Question that was being asked during my previous part II exam in USM. I hope these will help, can't remember everything exactly. For those who would like to contribute pls email it to me at zairulazwan@gmail.com, I will post it in this blogspot for the rest..
Long case:
- bilateral staghorn calculi with hydronephrosis
- causes of renal calculi
- risk factors developing renal calculi
- need to know the difference between DTPA and DMSA
- which is the commonest type of renal stone
Short case:
1. An elderly lady with large thyroid swelling and lymph node
- made a diagnosis of papillary thyroid carcinoma
- was ask for other differential diagnosis
- how to manage
- if the patient refuse for surgery what other modalities of treatment?
2. A young man with abdominal incisional hernia
- had laparotomy due to MVA
- was ask of type of repair; open vs laparoscope
- what type of mesh to use
- this patient had a burst abdomen after the laparotomy, was ask what are the most likely causes and how to prevent burst abdomen
3. A young lady with lipoma over the clavicle, about 3 x 4cm
- differential diagnosis
- how to differentiate between the differential
- for excision biopsy where would you place you incision
- show how you do 'slip' sign
- what is dercam disease?
Viva:
1. Pathology table
showed specimen / pictures, alhamdullilah no histopathology slides
a) dilated small bowel - intussusception of small bowel
- why you say this is small bowel?
- causes of intussusception?
b) picture of resected small bowel with 3 polypoidal lesions
- described the picture
- associated disease
c) partial gastrectomy specimen
- possible reason of gastrectomy
d) cut opened stomach with ulcer
- described and show the edges of the ulcer
- how to do classify stomach CA
- what is Borrmann and Laurens classification
e) Hip X-ray with multiple lytic lesion and pathological fracture neck of femur
- most likely primaries
d) MRCP film
- delineate the anatomy
- what is the most likely diagnosis - it was a cholangiocarcinoma... i think
e) Cut specimen of an abdominal aortic aneurysm
- how many ways to classify aneurysm
- difference between true and false aneurysm
- causes of AAA
f) A picture of a gangrene leg
- describe the gangrene and the edges
- how do you investigate and manage
- if this was due to a snake bite, what type of snake would cause it?
- type of venom i.e. neurotoxic, myotoxic, hemotoxic
2. Principal 1
a). was ask about retroperitoneal hematoma
- how to classify abdominal trauma? - blunt vs penetrating injury
- structures in each zone
- how do you manage for each zone
- when do you go in or observe
b). abdominal wound dehiscence and burst abdomen
- how to classify wound dehiscence
- what clinical signs to say wound dehiscence
- how to manage
3. Principal 2
a.) patient post laparotomy for PGU developed fever
- causes of postop fever
- how to investigate and manage
b.) patient post total thyroidectomy,
i. when do you stop carbimazole and propanolol? why?
ii. pt complain of numbness, what would you checked?
iii. what treatment to administer for hypocalcemia?
iv. what are the complication of hypocalcemia?
c.) was ask about body response to injury/surgery
i. talked about the erb and flow phase, what happen during these phase
ii. post op IVD to give all NS or mixture of NS and dextrose, why?
4. Operative
a.) Patient with obstructed sigmoid tumour
- how to do take consent for this patient?
- talked about hartmanns or colostomy
- what is hartmanns procedure
b.) how to do you do hemithyroidectomy
- post-op what do you look for?
c.) what is informed consent?
d.) what is suture and how to do classify sutures?
- give example
- where does cat-gut comes from? cattle - sheep
- which part of sheep does catgut comes from
- where does silk sutures comes from
There might be more, if later i recall i will post it..
All the best to those who are going to sit for the final exams
' Try your best and let Allah do the rest'
' To succeed is easier than to fail' ... (Fadzilah Kamsah)
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