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shami1978

FCPS II Theory Paper 24 June 2009

FCPS-II GENERAL SURGERY PAPER
JUNE 24, 2009

First paper was of theory , followed by MCQs

theory paper was of three hours and is as follows

Q-1
A young man has sustained head injury in an RTA. His GCS is 3. Hhis legal heirs have consented for donation of his organs for transplantation in case of his death.
a) how will you define death ?
b) what are the preconditions which must be met before making the diagnosis of brainstem death ?
c) what clinical tests will confirm brainstem death ?

Q-2
A man of 65 years sustained injury to his left lower leg. on examination there was a wound 5 cm above the ankle . X-ray showed comminuted fractures of tibia and fibula and medial malleolus.

Discuss the management and complications?

Q-3
A 30 years old lady presented with a firm mobile non tender swelling in front of right ear lobule.

a) what clinical steps you will take to reach at diagnosis ?
b) what is the differential diagnosis ?
c) how will you investigate the patient ?
d) how will you treat the patient ?


Q-4
A female of 40 years has undergone breast conservation surgery for carcinoma breast.

a) Briefly discuss the disadvantages of post operative radiotherapy in this patient ?
b) Briefly discuss the rationale and technique of intra operative radiotherapy ?

Q-5
A middle aged person is brought in emergency with history of sudden onset of pain in epigastrium for 24 hours. He is a chronic smoker , now he is complaining of vomiting and generalized pain in the abdomen. Abdominal examination reveals that it does not move with respiration. whole abdomen is tender with board like rigidity.

a) what is the diagnosis ?
b) name investigations ?
c) discuss various options of management ?

Q-6
A 60 years old male has presented with a mass in right lower abdomen which is mildly tender. there is previous history of having sometimes constipation and sometimes diarrhea for the last 06 months. He has also lost some weight.

a) list the differential diagnosis in order of priority ?
b) how will you confirm the diagnosis and treat this condition ?


Q-7
A 45 years old female was hospitalized for acute pancreatitis. she was managed conservatively . Four weeks after admission , she developed epigastric fullness and discomfort.

a) what is the most likely diagnosis ?
b) How will you confirm the diagnosis and treat the condition ?

Q-8
A forty years old female has undergone laproscopic choleystectomy and on 3rd post-operative day drain reveals 300 ml of bile. The patient is febrile with distension and tenderness in the upper abdomen.

a) Give three likely causes of bile leakage in the patient?
b) how will you localize the site of leak ?
c) how will you treat the patient ?

Q-9
A 25 years old male notices a lump in the right testis with the sense of heaviness. on examination right testis in enlarged with a softer protuberance on one side with loss of testicular sensation.

a) what is the most likely diagnosis?
b) what investigations will be needed to evaluate this case ?
c) how would you manage this patient ?


Q-10
A 50 years old female is admitted with a swelling in her groin . she has mild dragging pain in this swelling . there are no other complications . on examination , the swelling is about 4 cm X 2 cm. located below and lateral to the pubic tubercle.

a) what is the likely diagnosis ?
b) give the differential diagnosis ?
c) how would you manage this patient ? Name various surgical options ?

[Edited by shami1978 on 24-06-2009 at 08:01 PM GMT]