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Times General Surgery I

Essays - General Surgery

*What are the types of/classify haemorrhage (2). Describe in
detail the aetiology, clinical features, investigations and
management (3) of haemorrhagic (hypovolemic) shock.
*Define (2) and classify (2) shock. Describe the pathogenesis,
clinical features and management (2) of septic shock.
8 *Define (2) and classify (2) (the various types of) shock. Describe ● ● ● ● ● ● ● ●
the aetiology, pathogenesis/pathophysiology, clinical features (2)
and management (2) of hypovolemic shock.
*Define shock. Classify the various aetiological factors causing
shock. Describe the clinical features, investigations and
management of hypovolemic shock.
Describe/discuss the aetiology, clinical features (3),
3 investigations/diagnosis and management (2)/treatment of ● ● ●
tetanus.
*Define haemorrhagic shock. Discuss various methods of
haemostasis. Discuss indications for and complications of blood
transfusions.
2
*What are the indications for blood transfusion? Mention the
● ●
various complications of blood transfusion. Add a note on fresh
frozen plasma.
*Classify burns. Describe the management of burns.
2
*Discuss the management of an adult with 50% burns.
● ●
Explain the aetiopathology, clinical features, investigations and
1
treatment of early breast carcinoma.
●
Classify tumours of the salivary glands. Describe the pathology,
1 clinical features, investigations and treatment of pleomorphic ●
adenoma.
Describe the aetiology, clinical features and management of
1
carcinoma rectum.
●
Cases - General Surgery
 *40-year-old lady weighing 52 kg sustained burn injuries
extensively over the chest, back and abdominal wall.
a) Give an account of the assessment of the burn area and the
pathophysiology of burn injury.
b) How will you resuscitate this patient and manage the burn
wound? (2)
3 ● ● ●
*40-year-old lady weighing 50 kg tried to self-immolate herself by
pouring kerosene. She did not succeed and sustained burn
injuries.
a) How will you calculate the burnt surface area of the body?
b) Explain the management if she has 50% mixed thermal burns.
*30-year-old male sustains multiple injuries in a road traffic
accident and is brought to the emergency room.
O/E: Conscious (GCS - 13/15).
Multiple lacerations over the extremities and abdominal
distension.
Vitals: Pulse - 130/min, BP - 80/?, RR - 20/min.
Sweating profusely with cold extremities.
a) What are the types of haemorrhage? [2 marks]
b) Define and classify shock. [3 marks]
c) Describe the clinical features and management of a patient
2 with hypovolemic shock. [10 marks] ● ●
*65-year-old diabetic presents to the emergency department.
H/O: Swelling over nape of neck for 5-6 days associated with
pain, now discharging pus.
O/E: Temperature - 101°F (Febrile), Pulse - 126/min, BP - 80/?.
a) What type of shock is this patient suffering from
b) Define and classify shock.
c) Describe the aetiology, pathophysiology, clinical features and
management of septic shock.
d) Add a note on SIRS and MODS.
 *22-year old lady.
H/O: Insomnia, weight loss, heat intolerance and diarrhoea.
O/E: Tachycardia and a diffuse swelling over the anterior aspect
2 of neck. ● ●
a) What is your diagnosis?
b) Describe the aetiology, pathophysiology, clinical features and
treatment of this condition.
*55-year-old male presents with a slow-growing swelling below
and behind his left ear of 6 years duration.
a) Enumerate the differential diagnoses.
1
b) Classify tumour of the salivary glands.
●
c) Describe the pathology, clinical features, investigations and
treatment of pleomorphic adenoma.
*45-year-old woman presents with a lump in the breast, of 2
1 months duration. ●
Discuss the differential diagnosis and management.
Essays - Orthopaedics
*Describe/discuss the classification, clinical features (3)/clinical
presentation, radiological features, complications (3) and
management (4) of fracture of neck of femur in adults/in a 60-
year-old female (in the elderly).
6
*Describe the mechanism, clinical features and management of
● ● ● ● ● ●
intracapsular fracture of neck of femur.
*Classify supracondylar fracture of femur and describe its clinical
features, treatment and complications.
*Describe the classification, clinical features, complications and
management of supracondylar fracture of humerus in children.
(3)
*Describe/explain the mechanism of injury, clinical features (2),
6
investigations and management (2) of supracondylar fracture of
● ● ● ● ● ●
humerus.
*Discuss the clinical features, diagnosis and different treatment
modalities for fracture of shaft of humerus in an adult.
 *Classify bone tumours. Explain/discuss the clinical features and
management of osteosarcoma of distal end of femur. (2)
3
*Classify bone tumours. Describe in detail the clinical features
● ● ●
and management of osteoclastoma.
*Define Colles' fracture. Describe the clinical features,
management and complications of Colles' fracture. (2)
3 *Discuss the differential diagnosis of fractures that occur due to ● ● ●
fall on an outstretched hand. Describe the management of any
one of them.
Describe the aetiology, pathology, investigations, differential
1
diagnosis and treatment of acute osteomyelitis.
●
Describe the aetiology, classification, pathological anatomy,
1
clinical features and treatment of club foot.
●
Describe the clinical features, radiological findings and
1
management of dislocation of the shoulder.
●
Describe the pathogenesis, clinical features, diagnosis and
1
management of tuberculosis of spine.
●
Cases - Orthopaedics
*16-year-old boy/13-year-old girl presents with a swelling in the
region of distal part of femur, of 2 months duration.
O/E: Ill-defined mass fixed to the bone.
3 a) What are the differential diagnoses? ● ● ●
b) What are the clinical and radiological features of
osteosarcoma?
c) What are the principles of management of osteosarcoma?
*72-year-old lady sustained a fall on her outstretched hand and
developed a wrist swelling.
1 a) Enumerate the differential diagnosis. ●
b) Describe in detail the clinical features, management and
complications of Colles' fracture.
*80-year-old lady had a fall in the bathroom and sustained a
fracture of neck of femur on the right side.
1
Describe the clinical features, investigations and treatment of
●
fracture of neck of femur.
Short Notes - General Surgery
 *Subdural hematoma/haemorrhage
*Extradural hematoma (6)
10 *Types of intracranial hematoma with a brief note on lucid ● ● ● ● ● ● ● ● ● ●
interval
*Lucid interval
*Gas gangrene (4):
8 - Clinical features (2) ● ● ● ● ● ● ● ●
- Management (2)
*Electrical burns (4)
- Management (2)
8
*Assessment of burn wound
● ● ● ● ● ● ● ●
*Assessment of depth of burns
*Carbuncle (3)
*Dermoid cyst (2)
8
*Cold abscess (2)
● ● ● ● ● ● ● ●
*Cold abscess in the neck
*Pleomorphic adenoma
*Pre-malignant lesions of the oral cavity (2)
8 *Warthin tumour (2) ● ● ● ● ● ● ● ●
*Ranula (2)
*Epulis
*Basal cell carcinoma (2)
*Rodent ulcer (basal cell carcinoma) (2)
6
*Marjolin's ulcer
● ● ● ● ● ●
*Pre-malignant lesions of skin cancer
*Indications of nutritional support and complications of total
parenteral nutrition (TPN)
6
*(Total) (par)enteral nutrition (1):
● ● ● ● ● ●
- Complications (3)
*Tetanus (tetany) (2):
5 - Clinical features (3) ● ● ● ● ●
- Management (2)
3 Glasgow coma scale ● ● ●
*Types of haemorrhage
3 *Septic shock ● ● ●
*Hypovolemic shock
 *Hydatid cyst (2)
3
*Hepatic hydatid disease
● ● ●
3 Thyroglossal cyst ● ● ●
*Complications of blood transfusion
3 *Blood transfusion and its complications ● ● ●
*Fresh frozen plasma
3 Keloid(s) ● ● ●
2 Tubercular/Tuberculous lymphadenitis ● ●
2 Skin grafting ● ●
2 Phyllo(i)des tumour ● ●
*Torsion testis
2
*Varicocele
● ●
1 Congenital hypertrophic pyloric stenosis ●
1 Universal precautions ●
1 Surgical site infection ●
1 Intussusception ●
1 HIV and the surgeon ●
1 Hypokalemia ●
1 Flail chest ●
1 Cystic hygroma ●
1 Upper gastrointestinal endoscopy ●
1 Nerve injuries ●
1 Lymphoedema ●
1 Psoas abscess ●
1 Fine-needle aspiration cytology (FNAC) ●
1 Decubitus ulcers ●
1 Epidural anaesthesia ●
1 Pilonidal sinus ●
1 Day-care surgery ●
1 Madura foot ●
1 Lingual thyroid ●
 *Thyroid neoplasms:
1 - Classification ●
- Clinical features
1 Obstructed inguinal hernia ●
1 Differential diagnosis of bleeding per rectum ●
Short Notes - Orthopaedics
*Osteosarcoma (osteogenic sarcoma) (2)
*Metastatic bone tumours
*Osteoclastoma (4)
*Giant cell tumour of bone (2)
15
*Chondrosarcoma
● ● ● ● ● ● ● ● ● ● ● ● ● ● ●
*Ewing's sarcoma (2)
*Exostosis
*Plasmacytoma
*Claw hand (2)
*Ulnar claw hand
●
11 *Wrist drop (6) ● ● ● ● ● ● ● ● ●
*Erb's palsy ●
*Tardy ulnar nerve palsy
*Osteomyelitis (6)
●
10 *Chronic osteomyelitis ● ● ● ● ● ● ● ●
*Sequestrum (3) ●
7 Volkmann's (ischaemic) contracture ● ● ● ● ● ● ●
*Colles' fracture (5):
- Causes
7 - Diagnosis ● ● ● ● ● ● ●
- Complications
*Smith's fracture
*Carpal tunnel syndrome (3)
7 *Compound palmar ganglion (3) ● ● ● ● ● ● ●
*Ganglion
*Club foot (congenital talipes equinovarus) (5):
7 - Pathogenesis ● ● ● ● ● ● ●
*Hammer toe
5 Pathological fracture ● ● ● ● ●
5 Myositis ossificans ● ● ● ● ●
5 Baker's cyst ● ● ● ● ●
4 Non-union ● ● ● ●
*Seddon classification of nerve injuries (3)
4
*Classification of nerve injury
● ● ● ●
*Fracture patella
2
*Cysts around the knee joint
● ●
*Perthes disease (1):
2
- Radiological features
● ●
*Bennett fracture
2
*Scaphoid fracture
● ●
*Anterior dislocation of shoulder
2
*Frozen shoulder
● ●
*Fracture olecranon ●
2
*Tennis elbow ●
*Septic arthritis
2
*Osteoarthritis
● ●
2 Greenstick fracture ● ●
1 Below-knee amputation ●
1 Rickets ●
1 Arthroscopy ●
1 Osteogenesis imperfecta ●
Deep vein thrombosis (DVT) and its management in a polytrauma
1
patient
●
1 Acute compartment syndrome ●
1 Osteoporosis ●
1 Trendelenburg sign ●