0124200
Final Year MBBS Examination
MDDS Part 2 Surgery Paper 1
Time: 3 hours
--- Content provided by FirstRanker.com ---
Max Marks: 100Instructions:
1. Answer to the points
2. Figure to the right indicates marks.
3. Use separate answer books for each
--- Content provided by FirstRanker.com ---
section.4. Draw diagrams whenever necessary.
5. Write legibly.
Section 1
1. Structured Long Question (any One)
--- Content provided by FirstRanker.com ---
a) Briefly discuss clinical 1X10 = 10 marksPresentation and management of pancreatic
Injury following blunt abdominal trauma.
b) Management of a 35-year female with
strong family history of breast cancer,
--- Content provided by FirstRanker.com ---
presenting with a T2N0M0 lesion in theright breast.
2. Case Based scenario (Any two)
a) A 19-year-old man
2X6 = 12 Marks
--- Content provided by FirstRanker.com ---
presents with a 2-day history of abdominalpain. The pain Started in the central
abdomen and has now become constant and
has shifted to the right iliac fossa. The
patient has vomited twice today and is off
--- Content provided by FirstRanker.com ---
his food. His motions were loose today, butthere was no associated rectal bleeding. On
examination patient has a temperature of
37.6?C and a pulse rate of 110/min. On
examination of his abdomen he has localized
--- Content provided by FirstRanker.com ---
tenderness and guarding in the right iliacfossa. Urinalysis is clear.
Question-1 What is the likely diagnosis?
Question-2 What are the differential
diagnoses for this condition?
--- Content provided by FirstRanker.com ---
Question-3 How would you manage thispatient?
b) A 20-year-old male is referred to surgical
outpatients complaining of pain in the right
groin and his pain is worse on exertion. He
--- Content provided by FirstRanker.com ---
has also noticed an intermittent swelling in
the right groin. There is a family history of
bowel cancer. On examination he is afebrile
with normal blood pressure and pulse. On
per abdomen examination mild tenderness in
--- Content provided by FirstRanker.com ---
the right groin. The patient is asked to stand,in the right groin, there is a swelling which is
more pronounced when the patient coughs.
The other groin and the scrotal examination
are normal.
--- Content provided by FirstRanker.com ---
Question-1 What is the likely diagnosis?Question-2 What are the anatomical
boundaries?
Question-3 How should the patient be
treated?
--- Content provided by FirstRanker.com ---
c) A 70-year-old man presented with acomplain of a 3-month history of loose
stools. The motions have been associated
with the Passage of blood clots and fresh
blood mixed within the stools. His appetite
--- Content provided by FirstRanker.com ---
has been normal, but weight loss present.The abdomen is soft and non-tender. 2 with
no palpable masses. On Digital rectal
examination a mass felt approximately 5 cm
from the anal verge.
--- Content provided by FirstRanker.com ---
Question-1 What is the likely diagnosis?Question-2 How should the patient be
investigated?
Question-3 What are the options for
treatment?
--- Content provided by FirstRanker.com ---
3. Write Short Notes on (Any Three)a) Enumerate the
3X6 = 18 Marks
complications of Total thyroidectomy
b) Management of appendicular lump
--- Content provided by FirstRanker.com ---
c) List the various types of hypospadiasd) Closed loop intestinal obstruction
4. Answer only in 2-3 sentence (Any 5)
a) Indications of Breast
2X5 = 10 Marks
--- Content provided by FirstRanker.com ---
conservative surgeryb) Richter's hernia
c) Biological Mesh
d) Pseudomyxoma peritonei
e) Mallory-Weiss Syndrome
--- Content provided by FirstRanker.com ---
f) Caroli's DiseaseSection 2
5. Structured Long Question (any One)
a) Pathophysiology,
1X10 = 10 marks
--- Content provided by FirstRanker.com ---
Sequelae and management of renaltuberculosis.
b) Clinical features, Investigations and
treatment of lower ureteric calculus.
6. Case Based scenario (Any two)
--- Content provided by FirstRanker.com ---
a) A 60-year-old female2X6 = 12 Marks
has a one month history of blood in the urine
with passage of some small blood clots. She
has had an intermittent urinary stream for
--- Content provided by FirstRanker.com ---
the last 24 h and complains off pain in thesuprapubic region on voiding. She has been
complaining of urinary frequency and
urgency for the last 6 months. She smokes
10 cigarettes per day and takes warfarin for
--- Content provided by FirstRanker.com ---
atrial fibrillation. On examination of theabdomen there is some minor suprapubic
tenderness, and a palpable bladder. The rest
of the examination is unremarkable. Her
pulse rate is 100/min and the blood pressure
--- Content provided by FirstRanker.com ---
is 105/70 mmHg.Question-1 What is the likely diagnosis?
Question-2 What are the differential
diagnoses for this condition?
Question-3 How would you manage this
--- Content provided by FirstRanker.com ---
patient?b) A 16-year-old boy attends the emergency
department complaining of sudden onset of
right testicular pain. The pain woke him
from his sleep and has persisted over the last
--- Content provided by FirstRanker.com ---
2 h. he has vomited once. His previousmedical history Includes a similar event a
year ago. On examination the left hemi-
scrotum feels normal but the right side is
acutely swollen and tender on palpation. The
--- Content provided by FirstRanker.com ---
testicle is elevated when compared to theother side and has an abnormal horizontal
lie. The abdomen is soft and non-tender. His
blood pressure is 130/84 mmHg and the
pulse rate is 110/min. The cremasteric reflex
--- Content provided by FirstRanker.com ---
is absent.Question- 1 What is the diagnosis?
Question- 2 What should you consider in the
differential?
Question- 3 What is the management in this
--- Content provided by FirstRanker.com ---
case?c) A 61-year-old male presented with
complain of intermittent left-sided loin pain
for 2 months. An ultrasound scan of the
urinary tract was done, which showed a large
--- Content provided by FirstRanker.com ---
central mass in the left kidney. His previousmedical history Included a recent diagnosis
of hypertension, hypothyroidism and non-
insulin-dependent diabetes mellitus. He is
currently on medication. He drinks 5-10
--- Content provided by FirstRanker.com ---
units of alcohol per week and smokes. Onexamination he is afebrile and his blood
pressure is 105/99 mmHg. He has a soft
non-tender abdomen with no palpable
masses. A left sided varicocele is present.
--- Content provided by FirstRanker.com ---
Digital rectal examination is unremarkable.Question 1.What Investigation is now
required?
Question 2. Can you explain why the patient
may have a varicocele?
--- Content provided by FirstRanker.com ---
Question 3 How would you manage thispatient?
7. Write Short Notes on (Any Three)
a) Discuss the causes of
3X6 = 18 Marks
--- Content provided by FirstRanker.com ---
acute scrotum
b) surgical anatomy of Adrenal glands
c) Premalignant conditions for penile cancer
d) Damage control surgery in a case of
polytrauma
--- Content provided by FirstRanker.com ---
8. Answer only in 2-3 sentence (Any 5)a) Prostate specific antigen 2X5 = 10 Marks
b) DTPA Scan
c) Horseshoe Kidney
d) Ureterocele
--- Content provided by FirstRanker.com ---
e) Cause of Raised Intracranial Pressuref) Ectopic Testis