0124 E573
Final Year MBBS Examination
III MBBS Part 2 Surgery Paper 1
Time: 3 hours
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Max Marks: 100Instructions:
1. Answer to the points.
2. Figure to the right indicates marks.
3. Use separate answer books for each
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section.4. Draw diagrams wherever necessary.
5. Write legibly.
Section 1
1. Write in detail (Anyone out of two)
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(10)a) Describe surgical anatomy of
thyroid gland and clinical features of its
hyperfunctioning.
b) Describe clinical features, causes
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and investigation in pauentientpresenting with acute intestinal
obstruction
2. Case based scenario/Applied Short
notes (Any two out of three)
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(12)a) A 24 year old man presents with
acute abdomen of 2 hour duration. His
pulse is 120: per minute and blood
pressure is 90 mm Hg systolic and
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abdomen is tender and guarded A)Which immediate measures will you
take? B) Erect abdominal X ray shows
radiolucent black rim inferior to the right
diaphragmatic dome. What is your
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interpretation? C) What will you planfurther?
b) A 55 year old women presents with
lump in right upper and outer edrant of
the breast which is 2 cm in size, hard
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but mobile. No other swelling ispalpable any here, A) What is the most
likely diagnosis? B) Which diagnostic
and other relevant investigations will
you order' C) Which treatment will you
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advice considering that patient hailsfrom a rural area where advanced
medical facilities are not available
c) A 40 years old man presents with
painless fresh anal bleeding. Blood ts
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not mixed with stools but blood drips
after passing stools. Patient has
noticed something coming out from
anus during passage of stools which
retums inside once patient stops
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straining. A) What causes will youconsider? B) Describe clinical and
bedside examination in such a patient.
C) Enlist relevant investigations and
treatment plan for the commonest
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cause for such symptoms.3. Write short notes (Any three out of
four)
(18)
a) Informed consent
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b) Complications of herniac) Anomalies of vitello-intestinal duct
d) Anorectal malformation
4. Answer only in 2-3 sentences (Any
five out of six)
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(10)a) Charcot triad
b) Triple assessment for breast
c) Virchow's lymph node
d) Herniotomy
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e) Berry's sign for thyroidf) Goodsall's rule
Section 2
5. Write in detail(Any one out of two)
(10)
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a) Describe ctiopathology, clinicalfeatures, investigations and
management ent of testicular tumours
b) Whatare the signs of raised
intracranial tension? Enumerate
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common causes and describemeasures to control raised intracranial
pressure.
6. Case based scenario/Applied Short
Notes (Any two out of three)
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(12)a) A 35 year old man presents with
sudden onset severe pain radiating
from loin to groin on right side. He says
he has passed some dark coloured
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urine. Patient is extremely restless andkeeps tossing about in bed. His pulse is
64 beats per minute and blood pressure
is 140/90 mm Hg A) How will you
control his pain? State possible
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adverse events of medications. B)What is the most likely cause? Which
other causes will you consider? C)
Which relevant investigations will you
order?
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b) A 25 year old patients presents withthe history of road traffic crash with
pulse of 120 beats/min, blood pressure
80 mm Hg systolic and incoherent
speech and cye opening to pain and
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withdrawal to pain. His right leg isswollen. deformed and bleeding. A)
Enlist immediate life saving measures.
B) What is the Glasgow Coma Score in
this patient? C) Which relevant bedside
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investigations will you order as a part ofinitial management?
c) A 60 year old non-diabetic patient
who is a chronic smoker, presents with
continuous pain in the right leg with
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right second and third toes being dryand shriveled. The pain has
progressively worsened over last one
month. It is somewhat less when he
keeps legs down. His pulse is 84 beats
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per minute. blood pressure is 12.8/88mmHg in the right upper limb. A) What
is the likely diagnosis? B) How will you
investigate this patient? C) What will
you advice to him? Provide a list of
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medicines and their mechanism ofaction.
7. Write Short notes (Any three out of
four)
(18)
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a) Medical management of benignprostatic hyperplasia
b) Brodie Trendelenburg test for
varicose veins
c) Extradural haematoma
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d) Mades of spread of renal cellcarcinoma
8. Answer only in 2-3 sentences (Any
five out of Six)
(10)
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a) Raynaud's phenomenonb) Clinical features of tension
pneumothorax
c) Paraphimosis
d) Lethal triad of trauma
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e) Definition of brain death
f) Triangle of safety for intercostal
drainage