1

A 45 year old unmarried woman presents to surgical OPD with

complains of palpable swelling and pain in the right breast. On
examination, there was a 5cm x 5cm hard mass in the upper outer
quadrant of right breast with enlarged axillary lymph nodes.

1. What is your diagnosis? (1)

2. What is retromammary space? (1)
3. What are the major group of axillary lymph nodes that may
probably have been enlarged in this case? (1)
4. Give any other 2 symptoms of this condition. (1)
5. Give any 2 sites where this condition can spread. (1)
2 A 42 year old obese female complains of tingling sensation of left
thumb, index and middle fingers that increases during sleep. On
examination, there is sensory loss over palmar aspect of lateral three
and half digits. There is flattening of thenar eminence and she was
unable to bring her thumb and little finger tips together.

1. What is your diagnosis? (1)

2. Name the anatomical structure compressed, give its root value (1)
3. What is the typical appearance of thumb in this condition called
and why does this happen?(1)
4. Explain why the skin of the thenar eminence escaped from
sensory loss (1)
5. What structure is surgically released to relieve the symptoms?(1)
3
A 48 year old obese bank manager developed constricting pain in chest
with radiation to left axilla and profuse sweating. Angiogram revealed
that he had a block in a major vessel that supplied the left chambers of
heart and needed a percutaneous intervention to restore blood supply.

1. What is your diagnosis?(1)

2. What is the most commonly involved vessel in the heart that may
have been affected in this case?(1)
3. Explain the reason for the radiation of pain(2)
4. Name the percutaneous procedure to restore the blood supply?(1)
4 A 40-year-old male who is a chronic alcoholic presents to surgical
emergency with acute onset of vomiting following reduced food intake
for 1 day. Initially his vomitus had only fluids, after a few episodes he
started vomiting frank blood.

1. What is the primary problem that has resulted in these

symptoms?(1)
2. Name 2 other clinical features of his disease.(1)
3. What will be the abnormality seen in the lower end of esophagus in
this patient?(1)
4. What are the blood vessels responsible for his hematemesis?(2)
5 A 16 year old boy presents to the emergency with fever, vomiting and
pain around the umbilicus. On examination, there was tenderness at a
point in the right iliac fossa. USG revealed inflammation of a structure
in right iliac fossa.

1. What is your diagnosis?(1)

2. What is the anatomical point to elicit maximum tenderness in this
case(1)
3. What is the blood supply of the affected organ? (1)
4. What is the reason if the above patient presents with severe pain
while flexing the hip? (1)
5. What is the most common position of the affected structure? (1)
6
A 60-year-old male patient gives h/o increased frequency of urine, urinary
urgency and feeling of incomplete voiding of urine since the last 2 yrs.
After examination, the doctor assured him that his problem is common
secondary to ageing.

1. What is the possible clinical diagnosis? (1)

2. What is the best way to clinically examine the patient? (1)
3. Which is the most affected zone in this condition? (1)
4. What are the various anatomic structures passing through / opening
within this organ? (1)
5. What are the hallmark microscopic structures found in this organ, in
aged persons? (1)
7
1. Identify the abnormality in the given picture.
Why does this happen? (1)
2. Name the anatomical structure injured. Give
the root value of the affected structure (1)
3. What are its terminal branches? (1)
4. Mention one common site where the structure
is injured (1)
5. Give one site of sensory loss associated with
the given condition (1)
8

1. Name the clinical condition (1)

2. Name the nerve and muscle affected (1)
3. Give the root value of the affected nerve (1)
4. What is the action of this muscle? (1)
5. How can you test for this muscle? (1)
9

1. Identify the clinical condition (1)

2. Name the affected vein. How does it begin
and terminate? (1)
3. What is the relation of the vein to medial
malleolus? (1)
4. Name the nerve accompanying it (1)
5. Give a common cause of this condition? (1)
10

1. Identify the clinical sign(1)

2. What is the anatomical structure
involved? (1)
3. What are the muscles that are
paralysed?
4. Explain the sign. (1)
5. What are the different types of gait
seen in such patients (1)
11

1. Name the procedure. Give one

indication (1)
2. At what level is this usually performed?
(1)
3. What is the area in the pleural cavity
where effusion is seen first? (1)
4. Give the radiological finding in this
condition. (1)
5. Mention 1 complication of this
procedure. (1)
12

1. Name the organ affected (1)

2. Give the arterial supply of this organ (1)
3. What is the typical identifying feature of
this organ? (1)
4. Name the important nerves to be
protected during surgical removal of this
organ (2)
13

1. Name the anatomical structure

involved (1)
2. Give its location (1)
3. What is its major arterial supply?
(1)
4. Give its function (1)
5. What is the most common cause
of bleeding following its surgical
removal? (1)
14

1. Identify the clinical condition (1)

2. What is the commonest cause of
this condition? In what age group
is this commonly seen? (1)
3. What is the common site of
bleeding? (1)
4. Name the plexus responsible for
this condition and the vessels
forming it (2)
15

1. Name the procedure (1)

2. At what vertebral level is this performed?
Why? (1)
3. Give any 2 indications? (1)
4. Name the layers pierced by the needle(2)