Kerala University of Health Sciences Bachelor of Medicine and Bachelor of SurgeryGeneral Surgery Previous Year Question Papers

Keloid

Barlow’s test

Universal precautions

Baker’s cyst

Scaphoid fracture

25-year-old female presented with history of swelling in front of the neck measuring 3x3 cm that moves with deglutition a) What are the probable diagnosis and substantiate b) How do you investigate the case c) Briefly discuss the management

30-year-old woman presenting with painless swelling of six months duration in front of the lower part of neck. Swelling has two nodules, swelling moves with deglutition. Answer the following • What is the diagnosis • What are the investigations required • Discuss the complications and management

A 60-year-old lady complaints of a painless swelling of 1-year duration in her right breast. On examination it showed a hard 3x2 cm non tender swelling in the right upper quadrant along with a mobile 2 cm hard node in the (Right) axilla. a) What is the most probable diagnosis b) What are the clinical manifestations of this disease c) What are the investigations you do in this patient. d) Discuss the principles in the treatment of this condition

A 40 years old male presented with swelling of left testis noticed after fall from 2 wheeler. On examination, enlarged left testis with normal cord structures and testicular sensation lost. Right testis – normal. Abdominal examination shows swelling in epigastric region. Answer the following: a) What is your diagnosis and how will you proceed b) Classification of the disease c) Management of the above condition

A 45 years old female presented with lump in the left breast since 6 months of size 4x3 cms in the upper outer quadrant, on examination lump is hard in consistency with nipple retraction, a single mobile axillary lymphadenopathy on the same side a) What is the probable diagnosis b) How do you investigate this case c) Briefly discuss the management

What is your clinical diagnosis and what are the invasb196estigations to be done" Corrected as "What is your clinical diagnosis and what are the investigations to be done?" • What is your clinical diagnosis and what are the invasb196estigations to be done • Discuss the treatment • Add a note on the complications of the surgical treatment and follow up of the patient

35-year-old female presented with history of swelling of 5x4cm since 4 months in front of the neck which moves with deglutition with loss of weight in spite of increased appetite. She is irritable with lack of sleep and oligomenorrhea. On examination tachycardia noted, patient looks anxious with lid lag and staring look. a) What is the probable diagnosis b) How do you investigate c) Briefly discuss management

A 50year old male, who is on treatment for diabetes mellitus for 10 years is admitted with history of an injury in his right foot. Examination showed that he is febrile, the right foot and leg is oedematous reddish, along with an ulcer with slough on the dorsum of foot and black patches around it. • What is the clinical condition • What are the investigations required • How is the situation managed • How is the person rehabilitated

A 50 years old male, traffic constable has come to surgical OPD with complaints of dull aching pain in both legs for past 10 years along with a small ulcer over right leg since 1 month. On examination there is dilated and tortuous veins over both lower limbs along with a 4x3 cm ulcer over the medical malleolus on right leg. Answer the following: • What is the most probable diagnosis in this case and how will you proceed to investigate this patient. • Discuss in detail upon the various management options available for this patient. • Discuss about conservative management of ulcer in this case, if the patient is not willing for surgery

A 35year old lady presents with history of palpitations and weight loss despite an increased appetite since 4 months. She has tachycardia and a uniformly enlarged firm goiter. Answer the following questions: a) What is the most probable diagnosis b) What are the other symptoms and signs which would support the diagnosis c) What investigations would be required to confirm the diagnosis d) Briefly outline the management of this condition

A 30 year old female presented to the casualty with history of burn injury to the head and neck, both upper limbs and the front and back of chest. a) How will you assess the area and degree of burns b) Describe pathophysiology of burns and its classification c) Outline the management for this patient

Liver abscess.

Classify burns injury. Discuss the management of 60% burns in a 40-year-old man

Discuss the pathophysiology clinical features, investigations and treatment of venous ulcer

Management of haemothorax and indications of thoracotomy

GERD

Define shock, discuss the clinical features, classification, presentation and management of various types of shock

Discuss the types of burns and its management.

Classify wounds. Describe factors affecting wound healing.

Discuss the clinical features, investigations and treatment of toxic Goiter.

Define and classify shock and discuss the initial management & resuscitation in shock.

Discuss the clinical features, investigation and treatment of acute limb ischemia

Principles, indications, complications of blood transfusion

Diagnosis and management of subdural heamatoma

Solitary thyroid nodule

Describe briefly pathogenesis of Nodular goitre and its management

Ca Penis

Total parenteral nutrition

Fluid management in burns.

Tetanus

Seminoma testis.

Extradural hematoma

Diagnosis and management of Deep vein thrombosis

Extra dural hematoma

Principles of treatment of hand infections

Ameloblastoma

Carcinoma penis.

Pilonidal sinus

Define gangrene, describe clinical types, causes, clinical features and management of atherosclerotic gangrene of lower limb

Tracheostomy

Dermoid cyst

Plunging ranula

Neck dissection

Gall stones.

Madura foot

Papillary carcinoma thyroid

Hormonal therapy of breast cancer

Classify salivary tumors, describe Warthin’s tumor

Implantation dermoid cyst

Necrotizing soft-tissue infections

Complications of hydrocele surgery

Malignant melanoma

Pain management

Hypokalemia

Hiatus hernia

Triple assessment in breast diseases

Hodgkin’s lymphoma.

Cystic hygroma

Indication for artificial nutritional support, Describe in detail about Total Parenteral Nutrition (TPN)

Renal stones

Pressure ulcer

Bladder stones

Buerger’s disease

Colonoscopy

Local anesthetic agents

Horner’s syndrome

Pleomorphic adenoma of the parotid gland

Urolithiasis

Thrombo angitis obliterans (TAO)

ERCP

Fluid resuscitation in burns patient

Medullary carcinoma thyroid

Carcinoma tongue

Fecolith

Cystosarcoma phyllodes

Fissure in ano

Prophylactic antibiotics

Retrosternal goiter

Describe causes, clinical features and treatment of hyponatremia

Glasgow coma scale

Ludwig’s angina

Sebaceous cyst

MOHS- micro graphic surgery

Thyroglossal cyst

Complications of varicose veins of lower limbs

Sentinel node biopsy

Describe types of wound healing

Deep vein thrombosis

Split skin grafting

Felon

Phases of wound healing

Pheochromocytoma

Thyroiditis

Informed consent

Types of regional anesthesia

Fat Embolism

Classify lymphedema, describe clinical features and management

Intra venous anesthesia

Dercum’s disease

Lumbar sympthectomy

Bone grafts

Congenital hydrocoele

Claudication

Types of dermoids

Crush syndrome.

Chemodectoma

Secondary haemorrhage

Sportman hernia

Stress ulcers

Urethral stricture

Wound healing

Surgical site infections

Primary lymphoedema

During a surgical procedure, a patient experiences a sudden drop in blood pressure. What is the immediate priority a) Continue the surgery without interruption b) Administer a large volume of fluids rapidly c) Identify the cause of the hypotension and take appropriate corrective measures d) Call for a psychiatric consultation

Routes of spread of renal cell carcinoma

Frey’s syndrome

Vasectomy

Fluid resuscitation in burns

Lisfranc’s amputation

Congenital hypertrophic pyloric stenosis

Marjolin’s ulcer

A patient requires long-term nutritional support following resection of more than 200 cm of gangrenous small bowel. What is the most appropriate access a) Peripheral intravenous catheter c) Butterfly needle b) Central venous catheter d) Feeding jejunostomy

Encysted hydrocele of the cord

Triple assessment

Glasgow coma scale score for head injury

Carbuncle

Ulnar paradox

Sequestrum

Cubitus varus

A patient presents with a dislocated tooth. What is the best initial management a) Replant the tooth immediately if possible and seek dental consultation b) Leave the tooth as it is and advise rinsing with water c) Extract the tooth to prevent further damage d) Apply ice to the area and wait for it to heal

Phylloides tumour of breast

Jaipur foot

Claw hand - deformity

Split skin graft

Mallet finger

Triage

Torsion testis

Varicocele

The most common long term complication of perineal abscess is a) Incontinence b) Perineal pain c) Tenesmus d) Fistula in ano

Osteoclastoma

Rule of 9 in burns

Percutaneous tracheostomy

Compartment syndrome

Bone graft

Intercostal tube drainage

Open fracture

Outline the causes of Hematuria

Mastalgia

A 65-year-old male presents with painless jaundice which is progressive and there are scratch marks over body on examination a) Discuss the differential diagnosis b) Elaborate on the investigation algorithm including the role of imaging (ERCP, MRCP) c) Outline the patient preparation and surgical options with a brief mention of their complications d) Discuss the importance of palliative care in inoperable cases what are the palliative measures feasible

Paronychia

Fibroadenosis

Submandibular sialolithiasis

Aortic aneurysm

Nerve repair.

Pre malignant condition of carcinoma penis

Hydrocoele

Gout

Bupivacaine

Describe the anesthetic considerations for a patient undergoing emergency laparotomy for a perforated peptic ulcer. a) Preoperative assessment and optimization. b) Intraoperative management, including fluid balance and monitoring. c) Postoperative pain management and potential complications.

Ranula

Fibroadenoma

Discuss the principles of management of a child with Hirschsprung's disease.

Treatment of venous ulcer

Multiple endocrine neoplasm syndrome

Patellar tap.

Explain the classification and management of vesicoureteral reflux (VUR) in children

Raynaud’s disease

Advantages and limitations of minimal access surgery

Describe the complications of gastrectomy and their prevention.

List four causes of small bowel obstruction.

Describe in detail with examples - Conflicts in professional relationship

Outline the steps of the WHO Surgical Safety Checklist

Describe the aetiopathogenesis, clinical features, investigations and principles of management of dislocation of the shoulder joint.

Describe the clinical features, investigation and principles of management of Tuberculosis of the knee joint.

Describe the aetiopathogenesis, clinical features, investigations and principles of management of osteosarcoma of distal end of femur

Arthrocentesis

Tennis elbow

Monteggia Fracture

Plaster of Paris

Pseudoarthrosis

Skeletal traction.

Discuss the etiopathogenesis, clinical features and management of 10-year-old child with acute osteomyelitis of proximal tibia.

Classify shoulder dislocation. Describe clinical features, diagnosis and management of anterior dislocation of shoulder in adults.

Discuss classification, mechanism, clinical types of fracture healing, general principles of management of fracture

A 65-year-old lady presents with inability to walk following a fall at her home. Her left lower limb is externally rotated and shortened. Examination reveals tenderness at the left hip. Answer the following: • What are the most likely diagnoses • Discuss management of this patient • How can this injury be prevented

Define osteomyelitis. Describe etiology, pathology, clinical and radiological features and management of chronic osteomyelitis.

Describe mechanism of injury, clinical features and management of posterior dislocation of hip

Clinicoradiological features of osteosarcoma.

Management of Brodie’s abscess

Neuropathic arthritis.

Hand deformities of Rheumatoid arthritis.

Ulnar claw hand

Evaluation of Genu varum in a child.

McMurray’s test

Simple bone cyst

Fracture clavicle.

Charcot’s joint.

Spondylolisthesis

Features and uses of Thomas splint.

Giant cell tumor of bone.

Malunion.

Torticollis

Classification of Non-union in fracture.

Radiological features of Developmental Dysplasia of Hip (DDH).

Deformities in CTEV.

Radial nerve palsy

Galeazzi fracture dislocation.

Osteoid osteoma

Septic arthritis principles of management

MRC grading of muscle power.

Complications in fracture shaft of femur.

Anterior drawer test

Foot drop splint

Clinical features of carpal tunnel syndrome.

Complications of chronic osteomyelitis

Bursa around knee

Saturday night palsy

Umbilical hernia

Meckel’s diverticulum

Choledochal cyst

Pseudo cyst of pancreas.

Achalasia cardia

Goodsall’s rule.

Intussusception.

Hirschsprung’s disease.

A 70 year old male presents with recent anorexia, early satiety and weight loss. Physical examination reveals pallor and a palpable epigastric mass which moves with respiration. • What is the most probable diagnosis • How will you investigate • Briefly outline the management

An elderly female presented with pain and distension of abdomen with reduced appetite and loss of weight since 4 months. The patient also complains of yellowish discolouration of skin, eyes and passage of clay coloured stools since one month. On examination scratch marks present all over the body. a) What is the probable diagnosis b) What are the relevant investigations c) Discuss the management

A 50-year-old man came to emergency department with severe intermittent abdominal pain, absolute constipation since two days with history of late vomiting. On physical examination abdomen is distended. Tense, tender and sluggish bowel sounds present. Rectal exam is empty. • Likely diagnosis • What are the investigations to conform diagnosis • Management in brief

21 years old male presents to casualty with abdominal pain starting around the umbilicus and shifting to right iliac fossa with history of fever and vomiting for one-day duration. Clinical examination reveals fever with tachycardia, guarding, tenderness and rebound tenderness in right iliac fossa. Answer the following: • What is the probable diagnosis • What are the investigations • How will you manage this patient

A 55 years old woman is admitted with history of progressive jaundice, loss of appetite, generalized weakness, itching all over the body and weight loss. On examination patient has hepatomegaly and a globular swelling in the right hypochondrium. Answer the following: • What is the probable diagnosis • What are the investigations to diagnose the disease • Discuss the management

46 year old male patient presented with diffuse pain in the abdomen since 3 days, with 3-4 episodes of vomiting, not passing flatus and stools since 2 days. On examination there is tachycardia, distended abdomen with no guarding and no rigidity, bowel sounds sluggish in nature. a) What is the most probable clinical diagnosis b) What are the relevant investigations c) Briefly describe about the management of the condition

Male aged 30 years presented in surgery casualty with severe vomiting of large quantity of blood with bloody stools in state of unconsciousness. History of chronic alcohol intake a) What is the diagnosis b) What investigation required to confirm the diagnosis c) Resuscitation and management of the condition

Etiology, clinical features and management of cholelithiasis.

Familial adenomatous polyposis

Gastrointestinal Stromal Tumor (GIST)

Ileo caecal tuberculosis.

Koch’s abdomen

Carcinoid tumor

Duodenal ulcer

A 40 year old obese lady presents with right upper quadrant abdominal pain since 1day. She has tenderness and guarding in the right hypochondrium. • What is the likely diagnosis • What are the relevant investigations • Outline the management briefly

A 20-year-old presented with pain right lower abdomen of one day duration. He gives h/o pain around the umbilicus on the previous day. He also has nausea and fever of one day duration a) What is the most probable clinical diagnosis b) What are the relevant investigations c) Describe briefly about management

35 year old male brought to casualty with complaints of severe upper abdomen pain patient is rolling on the bed, vomiting, pain radiating to back, pain worse soon after eating, history of chronic alcoholic abuse examination of abdomen, tender and distended, fever and rapid pulse present • What is the probable diagnosis • What all investigation is required to confirm diagnosis • Management of the patient

35 years old male, a known case of acid peptic disease is presenting with acute onset of upper abdominal pain, guarding and rigidity of upper abdomen with obliteration of liver dullness and tachycardia. Answer the following: • What is the most probable diagnosis • What are the relevant investigations • How will you manage this patient

A young male is brought to casualty with massive hematemesis. On examination patient has pallor. His pulse rate is 120/min. BP is 80/60 mmHg. Answer the following: • What are the probable causes • How will you investigate • Mention briefly the management

50Y old male patient presented with vomiting about 1-1.5 hrs after consuming food since 3 months and tolerates only oral liquids and soft diet. History of significant weight loss and loss of appetite present. He also has history of peptic ulcer and is on treatment for the same since 2 years. No history of malena, no history of altered bowel habits. On examination, abdomen is distended, visible gastric peristalsis present. a) What is the clinical diagnosis b) What are the relevant investigations c) Describe briefly about the management of the condition

55-year-old male patient presented with acute onset pain which started at the epigastric region later spread to the entire abdomen. He is lying still, with shallow rapid breath. O/E his abdomen is rigid and diffusely tender • Possible diagnosis • Investigation • Management

Alterations in liver function tests in obstructive jaundice.

Curling’s ulcer

Pseudomembranous colitis

Types of mesenteric cysts.

Crohn’s disease.

Meckel’s diverticulitis

Enumerate complications of gall stones.

Mention causes of reflux esophagitis

Colonic pseudo obstruction

Principles of laparoscopy.

Pancreatic calculi

Complications of acute pancreatitis.

Complications of splenectomy

Amoebic colitis

Blunt abdominal trauma evaluation

Sigmoid volvulus.

Types of colostomy

Pelvic abscess

Fistula in ano

Sigmoidoscopy

Epidural anaesthesia

Dentigerous cyst

45year old male patient presented with upper abdominal pain and vomiting of one day duration. Pain radiating to back. There is history of alcohol intake 2 days back. On examination there is tachycardia, mild abdominal distension and tenderness with guarding in epigastrium. a) What is the most probable diagnosis b) How do you investigate c) How do you manage this patient

27year old male patient presented with pain in right lower abdomen, vomiting and fever of 3 days duration. On examination there is tachycardia, pyrexia and tender mass in right iliac fossa. a) What is the most probable diagnosis b) What are the relevant investigations c) How do you treat this patient

65years old male patient presents with massive abdominal distension, absolute constipation and pain abdomen of one-day duration. On examination there is tachycardia, massive abdominal distension and tenderness, no guarding or rigidity plain X ray of erect abdomen showed coffee bean sign. a) What is your diagnosis b) What are the etiological factors c) How do you investigate and treat this patient

35 year old male patient with history suggestive of peptic ulcer disease presents to emergency with complaints of severe diffuse abdominal pain, vomiting and abdominal distension of 1 day duration. On examination, abdomen is distended, tender with guarding and rebound tenderness. a) What is your probable diagnosis b) How do you manage this patient

Assertion (A): Incisional hernias are a common complication of abdominal surgery Reason (R): They occur due to inadequate wound healing a) Both A and R are true, and R is the correct explanation of A c) A is true, but R is false b) Both A and R are true, but R is not the correct explanation of A d) A is false, but R is true

Amoebic liver abscess

Carcinoid tumour of appendix

Assertion (A): Undescended testis (cryptorchidism) increases the risk of infertility and testicular cancer Reason (R): The higher temperature in the abdomen impairs sperm development a) Both A and R are true, and R is the correct explanation of A c) A is true, but R is false b) Both A and R are true, but R is not the correct explanation of A d) A is false, but R is true

Meckel’s diverliculum

Regional anaesthesia

Assertion (A): Dental caries is a preventable disease Reason (R): Regular oral hygiene and fluoride use are effective preventive measures a) Both A and R are true, and R is the correct explanation of A c) A is true, but R is false b) Both A and R are true, but R is not the correct explanation of A d) A is false, but R is true

Mammography

Assertion (A): Focused Assessment with Sonography for Trauma (FAST) is a rapid tool for detecting intra-abdominal free fluid Reason (R): It is highly accurate in identifying solid organ injuries a) Both A and R are true, and R is the correct explanation of A c) A is true, but R is false b) Both A and R are true, but R is not the correct explanation of A d) A is false, but R is true

Undescended testes

In the management of a child with acute appendicitis, the essential steps include: 1) Laxatives 2) Prompt surgical intervention, preoperative antibiotics 3) Managing pain 4) Adequate hydration a) 1 and 2 b) 1, 2, 3 and 4 c) 2 and 4 d) 1 and 3

Causes of Haematuria

Regarding the principles of informed consent, the crucial elements are: 1) Patient's signature and Doctor’s approval 2) Disclosure of risks and benefits 3) Patient's capacity to understand, and voluntary decision 4) Guarantee of a successful outcome, and family's approval a) 1 and 2 b) 2 and 3 c) 3 and 4 d) 1 and 4

Benign prostatic hypertrophy

Complications of gall stones

Postoperative nausea and vomiting (PONV) can be minimized by: 1) Multimodal antiemetic prophylaxis 2) Prolonged fasting, minimal fluid intake and antiemetics only if symptoms develop 3) Adequate hydration and minimizing opioid use 4) Deep breathing exercises and opioid analgesics a) 1 and 3 b) 2 and 3 c) 3 and 4 d) 2 and 4

Discuss how you will obtain consent for a permanent colostomy from a patient.

How will you counsel a patient for radiotherapy for a recently diagnosed cancer rectum Precise answers

The advantages of laparoscopic surgery compared to open surgery typically include: 1) Smaller incisions and reduced blood loss 2) Faster recovery 3) Higher risk of complications, longer operative time 4) Similar recovery time but increased cost a) 1 and 2 b) 2 and 3 c) 3 and 4 d) 1 and 4

Surgical treatment of Haemorrhoids

Complications of ulcerative colitis

Mallory Weiss tear

Mesenteric cyst

Triangle of doom

Diagnosis and treatment of acute intussusception

Infantile hypertrophic pyloric stenosis

Describe Gustilo and Anderson Classification and management of Open fractures.

Carpal Tunnel syndrome.

De-Quervain’s tenosynovitis.

Describe aetiopathogenesis, clinical features, management of Developmental Dysplasia of Hip.

Describe etiopathogenesis, clinical and pathological features of Osteosarcoma. Management of Osteosarcoma of Proximal Tibia in a 20-year-old patient.

Classification and management of Fracture Neck of Femur in Adults.

Management of a 2-year-old child presenting with suspected Septic arthritis of Knee.

Management of Chronic Osteomyelitis.

Classification of Joints. Short notes

Gait -definition and examples.

Role of exercise as a therapeutic modality.

Differences between Primary and Secondary fracture healing.

Deformities in Erb’s Palsy.

Radiological findings of Chronic Osteomyelitis.

What is Distraction osteogenesis. Give two examples where it is used.

Gun Stock deformity.

Three clinical tests for Ulnar nerve (Function).

Deformities in Tuberculosis of the Knee.

Types of Bone graft.

Tension Band Wiring-principle.

Stages of Fracture healing.

Deformities in Congenital Talus Equino Varus.

A 14 years old boy with a swelling of distal thigh of 6 years duration presents with a 3 months history of pain in the swelling and a recent increase in size. There is no history of trauma. Patient is moderately built. Examination reveals a firm to hard tender swelling localized to the medial aspect of distal metaphysis of the femur. Discuss: • Give the probable diagnosis • Outline its management

Myositis ossificans.

Osteogenesis imperfecta.

Stress fracture.

Epiphyseal injuries.

Gunstock deformity elbow joint.

Morrant Baker’s cyst.

Anatomical classification of fracture neck of femur.

Bennett’s fracture dislocation.

Assertion (A): General anesthesia involves a reversible loss of consciousness Reason (R): It primarily works by blocking pain signals a) Both A and R are true, and R is the correct explanation of A c) A is true, but R is false b) Both A and R are true, but R is not the correct explanation of A d) A is false, but R is true

In the management of urinary stones, the following considerations are important: 1) Stone size 2) Location 3) Composition 4) Presence of infection a) 1 and 2 b) 1, 2 and 3 c) 3 and 4 d) 1, 2, 3 and 4

The characteristic finding in Barium swallow in a case of achalasia cardia is a) Bird beak appearance c) Lead pipe appearance b) Apple core appearance d) Leather bottle appearance