Problems
Dr. Ritankar Sengupta.
Associate Professor.
Department of Surgery, DMGMCH.
Problem
A new born infant was brought to the
emergency with bubbles at the mouth with
excessive oropharyngeal secretions.
What is the probable diagnosis ?
What is the best first investigation ?
problem
A new born infant was brought to the
emergency with features of acute intestinal
obstruction.
What are the important causes ?
What is the best investigation ?
Problem
A new born baby was brought to the emergency
with history of non passage of meconium.
What are the important causes ?
What is the best investigation ?
Problem
A 5 years old child was brought to the OPD with
history of gradual abdominal distension. On
examination a solid abdominal mass
detected..
What are the common childhood solid
abdominal tumours?
What is the best first line investigation ?
Problem
A child was brought to the surgery OPD with
history of limping .
What are the important causes of childhood
limping ?
Name the best investigation.
Problem
A 30 years old road traffic accident victim was
admitted in surgery ward after management
of the life threatening conditions.
What are the areas of secondary survey ?
Name the best investigations ?
Problem
A 35 years old road traffic accident patient is
found to have severe respiratory distress.
What are the probable causes ?
Name the best investigation .
Problem
A 35 years old road traffic accident patient is
found to have abdominal pain, tenderness and
rigidity.
What are the probable causes ?
What is the best investigation ?
Problem
A 35 years old road traffic accident unconscious
patient (not dead) was brought to the
emergency .
Name the areas of advanced trauma life-support
(ATLS) system.
Name the best investigation.
Problem
A 40 years old male patient came to the OPD
with complaints of gradual appearance of a
right sided scrotal mass. On examination it
was possible to get above the swelling.
What are the probable causes ?
What is the best investigation ?
Problem
A 20 years old patient came to the emergency
with acute onset of right sided scrotal pain.
What are the possibilities ?
What is the best investigation ?
Problem
A 50 years old male patient came to the OPD
with complaints of recurrent attack of
passage of blood in urine.
What are the important causes ?
Name the investigations .
problem
A 50 years old male patient came to the
emergency with complaints of inability to
pass urine with severe lower abdominal pain.
What are the important causes ?
What are the next steps of actions ?
Problem
A 50 years old male patient came to the OPD
with complaints of gradual appearance of a
right mid abdominal mass. On examination
the lump was bimanually palpable.
What are the probable causes ?
What are the suggested investigations ?
Problem
A 6 years old male child came to surgery OPD with
complaints ( by mother) of growth retardation, pallor
and gradual enlargement of abdomen. The mother
gave history of repeated blood transfusion. On
examination there was severe pallor. Examination of
abdomen revealed a large left upper abdominal mass.
What is the clinical diagnosis ?
What is the mass?
What is the cause of severe pallor ?
How will you confirm your diagnosis ?
Problem
A 35 years old male came to surgery OPD with
history of sero-purulent discharge from a left
neck mass. On examination a 5cm x 3 cm
irregular , uneven surface, fixed mass with over
laying sinus detected over the left side of neck.
What is the probable diagnosis ?
What is the stage ?
What investigations you will do to confirm diagnosis
?
Problem
A 40 years old male came to surgery OPD with
complaints of difficulty in swallowing.
What are the probable causes ?
Name the investigations to confirm diagnosis .
Problem
A 40 years old male came to surgery OPD with
history of several attacks of coffee ground
vomiting and passage of tarry stool.
What are the common causes ?
How will you confirm your diagnosis ?
Problem
A 25 years old male was brought to emergency
with severe upper abdominal pain for last 6
hours. On examination he had a pulse of 110
per minute and BP of 90/60 mm Hg. Abdomen
was found to be tense, tender and rigid.
What are the possible causes ?
What is the best immediate investigation ?
Problem
A 60 years old male came to surgery OPD with
history of vomiting, loss of health, asthenia
and anorexia. Examination revealed pallor and
a firm upper abdominal mass ,not moving
with respiration.
What are the important causes ?
Name the investigations to confirm diagnosis.
Problem
A 50 years old male came to surgery OPD with
history of painless progressive jaundice,
yellow urine and clay coloured stool. On
examination he had deep jaundice and scratch
marks on skin.
What are the possible causes ?
How will you investigate the patient ?
Problem
A 40 years old female patient came to surgery
OPD with history of right upper abdominal
pain and flatulent dyspepsis. Examination
revealed a globular, smooth ,non tender upper
abdominal mass moving ups and down with
respiration.
What are the possible causes ?
Name the first investigation for diagnosis ?
Problem
A 40 years old male came to surgery OPD with
history of painful bleeding per rectum.
What are the possible causes ?
How will you investigate to confirm your
diagnosis ?
Problem
A 50 years old male patient came to surgery
OPD with history of painless bleeding per
rectum.
What are the possible causes ?
How will you investigate the patient to confirm
diagnosis ?
Viva: station 1
two x-rays 10x2=20
• Identify the imaging 1 marks
• Region showing 1 marks
• Describe abnormality 4 maRKS
• Diagnosis & D/D 4 marks
Viva: station 2
two specimens 10X2=20
what is the viscera/calculus 2 marks
what is the pathology /composition 2 marks
What operation done 2 marks
Complications of the operation 4 marks
Viva: station 3
two instruments (general+special) 10X2=20
• Identify 2 marks
• Parts 2 marks
• How to hold 2 marks
• Use 2 marks
• Sterilization 2 marks
Viva : station 4
two problems 10X2=20
• Giving reasonable diagnosis 3 marks
• Giving correct line of investigations 3 marks
• Plan of treatment 4 marks