

GENERAL SURGERY -Syllabus

1) Fluid, Electrolyte and Acid-Base disturbances – diagnosis and management. Nutrition in the surgical patient. Wound healing – basic process involved
in wound repair, basic phases in the healing process, clinical management of wounds, factors affecting wound healing. Scars – types and treatment.
Hemostasis – components, hemostatic disorders, factors affecting bleeding during surgery. Transfusion therapy in surgery – blood components,
complications of transfusion. Surgical Infections; General Post – Operative Complications and its management [6Hours].

i. Reasons for Surgery: Types of anesthesia and its effects on the patient; Types of Incisions; Clips Ligatures andsutures; General Thoracic Procedures –
Radiologic Diagnostic procedures, Endoscopy – types, Biopsy – uses and types. Overview and Drainage systems and tubes used in Surgery.[3Hours].

ii. Causes, Clinical Presentation, Diagnosis and treatment of the following Thoracic Trauma situations – Airway obstruction, Pneumothorax,
Hemothorax, Cardiac Tamponade, Tracheobronchial disruption, Aortic disruption, Diaphragmatic disruption, Esophageal disruption, Cardiac and
Pulmonary Contusions. [4Hours].

iii. Surgical Oncology – Cancer – definition, types, clinical manifestations of cancer, Staging of Cancer, surgicalprocedures involved in the management
of cancer. [3Hours].

. 2) Disorders of the Chest Wall, Lung and Mediastinum – Definition, Clinical features, diagnosis and choice of management for the following disorders
– chest wall deformities, chest wall tumors, Spontaneous Pneumothorax, Pleural Effusion, Empyema Thoracis, Lung abscess, Bronchiectasis,
Tuberculosis, Bronchogenic Carcinoma, Bronchial Adenomas, Metastatic tumors of the Lung, tracheal Stenosis, Congenital tracheomalacia,
Neoplasms of the trachea, Lesions of the Mediastinum. Carcinoma of the female breast. [5Hours].

. 3) Disorders of the Heart – Definition, Clinical features, diagnosis and choice of management for the following disorders: Congenital Heart diseases –
Acyanotic congenital heart disease & Cyanotic congenital heart disease: Patent DuctusArteriosus, Coarctation of Aorta, Atrial Septal Defect,
Ventricular Septal Defect, Tetralogy of Fallot, Transposition of GreatVessels. Acquired Heart Disease – Mitral Stenosis & Insufficiency, Aortic
Stenosis and Insufficiency, Ischemic Heart Disease – Coronary Artery Disease, Cardiac tumors. [6 Hours]

4) Thoracic surgeries – Thoracotomy – Definition, Types of Incisions with emphasis to the site of incision, muscles cut and complications. Lung
surgeries:Pnuemonectomy, Lobectomy, segmentectomy – Indications, Physiological changes and Complications; Thoracoplasty, Pleurectomy,
Pleurodesis and Decortication of the Lung. Cardiac surgeries – An overview of the Cardio-Pulmonary Bypass Machine– Extracardiac Operations,
Closed Heart surgery, Open Heart surgery. Transplant Surgery – Heart, Lung and Kidney – Indications,

Physiological changes and Complications. [6 Hours]

. 5) Diseases of the Arteries and Veins : Definition, Etiology, Clinical features, signs and symptoms, complications, management and treatment of
following diseases : Arteriosclerosis, Atherosclerosis, Aneurysm, Buerger’s disease, Raynaud’s Disease, Thrombophlebitis, Deep Vein
Thrombosis, Pulmonary Embolism, Varicose Veins. [5Hours]

. 6) Definition, Indication, Incision, Physiological changes and Complications following Common operations like Cholecystectomy, Colostomy,
Ileostomy, Gastrectomy, Hernias, Appendicectomy Mastectomy, Nephrectomy, Prostectomy. [4Hours]
. 7) Burn: Definition, Classification, Causes, Prevention, Pathological changes, Complications, Clinical Features and Management. Skin Grafts – Types,
Grafting Procedures, Survival of Skin Graft ; Flaps – Types and uses of Flaps. [4Hours]

. 8) Women’s Health: Menstrual cycle and its disorders. Hormonal disorders of females-obesity and female hormones. Cancer of the female
reproductive organs-management Infections and sexually transmitted disease in female Menopause - its effects on emotions and
musculoskeletal system. Malnutrition and deficiencies in females. Sterility: patho- physiologyinvestigations-management. Maternal physiology in
pregnancy. Musculo skeletal disorders during pregnancy. Prenatal complications-investigations- management. Child birth- Stages - complications-
investigations-management – Pain relief in labour - Purperium - Post Natal care. Surgical procedures involving child birth. Incontinence – Types,
Causes, Assessment and Management. Definition, Indications and Management of the following surgical procedures – Hysterosalphyngography,
Dilatation and Curettage, Laproscopy, Colposopy, Hysterectomy. [8Hours]

. 9) ENT: Common problems of ear, otitis media, Otosclerosis, functional achonia and deafness, management facial palsy classification, medical and
surgical management of lower motor neuron type of facial palsy. [3Hours]

10) Ophthalmology: Ophthalmologic surgical conditions, refraction’s, conjunctivitis, glaucoma, corneal ulcer, iritis, cataract, retinitis, detachment of
retina, defects of extra-ocular musclessurgicalmanagement[3Hours]

Recommended books:

1. General Surgical Operations – by Kirk /Williamson

2. Surgery byNan

3. Bailey and Love’s – Short Practice ofSurgery

4. Chest Disease by Crofton andDouglas. 5. Patrica A Downie, Text book of Heart, Chest Vascular Disease for physiotherapists, JPBros.

MODULE I

Learning objectives- at the end of the lesson, the student Books with page numbers
Unit No. Name of lesson
must be able to..

Fluid, Electrolyte and Acid-Base 1.Current Surgical diagnosis

Identify abnormalities in fluid, electrolyte and acid base
Unit 1 disturbances – diagnosis and &treatment
balances and mention the treatment Pages: 34 to 47
management
2.Fundamentals of Ear, Nose &
Nutrition in the surgical Mention different modes of nutrition in a patient Throat disease including neck
Unit 2
patient. undergoing surgery surgery
pages:112 to 123
Identify processes involved in wound repair, process, 3.Textbook of Surgery pg 213to
Unit 3 Wound healing clinical management of wounds, factors affecting wound 243
healing

Scars
Unit 4 Explain types of scars and their management

Hemostasis – components, Identify the components of hemostatic disorders, mention

Unit 5
hemostatic disorders the factors affecting bleeding during surgery.
Unit 6 Blood transfusion therapy Mention the blood components and the complications of
transfusion.
Highlight different surgical infections and their
Unit 7 Surgical infections
management

General Post - Operative

Unit 8 Complications and its Mention complications of surgery and management
management
Important questions

1. Blood grouping and crossmatching.

2. How to prevent crossinfection?

3. Epistaxis.

4. Process involved in woundrepair.

5. Dehydration.

6. Complications of bloodtransfusion.

7. Factors affecting bleeding duringsurgery.

8. General post-operativecomplications.

9. Typesofscar.

10.Secondary intention of woundhealing.

MODULE II

Learning objectives- at the end of the lesson, the 1.Textbook of Surgery

Unit No. Name of lesson
student must be able to Pages 34-54
2.Short Cases in Surgery
Unit 1 Indications for surgery Mention indications for surgery pages 43 to 52
3.Bailey & Love’s Short Practice of Surgery
Types of anesthesia and its effects Identify different types of anesthesia used for 154 to 156
Unit 2
on the patient surgery and their effects on patient

Types of Incisions, Clips Ligatures Mention different types of incisions, ligatures and
Unit 3
and Sutures sutures used in surgery
General Thoracic&Radiologic Mention different thoracic and diagnostic radiologic
Unit 4
Diagnostic Procedures procedures done

Unit 6 Endoscopy – types Explain what is endoscopy and its types

Unit 7 Biopsy – uses and types Explain what is biopsy, different types and their uses

Overview and Drainage systems and Mention different drainage systems and tubes used
Unit 8
tubes used in Surgery during surgery
.

Important questions

1. Drainagetubes.

2. Anterior abdominal wallincisions.

3. What are the incisions used in thoracotomy? Explain any oneindetail.

4. Indications ofbronchoscopy.

5. Biopsy- types anduses.

6. Transverse abdominal incisions- advantages anddisadvantages.

7. Typesofanesthesia.

8. Indications oflaparoscopy.
MODULE III

Unit Books with page numbers:

Name of lesson Objective
No.

Manipal Manual Of Surgery

Unit 1 Pnemothorax
Pages: 213 to 243
Textbook of Surgery
Unit 2 Haemothorax 111 to 123
At the end of each module, the
Unit 3 Cardiac tamponade student must be able to identify the
causes, clinical features, diagnosis and
Unit 4 Trachea bronchial disruption treatment of the following thoracic
trauma and airway obstructions-
Aortic obstruction
Unit 5

Unit 6 Diaphragmatic obstruction

Unit 7 Esophageal obstruction

 Cardiac & pulmonary contusion
Unit 8

Important questions

1. What is diaphragmaticdisruption?

2. Cardiactamponade.

3. Esophagealdisruption.
MODULE IV

SURGICAL ONCOLOGY

Unit No. Name of lesson Books with page numbers

Unit 1 Cancer- definition & types 1.Post Graduate Mediacal Admission

Unit 2 Cancer- clinical manifestations
Unit 3 Staging of cancer
Surgical procedures involved in
Unit 4 management of cancer
Test (TUMORS)
Learning objectives- at the end of the lesson, the
page numbers: 111 to 143
student must be able to Define cancer, mention
2.Physical Diagnosis Secrets
its types Mention the clinical manifestations of page numbers: 213 to 223
cancer Explain how to stage cancer Explain 3.Principles of Physiotherapy in
surgical procedures done in treatment of cancer General Medical and Surgical
Conditions.
Page numbers: 223 to 243

Important questions

. Staging and management ofcancer.

. TNM staging of lungcancer.

MODULE V

DISORDERS OF CHEST WALL, LUNG AND MEDIASTINUM

Unit No.
Name of lesson Objective Books

Unit 1 Chest wall tumors 1.Post Graduate Mediacal

Admission Test (TUMORS)
Spontaneous Pneumothorax, Pleural Page 23 to 112
Unit 2
Effusion, Empyema Thoracis 2.Physical Diagnosis Secrets
page 24 to 234
Unit 3 Lung abscess 3.Principles of Physiotherapy
in General Medical and
Unit 4 Bronchiectasis
Surgical Conditions.
Page: 113 to 134
Unit 5 Tuberculosis

Bronchogenic Carcinoma, Carcinoma of

Unit 6
the female breast

Unit 7 Bronchial Adenomas, Metastatic tumors

 of the Lung

Tracheal Stenosis, Neoplasms of the

Unit 8
trachea

Unit 9 Congenital tracheomalacia

Lesions of the Mediastinum

Unit 10

Important questions

1. What is cold abscess? How will you manage Tuberculosis lymphadenitis inneck?

2. Lungabscess.

3.Tracheostomy.

4..Pneumothorax.

5.Bronchiectasis.

6.Empyemathoracis.
7.Carcinoma of femalebreast.

8.Pleuraleffusion.

9.Chest walldeformities.

MODULE VI

At the end of each unit, the student must be able to define, mention clinical features, diagnosis and different treatments for the following heart
disorders

Unit No. Name of lesson Objective Books

Unit 1 Patent ductusarteriosus, Coarctation of aorta

1.Symptoms and Signs of Surgical
Unit 2 Atrial Septal Defect, Ventricular Septal Defect Diseases
Pages: 221 to 243
Unit 3 Tetrology of Fallot, Transposition of Great Vessels 2.Bedside Clinics in Surgery
pages: 156 to 167
Unit 4 Mitral Stenosis & Insufficiency 3.A Concise Textbook Of Surgery
Pages: 123 to 143
Unit 5 Aortic Stenosis and Insufficiency

Unit 6 Ischemic Heart Disease – Coronary Artery Disease, Cardiac tumors

Important questions

1.Ludwig’sangina.

2..Classify congenital heart disease and write about clinical features and management of tetralogy offallot.

3.Coronary artery disease and itsmanagement.

4.What are the clinical features of mitral stenosis? Write an essay on management of valvulardisorders.

5.ASD.
MODULE VII

Unit
Name of lesson Objective Books
No.

Unit 1 Thoracotomy, Thoracoplasty

At the end of each unit, the
Pnuemonectomy, Lobectomy, student must be able to define,
Unit 2
segmentectomy mention different types of
incisions used, indications,
physiological changes and
complications of thoracic and
Pleurectomy, Pleurodesis and lung surgeries
Unit 3 Decortication
1.Bedside Clinics in Surgery
Pgs: 34 to 67
2. A Concise Textbook Of Surgery
Pgs: 77 to 113
3.Principles of Physiotherapy in General
Medical and Surgical Conditions.

Learning objectives - At the end

An overview of the Cardio-Pulmonary
Unit 4
Bypass Machine
Extra cardiac Operations, Closed
Unit 5
Heart surgery, Open Heart surgery
of each lesson, the student must
be able toExplain what is a cardio
pulmonary by pass machine
Mention types of heart surgeries
and their complicatio
 Transplant Surgery – Heart, Lung and
Kidney – Indications, Physiological
Unit 6 changes and Complications.

Important questions

1. What is CABG? Give the indications and Contra indications ofCABG.

2. ABC ofresuscitation.

3. Indications, physiological changes and complications oflobectomy.

4. Pleurodesis.

5. Decortications.

6. Segmentectomy.

7. Pleurectomy.
MODULE VIII

Unit
Name of lesson Objective Books
No.

Unit 1 Arteriosclerosis, Atherosclerosis 1.Belcher’s Thoracic Surgical

Management
Unit 2 Buerger’s disease, Raynaud’s Disease At the end of each unit,
the student must be able Pgs: 111 to 143
Unit 3 Thrombophlebitis, Deep Vein Thrombosis to define, mention clinical
2. Textbook of Surgery
features, complications
and management of pgs:45 to 87
following diseases
Unit 4 Pulmonary Embolism, Varicose Veins, Aneurysm 3.Current Surgical diagnosis
&treatment

Pgs: 67 to 89

Important questions

1. Deep veinthrombosis.

2. Varicoseveins.

3. Aneurysm.
 4. Buerger’sdisease.

5. Etiology and pathogenesis ofatherosclerosis.

6. Classify Peripheral vascular disease and write in detail about thromboangitisobliterans(TAO).

MODULE IX

Books and Page numbers:

1.Textbook of Surgery
Unit No. Name of lesson Objective Pages: 24 to 77
2. Current Surgical diagnosis
Unit 1 Cholecystectomy, Colostomy, Ileostomy, &treatment
pgs : 48 to 79
Gastrectomy, Appendicectomy At the end of each unit, the student must
Unit 2 be able to define, mention indications,
types of incision, physiological changes
and complications of following surgeries
Unit 3 Hernias, Mastectomy,

Nephrectomy, Prostectomy
Unit 4
Important questions

1. Explain procedure and complications ofCholecystectomy.

2. Mention different types of hernia and theirmanagement.

3. Describe anatomy of cervical inguinal canal and management of inguinalhernia.

4. Write aboutdefinition, indications, incision, physiological changes and complications following nephrectomy.

5. Explain the indications for appendicectomy. Mention thecomplications.

6. What is mastectomy? Explain procedure andcomplications.

7. Prolapsedrectum.

8. Episiotomy.

9. Gastrectomy.

10.Colonoscopy.

11. Endometriosis.
12.Write briefly about clinical features, pathology and management ofBPH

13.Fistula.

14.Colostomy.

15.Mastectomy.

16.Gallstones

17.Umbilicalhernia.

MODULE X

Unit No. Name of lesson Learning objectives- at the Books with page numbers:
end of each lesson, the
student must be able to 1.Belcher’s Thoracic Surgical Management
Burns Pgs: 34 to 58
Unit 1
2. Textbook of Surgery
define, classify, mention Pgs:112 to 143
causes,
Unit 2 Burns
3. Manipal Manual Of Surgery
prevention, clinical features
Pgs:34 to 58
and management of burns
Unit 3 Skin Grafts
 Mention types, grafting 4. Basic Principles and Techniques of Plastic Surgery.
procedures Pgs:56 to 87
Unit 4 Skin grafts
Survival of Skin Graft

Mention different types

Unit 5 Flaps
and uses of Flaps

Important questions

1. What is a burn? Classify burns and mention the management ofburns.

2. Explain about different types of skingrafts.
3. Describe the management of 30%burns.
4. Cleftlip.
5. Facialburns.
6. Wallace’s rule ofnine.
7. What is ashock?
8. What is meshedskin?
9. What is full thickness burn and how do youidentify?
10.Myocutaneousflaps.
11.Marjolinsulcer.
 12.Types of skingraft.
13.Describe clinical features, investigations and management of peptic ulcerdisease.
14.Autograft.
15.Sebaceouscyst.

MODULE XI- WOMEN’S HEALTH

Learning objectives- at the end of each lesson, Books with page numbers:
Name of lesson
the student must be able to

Unit 1 Menstrual cycle and its disorders
Hormonal disorders of females-
Unit 2
obesity and female hormones
Cancer of the female
Unit 3
reproductive organs
Explain menstrual cycle and its disorders, their 1.Principles of Physiotherapy in General Medical
management Conditions.
Pg: 34 to 56
2. Basic Principles and Techniques of Plastic Surgery.
Highlight hormonal disorders in females
Pg: 111 to 143
3..Manipal Manual Of Surgery
Mention causes, clinical features and Pgs: 38 to 64
management of cancer of female reproductive
organs

Unit 4 Infections and sexually Mention infections, clinical features and

transmitted disease in female management of sexually transmitted diseases
 Mention effects its effects on emotions and
Unit 5 Menopause
musculoskeletal system

Unit 6 Malnutrition and deficiencies in Explain malnutrition and other deficiencies in

females females

Define what is sterility, mention the patho

Unit 7 Sterility
physiology investigations and its management

Maternal physiology in Mention the physiological changes occurring in

Unit 8 pregnancy pregnancy

Musculo skeletal disorders Mention the common musculo skeletal disorders

Unit 9
during pregnancy in pregnancy

Prenatal complications- Mention common prenatal complications ad

Unit 10
investigations- management management

Child birth- Stages - complications-investigations- Explain the different stages and complications of child birth
Unit 11
management and the management
 Pain relief in labour - Purperium Explain mechanism of pain relief during labour
Unit 12

Unit 13 Post Natal care Mention post natal care

Mention different surgical procedures, indications and

Unit 14 Surgical procedures involving child birth
complications in child birth

Define what is incontinence, mention types, causes,

Unit 15 Incontinence
assessment and management of incontinence

Explain procedures of hysterosalphyngography, dilatation

Unit 16 Hysterosalphyngography, Dilatation and Curettage
and curettage

Laproscopy, Colposopy, Hysterectomy Explain procedures of Laproscopy, Colposopy, Hysterectomy

Unit 17

Important questions

1. Pelvic floorexercises.

2. Stress incontinence and itsmanagement.

3. Write a note on maternal changes ofpregnancy.

4. Describe incontinence under definition, types, causes, assessmentandmanagement.

5. Obesity.

6. Complications of multiple childbirths.

7. IUCD.

8. Menorrhagia.

9. Hysterectomy.

10.Hysterosalphyngography.

11.Causes of haematuriaandmanagement.

12.Medical termination ofpregnancy.

13.Lactation.

14.Sterility.

15.Effects of menopause on musculoskeletalsystem.

MODULE XII- ENT

Unit No. Name of lesson Objective Books with page numbers:

1.Textbook of Ear, Nose & Throat.

Unit 1 Otitis media
At the end of each unit, the Pgs: 34 to 56
student must be able to
Unit 2 Otosclerosis identify common problems of 2.A Short textbook of ENT Diseases
ear, classification and Pgs: 45 to 67
Unit 3 Functional achonia and deafness management of 3.Ear, Nose, Throat Disease
Pgs: 48 to 98
4.ENT Secrets
Unit 4 Facial palsy
Pgs:113 to 143

Important questions

1. Classify otitis media and mention itsmanagement.

2. What is functionalachonia?

3. What is facial palsy? Mention clinical features and management of upper and lower motor neuron type of facialpalsy.

4. Sinusitis.
 5. Otosclerosis.

6. Deafness andmanagement.

7. Otomyosis.

8. Chronic otitismedia.

MODULE XIII - OPHTHALMOLOGY

Unit No. Name of lesson Objective Bokksa with page numbers:

Unit 1 refractions, conjunctivitis, cataract 1.Manipal Manual Of Surgery

Page numbers: 234 to 246
Unit 2 glaucoma, corneal ulcer 2.Textbook of Surgery
. At the end of each unit, the
ENT Secrets
Unit 3 iritis, retinitis, detachment of retina student must be able to
Page numbers: 111 to 143
explain the following 3.Belcher’s Thoracic Surgical Management
defects of extra-ocular muscles surgical conditions and their
Unit 4 116 to 145
management- 4.A Short textbook of ENT Diseases
management
Ear, Nose, Throat Disease
Page numbers:34 to 56
Important questions

1. Defineconjunctivitis.

2. Define cataract. Management ofcataract.

3. Mention defects of extra ocularmuscles.

4. Glaucoma and itsmanagement.

5. Ptosis and itsmanagement.

6. Retinitis.

7. Cornealulcer.

. Define lung abscess? Discuss in detail the clinical features, diagnosis and choice of management of the same
. 1. Write an essay on abdominalincisions
. 2. Define and classify burns. Describe the management of 30% thermalburns
. 3. Management of facial palsy and itstypes