Download DNB 2015 Dec RURAL SURGERY P II Question Paper

FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2015
RURAL SURGERY

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Time : 3 hours
Max. Marks : 100

Important instructions:

• Attempt all questions in order.

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• Each question carries 10 marks.
• Read the question carefully and answer to the point neatly and legibly.
• Do not leave any blank pages between two answers.
• Indicate the question number correctly for the answer in the margin space.
• Answer all the parts of a single question together.

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• Start the answer to a question on a fresh page or leave adequate space between two answers.
• Draw table/diagrams/flowcharts wherever appropriate.

1. A 50 yrs old male presented with a painless, hard swelling measuring 2x2 cm in left submandibular region of six months duration. Briefly describe the salient points to be asked in history, steps of clinical examinations, differential diagnosis and investigations required to reach a final diagnosis. (2+3+2+3)

2. A 40 yrs old male, chronic smoker presents with intermittent claudication in left lower limb for the last one year. Briefly describe the salient points in history, clinical examination, differential diagnosis, investigations and treatment of the case. (2+2+2+2+2)

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3. A 50 yrs old male presents with generalized lymphadenopathy and hepatosplenomegaly. Enumerate the differential diagnosis. Give outlines of relevant investigations and treatment. (3+(4+3))

4. A 20 yrs female presents with a painless cystic swelling measuring 15x10 cm in subumbilical region for last one year. The swelling moves freely from right hypochondrium to left iliac fossa. Enumerate the differential diagnosis. Give outline of relevant investigations and treatment. (3+(4+3))

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5. Enumerate causes of dysphagia. Give outline of investigations for a patient with dysphagia. Briefly describe the treatment of gastro-esophageal reflux disease. (3+3+4)

6. A 20 yrs old male presents with high grade fever and tender hepatomegaly of 3 days duration. He gives history of diarrhea two weeks ago. Ultrasound abdomen shows hypoechoic collection measuring 10x8 cm in size in right lobe of liver. Briefly discuss the differential diagnosis, other investigations and treatment. (2+4+4)

7. A 50 yrs old female presents in the OPD with symptomatic gallstone disease. Give outline of her relevant clinical examination and preoperative investigations. Briefly describe the operative steps of open choleystectomy and enumerate the possible post-operative complications. ((2+2)+(4+2))

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8. A 35 yrs old chronic alcoholic male patient presents with acute onset epigastric pain with radiation to back that improves on bending forwards. On examination, there is a tender, tense cystic ill defined lump in epigastrium measuring 18x12 cm the size. Briefly discuss his differential diagnosis, investigations and treatment. (2+4+4)

9. A 20 yrs old male presents with acute pain in right iliac fossa, vomiting and burning micturition. Enumerate differential diagnosis and give outline of investigations. How will you manage the case if a 8 mm stone is diagnosed at right UV junction after investigations. ((2+4)+4)

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10. A 14 yrs old boy presents in emergency with history of painful penile swelling following retraction of tight prepuce that could not be reduced back for 6 hrs. What is the clinical diagnosis and how will you manage the case? Briefly describe the operative steps of circumcision and its post operative complications. ((1+3)+(4+2))

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