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General Surgery June 2011
PAPER I
1. What are diagnostic tumor marker? Enumerate their role in the management of specific
cancers. 5+5
2.
a)
b)
c)
What is septic shock? 6
Describe various scoring systems for sepsis. 2
Describe various components of "Systemic Inflammatory Response Syndrome."
3.
a)
b)
c)
Describe the "levels of evidence" in surgery. 5
What is a Phase-II trial? 3
Describe the significance of "NSABP" trials. 2
4.
a)
b)
c)
Describe the various modes of supplementing nutrition in a surgical patient. 4
What are the "pitfalls" in the use of total parenteral nutrition? 3
Describe the "Refeeding Syndrome". 3
5.
a)
b)
c)
Describe the various "dynamics" of wound healing. 4
Management of a non-healing wound. 3
Describe an "ideal dressing". 3
6.
a)
b)
c)
Describe the "Spring Coil" effect in relevance to the closure of abdomen. 4
Describe "mass closure" technique for abdomen. 3
What is a "Laparostomy"? 3
2
7.
a) What are the risk factors in the development of "Deep Vein Thrombosis"(DVT)? 4
b) Discuss briefly the various diagnostic tests to establish the diagnosis of DVT in a 65 year
old lady. 3
c) Describe the management of this patient. 3
8.
a)
b)
c)
Describe the "Cell Cycle" in relevance to cancer. 3
Describe the scientific basis to "Hormone therapy in cancers". 4
Describe the limitations of hormone therapy and its side effects. 3
9
a)
b)
Enumerate the local complications of acute pancreatitis.2
Describe in brief diagnosis and management of these complications. 8
10
a)
b)
c)
Describe the "aetiopathogenesis of thoracic outlet syndrome". 4
Describe the various levels of lymph nodes in the neck. 3
Enumerate the "types of neck dissections".
3
PAPER II
1.
a) What is a "High Risk" surgical patient? 2
b) How do you prepare a 45 year old with obstructive jaundice due to peri-ampullary
cancer for surgery? 6
c) What is "Hepato-Renal syndrome"? 2
2.
a)
b)
c)
Enumerate the types of gall stones. 2
Discuss the pathogenesis of gall stones. 4
List the complications of gall stones. 4
3.
a) Discuss the approach to management of a 10 year old boy with polytrauma. 6
b) What is "Triage" in the event of disaster? 2
c) Enumerate various imaging invasive diagnostic modalities in blunt abdominal
trauma. 2
4.
a)
b)
c)
What is "Cardiac Tamponade"? 3
Discuss its management in a 40 year old lady. 4
Enumerate the indications for "Emergency Room Thoracotomy". 3
5.
a)
b)
c)
Describe various "Energy Sources" in Surgery. 3
What are the characteristic of an "ideal suture". 4
Describe chemo-embolization in surgery. 3
6. a) Discuss the management of a 12 year old boy with 15degree thermal burns involving
head, neck and thoracic regions. 4
b) What are ideal fluid replacements in a patient with thermal burns? 3
c) Describe the selection of the type and calculation of the amount of fluid to be
supplemented in thermal burns. 3
7.
a)
b)
Describe the clinical presentation and diagnosis of Hydatid disease of liver. 5
Discuss in brief the surgical procedures performed for this condition. 5
8. a) Describe the significance of "Total Mesorectal Excision" in the management of rectal
cancer. 4
b) What is a "Metachronous" lesion? 2
c) Discuss the management of a 32 year old gentleman with carcinoma rectum 14cm
from the anal verge along with a solitary hepatic metastases in segment V. 4
9.
a) What is a "Metastasis of unknown origin"? 5
b) Describe the approach to management of a 50 year old man with a level-V cervical
lymph node metastasis of an unknown origin (The algorithmic approach). 5
10. a)
b)
4
c)
Enumerate the causes of lower gastrointestinal bleeding. 3
Describe the management of "Obscure GI hemorrhage" in a 60 year old man.
Describe briefly "Capsule Endoscopy". 3
PAPER III
1.
a)
b)
c)
Define autologus transfusion. 2
What are the risks of blood transfusion? 4
How will you manage transfusion reactions? 4
2.
a)
b)
c)
Enumerate complications of laparoscopic surgery. 3
How to prevent injury to bowel and solid organs during laparoscopy? 3
How will you manage bleeding and bowel injury? 4
3.
a)
b)
c)
Write briefly lymphatic drainage of esophagus. 3
What are the clinical features of carcinoma esophagus? 3
How will you investigate a patient of Carcinoma esophagus? 4
4.
a)
b)
c)
Discuss the etiopathogenesis of Hirschsprung disease. 3
Write the clinical features. 3
Discuss briefly its management. 4
5.
a)
b)
c)
Enumerate causes of kidney lump. 2
Write the clinical features.
Write the clinical features of renal cell carcinoma.
6.
a)
b)
c)
Define upper G.I. bleeding. 2
Enumerate its causes. 3
Discuss management of bleeding esophagealvarices. 5
7.
a)
b)
c)
Enumerate causes of foot ulcers. 3
How will you investigate? 3
Discuss management of varicose ulcer. 4
8.
a)
b)
c)
Enumerate causes of acute pancreatitis. 3
How will you investigate? 3
Discuss assessment of severity of pancreatitis. 4
9.
a)
b)
Classify germ cell tumors of testis. 5
Management of non-seminomatous germ cell tumours. 5
10. a)
b)
Describe Glasgow Coma Scale. 4
Discuss management of SubDural Haematoma. 6
PAPER IV
1.
a)
b)
c)
What are the indications for diagnostic peritoneal lavage? 3
Describe the procedure.3
Discuss the grades of splenic injury. 4
2.
a)
b)
Discuss various topical haemostatic agents. 4
Describe briefly the thermal methods of haemostasis. 6
3.
a)
b)
What are the various subphrenic spaces? 5
How do you manage subphrenic abscess and its complications? 5
4.
a)
b)
Discuss the surgical anatomy of thyroid. 4
What are the complications of thyroid surgery?
c)
Management of surgical complications. 3
5.
a)
b)
c)
What are the indications of renal transplantation? 3
Discuss graft rejection. 3
Immunotherapy postoperatively after renal transplantation. 4
6.
a)
b)
c)
Enumerate causes for generalized lymphadenopathy. 3
Describe classification and staging of Non-Hodgkin's Lymphoma (NHL). 5
Treatment of NHL. 2
7.
a)
b)
Discuss the causes and clinical features of entero-cutaneous fistula. 5
Discuss the management. 5
8.
a)
b)
c)
Discuss the etiopathology of tension pneumothorax. 4
Describe the clinical features of tension pneumothorax. 4
Describe briefly the management of tension pneumothorax. 2
9.
a)
b)
Discuss the segments of liver. 4
Describe the various types of anatomical liver resections. 6
3
10. a)
b)
Discribe "Fast track surgery". 4
Discuss its advantages and disadvantages. 6