Download MBBS 4th Year WBUHS General Surgery Paper I 2024 April New Regulation Question Paper

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The West Bengal University of Health Sciences

MBBS 3rd Professional Part-II Examination (New Regulation)

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March - April 2024

Subject: General Surgery Full Marks: 100

Paper: 1 Time: 3 hours

Attempt all questions. The figures in the margin indicate full marks.

1. a) A 40 year old female presented in the OPD with a 2x3cm SOL in upper and outer quadrant of the right breast that is free from skin and underlying structures and having a single mobile palpable lymph node in ipsilateral axilla. Her chest X-ray and USG abdomen reports are within normal limits. What is the TNM classification of this patient? What is triple assessment? Briefly outline the treatment options of early breast carcinoma. 3+6+6

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2. b) A 65 year old male patient presented with recurrent vomiting especially in the evening over the last month. The vomitus contains old undigested food particles. He also complains of anorexia and unintentional weight loss for the last 3 months. On examination there was pallor, positive succession splash and ausculto-percussion test. Serum sodium: 133 meq/l; serum potassium 3.6 meq/l, Albumin 2.7g/dl. 1+2+5+3+4
   1. What is your provisional diagnosis?
   2. Enumerate any four etiological factors for development of this disease.
   3. Discuss in brief any two important investigations to confirm your diagnosis and staging the disease.
   4. Discuss in brief the modes of spread of this disease.
   5. How will you prepare this patient for surgery?

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3. a) Classify parotid tumors. How will you manage a case of pleomorphic of the parotid in a 40 year old man? 4+6
4. b) Discuss the management of burns involving 25% BSA in a 50 year old lady whose body weight is 55kg. 10
5. c) A 55 year old male patient presented in the OPD with history of bleeding per rectum for last 7 days. What are the differential diagnosis? Briefly outline the treatment of acutely bleeding haemorrhoid. 5+5
6. Write short notes on the following: 2x5
   1. Complications of TPN.

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   2. Roles of an IMG.
7. Explain the following statements: 5x4
   1. Prolene mesh is used in direct inguinal repair.
   2. Marjolin's ulcer is painless.
   3. Keloid differs from hypertrophic scarring.

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   4. Frey's syndrome may occur after parotidectomy.
   5. Splenectomy is indicated for hereditary spherocytosis.

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5. Choose the correct option for each of the following:
   1. Commonest organism causes cellulitis is:
      1. Staphylococcus
      2. Streptococcus
      3. E.coli
      4. Hemophilus

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   2. Felon is:
      1. Mid palmer space infection
      2. Pulp space infection
      3. Infection of ulnar bursa
      4. Infection of radial bursa

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   3. The following are different phases of wound healing except:
      1. Inflammatory phase
      2. Proliferative phase
      3. Ischemic phase
      4. Remodeling phase

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   4. Which of the following blood products is best suited for treating a patient having active bleeding due to multiple clotting factors deficiency?
      1. Packed RBCS
      2. Cryoprecipitate
      3. Platelets
      4. Fresh frozen plasma

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   5. Changes in the body metabolism that occurs in response to trauma are all except:
      1. Lipolysis
      2. Hypoglycaemia
      3. Gluconeogenesis
      4. Protein breakdown

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   6. Coffee bean sign is usually seen in:
      1. Sigmoid volvulus
      2. Pyloric obstruction
      3. Intussusception
      4. Strangulated epigastric hernia

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   7. Ramsted's operation is performed for:
      1. Hirschsprung's disease
      2. Congenital hypertrophic pyloric stenosis
      3. Duodenal atresia
      4. Anorectal malformation

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   8. Surgical treatment for varicose vein is contraindicated in the presence of:
      1. Venous ulcer
      2. Deep vein thrombosis
      3. Multiple incompetent perforators
      4. Sapheno-femoral incompetence

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   9. Backwash ileitis is seen in:
      1. Colonic carcinoma
      2. Crohn's disease
      3. Ulcerative colitis
      4. Colonic polyp

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   10. Which is the most common cause for pyogenic liver abscess?
       1. Trauma
       2. Biliary tract infection
       3. Colonic diverticulitis
       4. Appendicitis

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