Download MBBS Important Topics Surgery OSCE

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Important Topics Surgery OSCE for MBBS 1st Year Important Topics, MBBS 2nd Year Important Topics, MBBS 3rd Year Important Topics & MBBS Final Year Important Topics.

SURGERY OSCE
Sister Mary Joseph nodules
Stomach and pancreas carcinoma
Falciform ligament
Bad prognosis

Elephantiasis chirugens - Post operative lymphedema of the upper limb
Elastic bandage, antibiotics, exercise and massage
Radiation should not be given after you do block dissection
Lynphangiosarcoma- Stewart-Trevis syndrome

Cholangiocarcinoma
MRCP, CT scan
Jaundice that can be corrected by surgery
In obstr jaundice if gall bladder is palpable, then it is not due to gall stones

'CBC - Hb- 10.4 g/dI. Total Count - 6,500
LFT - Albumin - 2.1 g/dl. SGOT - 103 IU/L.
1
GGT - 90 U/L. Bilirubin ? Total - 8.3 mg/dI. Direct
1. What is your probable Diagnosis?

Post acoustic shadow, gall bladder wall edema
Mirizzi syndrome, cholelithiasis, mucocoele
Lap. Cholecystectomy
Cystic artery damage

yTATION 2
The 36/F from station 1 had an ultrasound of the abdomen
Viurphy sign was positive

e on the
Rt R
Name 2 findings you would expect tos
ultrasound?
. e S
> Name a complication that can occur if the pt is not
treated?
3 What surgery will be advised for the patient ?
3
g ..l &
most common complication of surgery.
4.What is the
\ A
Perforation of stomach
X-Ray
Urgent Laparotomy, suture of perforation using omentum

Thyroid gland
lodine deficiency, multinodular goitre
TSH, T3, T4
Recurrent laryngeal nerve

SPECIMEN
1. IDENTIFY THE SPECIMEN.

2. TWO CAUSES OF ENLARMENT OF THIS GLAND:
3. WHAT ARE THE BIOCHEMICAL TESTS TO ASSES THE
FUNCTION OF THIS GLAND?
4. WHAT NERVE DO YOU TRY TO PRESERVE WHEN OPERATING
ON THIS GLAND?

Cholecystitis
In sitting position, catching breath with wincing pain occurs when deep breath is
taken with deep palpating at the sub-costal border
Cholesterol stones, pigment stones
Hepatitis, cholangitis

What is the diagnosis from the history?
2. What is Murphy?s sign?
3. Name 2 types of gallstones 71y
4. Give 2 differential diagnosis for acute RUQ pain
Lymphoma (LDH increases in non-hodgkin's type)
Excision biopsy of the lymph node
PET-CT and immunohistochemistry

Sialadenitis/ sialolithiasis
Warthon's duct drains against gravity
Papillotomy and sub-mandibular excision
Injury to lingual, marginal mandibular and hypoglossal nerve. Seroma and infections



X-RAY
1. WHAT IS YOUR DIAGNOSIS?
2. WHAT ARE THE TYPES?
3. GIVE ANY TWO CONDITIONS THAT CAN CAUSE THE
ABOVE FINDING.
4. WHAT IS THE MOST COMMON CAUSE OF LARGE BOWEL
OBSTRUCTION IN AN OLD MAN?
Inguinal hernia
Inguinal ligament, lateral border of rectus, inferior epigastric artery
Modified Bassini's, Laparascopic - TEP, TAPP
Pantaloon's hernia, Richter's hernia

Ryle's tube
Different sizes up to 65 cm
Gastric aspiration, nasogastric feeding
25 cms

INSTRUMENT
1. IDENTIFY.
2. WHAT IS THE LENGTH OF THE TUBE?
3. WHAT ARE ITS USES?
4. WHAT IS THE NORMAL LENGTH OF THE OESOPHAGUS?
Ureteric stones
Ultrasound, Intravenous pyelogram
Extracorporeal shockwave lithotripsy with Double loop J-stent (ESWL with DJ stent)

Acute pancreatitis
Serum lipase, abdominal USG
Hypocalcemia, hypovolemic shock, ARDS

/ith sudden onset of
< and recurrent


Cervical rib
X-Ray chest
Extra-periosteal excision of the cervical rib with cervical symphatectomy
Cervical spondylosis, cervical disc protrusion, Carpal tunnel syndrome, Raynaud's
phenomenon

n the left upper
ith mild
ght





with pain i
ynths associated W
sensation over the ri
ly developed plackish
nger. tion her
er tips. On examina i
es?alre . nd has a hard
of low volume @ "
jelling in the e






ft supractavicu\ar fossa.
Carcinoma in pleomorphic adenoma of parotid gland
Rapidly growing, fixity to mandible, hard swellings in the neck
Frey's syndrome, facial nerve injury

Gastric outlet obstruction
Ca stomach
Upper Gl scopy from which biopsy is taken, CT scan
Billroth 1 and 2

Obstructive jaundice
CBD stones, Ca head of pancreas
CA-19-9
ALP and GGT are elevated

Leukoplakia
Malignancy leading to trismus
Wide local excision

A 60 year old chronic smoker was noticed to have
two white indurated lesions over the buccal mucosa
which could not be removed easily. It was not
associated with bleeding and there was no cervical
lymphadenopathy.
Questions:
1. What is the probable clinical diagnosis? |
2. What is the complication, if left untreated? l{y
3. What is the treatment? )

Tension pneumothorax
Needle thoracocentesis in 2nd intercostal space in midclavicular line
X-Ray chest
Intercostal drainage tube

BRCA 1, BRCA 2
3Aand 3B
Lumpectomy, MRM with chemo-+radio, QUART (quadrantectomy with ancillary node
dissection and radiotherapy)
Axillary vessels, Long thoracic nerve, Ceohalic vein, pectoralis major, nerve to

lattismus dorsi
Flap necrosis and lymphedema
Cold abscess
Sinus, fistula, dissemination
Lymph node biopsy or aspiration and AFB staining
Att

A 20 year old patient
swelling of |eft side o
low grade fever for 2
hepatosplenomegaly
or axilla. He does not
Or neck symptoms,
presented with cough,
f the neck, loss of weight a
months. He does not hav
or swelling of inguinal r
have any other neck sw
Questions:
1.What is the probable clinical diagnosis?
2.What is the complication of this condi
treated?
3.What are the tests for confirming the
4.What is the treatment after diagni
confirmed?

1. WHAT IS THE TYPE OF JAUNDICE THE PATIENT HAS??
2. WRITE 2 CAUSES FOR THIS TYPE OF JAUNDICE THE PATIENT HAS,
3. WRITE 2 IMPORTANT INVESTIGATIONS YOU WILL DO TO ARRIVE AT YOUR DIAG
4. WHAT TUMOUR MARKER MIGHT BE ELEVATED IN THIS PATIENT??

Appendicitis . . o
Junction of medial 2/3 and lateral 1/3 on the right spinoumbilical line
Rebound tenderness and rovsing sing
Alvarado (mantels)

STATION ? N
23M comes to the Casuali i
SAL comes suality with 2 days of pain
vight iliac fossa, which started amuml?!he umbili
\.tw\-ian'-d with low { ? 1
4 gru\le fever nause ?y
oy ? nausea and loss of
What is the diagnosis from the history?
e
2. Defime McBurney's Point
3. Name rwo fests on examination of the abdomen
that will confirm your diagnesis
< What is the name of the scoring system 1
dagnosis?
Cholelithiasis
Laparoscopic cholecystectomy
Kochers incision
Mucocoele, carcinoma, mirizzi syndrome

Urinary catheter
Unit - Fr

Male - 20cm. Female - 3.7cm
Ranula
Marsupialization, Complete excision
Obstruction of the ducts secreting mucus - retention cysts

Lingual thyroid
Thyroid scan, Technetium scan
Give thyroxine. If size of swelling doesn't decrease then excision, radio iodine
Hypothyroidism

Obstructive jaundice
Elevated ALP, GGT
Ultrasound
Cholangitis