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Surgery Viva/OSPE/OSCE Questions by batch 2015





Steel wali chezen autoclave

Syringes catheter iv line by gamma

Aur Lap chole sterilize by??

Suture by ethylene

xtrnal said ethylene hai mayo ma available, i said no tw he was like wo batain jo yahan hte hai
autoclave b ne hty laproscopy k na wo peracetic acid n formldhyde pa manay hn


Mera north aur west ka combo tha...osce main cheating ho rahe the thori bohat...short cases main multi nodular goitre, breast lump, right iliac fossa mass, para umbilical hernia, sebaceous cyst, lipoma tha...long main mera burns tha mam ayesha k pas...table viva main x ray chest ercp wagaira rakhe huwe the...kaha explain any one aur phr us se related questions

Long case k liye just 1/2 hour...no help at allπŸ˜”


Short case osce in east. Sir naqi examine groin region Tell ur findings . Ring occlusion kahan ki. Other relevent findings in abdomen or other place ( hernia ki. Abdominal mass chest etc btana tha. Or dre my bph) Palpate Lower limb arteries . Okay jao. External thyroid examine kro. Finding. Multinodilular goiter. Y? Retrosternal extension dykho. Compressive symptom dykho ( kocker) carotid palpate kro. Kahan krty han. Acha jao Ospe asan thi cheating ho gyi end py usmy b. Table viva sir Ibrar ny specimen rkhy thy upr nam likhy thy. Sbki surgeries btao. Unki complications btao. Acha jao. Table viva extrnal CT dykho pancreatic area hazy. Causes btao. Nacrotising my kia kro gy. Instrument heavy siezur . Ismy or disecting my difference. Acha how to sterlize chalo jao Long case. Testicular mass. External dd btao. Most likely dx. How to differentiate b/ w different dds of urs. Types or testicular tumor. Uski staging. Investigations mangmnt . Stage 4 ka mangmnt relevant examination Long case my parhny ka khula tym

And sir gondal is love atleast subha k intro my tw thy. K v are here to facilitate u

Ayaan Ali ki cholecystectomy kesay karen gay...??? By Dr.Abrar..

Us ka answer hae
NOTES
(natural orifices transluminal endoscopic surgery) πŸ™ˆ

As it is without external scar marx

Uski varicose veins ka b sir ko bht khyal, Uska bhi aesa e koi question pucha tha

Osce qs that v cn remembr... pic of hemarhoid id n Rx. IVU.. findings. Vicryl..sterilize n 4 properties. 
Gastric outlet obs... metabolic derangement 
Stoma prolapse n complications... babcock....uses sterilize
Hydatid scenario n complications. Foley id uses...
Hemothorax xray n indis of thoracotomy.
Extradural hematoma n Rx. Marjolin ulcer scenario n definitiv Dx.

Short case dr abrar.... mark deep ring... wanted running commentry of wat i ws doin. Diff btw midinguinal pt n midpoint of inguinal lig n their sig.... dint kno. His PGs dint kno either... unko kaha kal parh k ana. πŸ˜‚
Palpate spleen. How diff frm kidney... kr k dikhain.
Examine rt facial nerv... wen is it not intact in parotid swelling? Ca. How will u get histo dx. I sed excisional biopsy after surgery. Y nt trucut? I sed seedling

Short case ext. Thyroid... Examine nek swelling... aur kia kia examine krain gi? Tell Dx. solitary nodule thats clinically euthyroid... Ix. Rx if colloid goitre on fnac. Will try thyroxine. If doesnt work n pt anxious abt cosmesis? Surgery. Wat structures to preserv. Findings of ext laryngeal n injury. Bilat recurrent injury

Table viva east ext... a realy cool guy πŸ‘πŸ» asked instruments... morris ryt angl retractor, toothed forceps, proctoscopes. Uses of all. Askd morris incision. Laparoscope intruments ki sterilization... nt autoclave itl melt em :p
Ethylene oxide .. but not in mayo. 
Its glutaraldehyde i thnk.

Table viva dr naqi. Wats this specimen? Gallbladder with stone. I say its intestine prove me rong. GB is blind ended πŸ˜„
Tell all 4 xrays... ercp  show whr cbd dilated. Whr filling defect. Rx cbd stone. Ercp extraction. Wat size u cn remov wid it? Uhh 7 mm. Ye bara lgra h ya chota? Bara.
T tube cholangiogram. Show whr dilation. Nikal den t tube? No theres no contrast in duodenum so Γ³bstruction persists. 
Xry ...show dilated loops air-fluid levels. 
Xray gas undr diaphrgm... mx. Fluid fr resuscitation. Comp of ringer

Long case dr naqi. Ac on chr cholycystitis.... takes ur sheet so u shud kno ur his. n reads it so write properly :p
Prove on his tht pt has symptomatic gallstone dises. Tels u to examin in  front of him  . Ix  . Y lap choly gold standard. Late comps  . Ca GB staging. Rx. Wats extended cholycystectomy. Kahan tk lymphadenectomy.

Significance of midpoint of inguinal ligament ??
Femoral pulse hoti at mid inguinal point
While
DIR 1.5cm above at midpoint of inguinal ligament                        
Mid inguinal point
Is from ASIS to pubic symphsis
Midpoint of inguinal ligament 
ASIS upto pubic tubercle ka midpoint
Midinguinal point is also midway b/w ASIS n pubic symphysis

Ankle jerk lita kr e krni h ya baith k b hojati? πŸ™ˆ                        
Beth k b ho jati...

Pt ko kaho k relax ho kr betho..
Aur 1leg ko doosri k ooper rakhey...
Flex the foot n strike the mallet 😊😊

Told by. Dr.Abrar

Ideally ankle jerk leta k hona chahye...
Bt when u examine whole of thyorid in sitting n pt is unable to lie as couch is nt availablπŸ˜‚πŸ˜‚
Tou betha k b possible ho sakta hae πŸ˜‚πŸ˜‚

North long case, table viva
West short case and OSCE

OSCE
Hamarye immediate seniors hotye hain west main sab karwa daitye hain.

Short cases
Dr. Ayeisha
Thyroid swelling
Indirect hernia
Ghoomati hain aur ajeeb questions karti hain, doest really get happy

External
Very nice
Parotid swelling
Breast CA
Asked about pagets disease, blood cancers, leukemias, reasons for chronically enlarged lymphnodes, side effects of radiations, typers of parotid CA, facial nerve, warthins adenoma

North Table viva
Sir gondal
Treatment of thyroid perforation
Sutures
Treatment of air under diaphragm

External
Describe parts of various instruments

LONG CASE
EXTERNAL
Thyroid
Types of thrrotoxicosis
What is combination of splenomegaly, neck swelling and pretibial myexdema.
Treatment
Eye signs

Long case

Inguinal hernia main bph related stuff treatment how identify -.- 

Short main diabetic foot main how trophic y not ischemic nd y immunity weak in dm -.-

ek lafz help ni hui ksi b cheex me. Just short case bahir btadea tha. Aur andr kch aur e tha mera toh.

east-south.
Parh k jana for ospe.
Short case hernia incsional, inguinal, MNG, parotid. Varicose. Aur ek pta ni kya tha jo mjse poocha spleen pr viva tha shayad mass LHC

Long case diffuse goiter
Table.dr naqi babcock ETT
External Ba enema, gall bladder specimen

Mass LHC k differentials poochay thy                        
Dr naqi asked autoclave available ni toh kesay sterilize kreingay babcock ko. I said hot oven. He asked temperature                        
Hot air oven *                        
Sterilizatn wala temp rat lo. Temp bhe. Time bhe. Pressure bhe

East south combo...long case in east. We were told not to open books...no help...end k kareeb aik pg ne sbko aa k thora guide kia tha.
No help in osce in south...short cases bahir bta die thay..short case n table viva dono me they cheked ward cards.

Long case...sir naqi started. Case..parotid swelling...heard history n exam. If i say both parotids n both submandibular are enlarged wats ur d/d? I said sjogrens...wo kia hai? How do u treat it? If fnac said its warthins wat is dat?treatment? Wats the procedure? Complications? Anatomical landmarks of facial nerve? Ur doing the procedure n uv transected the facial nerv wat do u do? Wat if its malignant? How do u stage it? T3 N2 hai...ab kia krainge? Wat is radical modified n selective neck dissection?
Phr external b aa gae. Wat if its pleomorphic adenoma? Y called so? Y not enucleate? Freys syndrome ho gia hai. How do u diagnose it? How will u treat it? Patient ki kal surgery hai...isko counsel kr k dikhaen....

Short case in south. external. Really easy going. Examine abd. Findings? Wat wud b cause of splenomegaly in dis patient? She ws a middle aged female. Complications of splenectomy. Manouvres of palpating spleen. Is area me aur konsi cheez palpable ho skti hai? How do u differentiate spleen n kidney. 

Short case dr Abrar...varicose veins ka case....do fegans test..how do u cnfrm ur findings? Next pt...just inspect abd n tell findings....incisional hernia tha...pta ni sth like how do u cnfrm?  Ya size of defect or sth. Next patient....inspect face...puffy swollen...correlate it wid da finding in neck...mng tha...hypothyroid...wat other clinical test will u do to confrm?

Table viva dr naqi. Round body retractor pkraya..uses? How do u sterilize it? If u dnt hav autoclave?  Chest tube di...wich end is inside? Wat is other end connected to? Y do ee hav an underwater seal? Indications for removal? How do u remove it? Triangle of safety? If u insert below it on right side wat will happen? 

Table viva east external...three models appendix gallbladder n MNG..y is this appendix...does it look inflamed? It ws normal wen we opened abd now wat shud we do? We examine ileum n pt has crohns disease..do we still remove it? Abdomine pelvis radiograph wid contrast tha...i think barium follow through...stricture in colon. Wat diagnostic investigation will u do?

North surgry
Osce as told by mariam plus
-Ascending hemicolectomy ki diagram thi..identify procedure n is me kon se structure preserve krty hain
-dilated small bowel loops X-ray..what is this investigation n +ve findings
-barium swallow film..+ve findings n what materials r used for contrast studies
-allen test ki significance
Short case
Sir gondal:
CA breast
+ve findings?
Kesy pta chly ga k cancer pec major me infiltrate kar chuka h
Serratus ant ki infiltration ko kesy tst kro gy
Serratus ant ki nerve supply
FNAC me C3 smear aye ga to kia kren gy?
(Sir was asking about FNAC smear by every secnd student so achy se kr lena)
Stage btao is cancer ki
How will u manage it
MRM me kia structures remove krty hain
BCS me kon se structrz remove krty hain
MRM me kia preserve krty hain
Thoracidorsal kis msl ko supply krti h
External
Swelling in post triangle
Examine head n neck
What r +ve findings
Facial nrve kis head n neck swelling me zrur chek krty hain
Sabaceous cyst k cahractristics on exam
Slip sign
Cystic hygroma ki charactristics on exam
Swellng in post triangle k DDs
Table viva..mam Ayesha
What is this instrumnt (non traumatizing intestinal clamp)
Its uses
Gut q occlude krty hain during srgry
Agr infection ho jaye during srgry to kia hoga
Adhesions ki types
Adhesion ka treatmnt
Gut ki viability kesy chek krty hain
Long case..mam Ayesha
Case hydrocoele
History puri suni..presnting complaint me swelling k sath plyuria tha so viva usi py hua
Polyuria ka kia mtlab hai
Polyuria ki investigations
Kidney stones me kia urinary complaints hon gi
Bladder stones ki types
Blader stones ka treatmnts
South and east combination
Osce... donno wards mai bakwas .. no help at all... aur haad ki buri osce
Match the following
Upper arm k dermatomes aur normal LFT
Oropharyngeal airway aur size is ka
Cannula green.. size and flow rate
Air under diaphragm ka aur ileum ka xray
T tube cholangiogram
Facial trauma tou definite airway kay indications and kis sai karain gai
Varicose veins treat
Cystic hygroma aur kahan kahan ho ga
Proctoscope its parts and positions for its use
Allens test
Tetanus toxoid .. indications and route
Baki yaad naj mjhay..
Short case ..
Thyroid ... dr abrar..
Neck and face exam karo n btao kya hai .. myxedema kya hotta hai .. pretibial edema hotta hai ?
Radial nerve examine karo .. yaad sai sensations k waqt ankhain close karwa laina...
Fagans test karo..
External..
Inguinoscrotal herbia tha n some questions .. d/d btao tests karoo n treat karoo
Long case...
Dr naqi.. cholecystitis
History sunao .. positive findings on examination n d/d
Murphys sign karo..
Investigate karoo.. usg findings? HIDA ka full form bta n kyun kartay..
N treat the patient
Table viva...
External..
Model of gall bladder with stone types of stones.. open chole .. other types of incisions.. others were mng and appendix..
Xray of obstruction of abdomen .. others were ERCP n some chest xray
Dr naqi..
Instruments ...
Cv line indications n complication ..
Lidocaine uses n doses
NG tube indications n uses
Allis forcep uses..
Sterilization agar auto clave na ho..
Formaldehyde n glutraldehyde sai kon sai instruments ko karo gi? .. laproscopic instruments ..
Long case mai koi kitaab kholnay nai daitay .. n baat bhi nai karnay daitay n change bhi nai kartay case...
Short case were... mng.. inguinoscrotal and incisional hernia... varicose veins ... parotid swelling ...
East short case:
Mng ,relative examination for hypothyroid, median nerve exam :-/
Inguinal hernia examination position sense of lower limb.
Table viva: 
External: dissecting scissors,proctoscope
Dr.abrar : infusion set.formula to calculate rate, 1ml kitne drops.
Long case : Dr abrar Murphy sign, biliary colic nd cholecystitis clinically kese differentiate krna? pneumoperitoneum pressure?complication on 10 nd 15 mmHg?
Ayan Ali ki cholecystectomy kese krni.

South Osce and short case
Osce no help :-( even cheating krne se rok rahe the. Be really sneaky cheat krte waqt :-P sir khalid sir irfan sir shahid sab udhr like hawks ki tarah dekh rahe the
15tables. 2marks each
Stoma prolapse.vicryl.hemorrhoids.ivu.epidural hematoma.compartment synd.bcc.chest tube indication.hemopnemothorax. hytatid cyst c.t . Barium meal. No councel table
Short case sir abrar and external
Lipoma.parotid.thyroid.splenomegaly.inguinal hernia
Timer lagaya huwa tha.. 5min only
Mjh se sirf sir abrar ne examination krwai
External examination.plus throidectomy complications
Table viva and long case east sir naqi
Table viva sir naqi models appendectomy.colloid.gall bladder
ERCP.t tube . Chest xrays
Appendectomy complications.t tube complications.removal of gall stones.t tube nikal k hole ka kiya karein ge?
External table viva... instruments laproscopic appendectomy .incisions.babcock kocher.
Long case sir naqi... MNG thyrotoxic
History paper le leyte.zubani sunao
Signs pooche.malignant changes.carotid pulses.ankle jerks...akhiri bandi thi itna nai suna...baki sab se bht lamba le rahe the...overall easy liya mjh se bakiyon k nisbat

Short case osce in east.
Sir naqi examine groin region
Tell ur findings . Ring occlusion kahan ki. Other relevent findings in abdomen or other place ( hernia ki. Abdominal mass chest etc btana tha. Or dre my bph) Palpate Lower limb arteries . Okay jao.
External thyroid examine kro. Finding. Multinodilular goiter. Y? Retrosternal extension dykho. Compressive symptom dykho ( kocker) carotid palpate kro. Kahan krty han. Acha jao
Ospe asan thi cheating ho gyi end py usmy b.
Table viva sir Ibrar ny specimen rkhy thy upr nam likhy thy. Sbki surgeries btao. Unki complications btao. Acha jao.
Table viva extrnal CT dykho pancreatic area hazy. Causes btao. Nacrotising my kia kro gy. Instrument heavy siezur . Ismy or disecting my difference. Acha how to sterlize chalo jao
Long case. Testicular mass. External dd btao. Most likely dx. How to differentiate b/ w different dds of urs. Types or testicular tumor. Uski staging. Investigations mangmnt . Stage 4 ka mangmnt relevant examination
Long case my parhny ka khula tym

West short case and osce.
They helped a lottt in osce.
Short cases, lipoma with external. Describe ur exam findings. Dx? Why is lipoma lobulated? Diagnostic test to confirm. How sensitive is FNAC in case of lipoma. What is sensitivity of a test?
Breast lump with dr Aisha shaukat.
Describe findings. What is the stage? Whole of the TNM staging.
Long case with external.
Thyroid lump. (That was MNG progressed to a follicular CA, as per my clinical approach)
Hx. Provisional Dx? What makes u think it's a CA? What findings in the swelling are suggestive of CA? Palpate carotid. What conditions can cause leg paralysis, if we assume it is not related to thyroid?
Table viva with Dr Gondal.
Saw Ward cards. Right side se btana shuru krain instruments. On 9th or 10th he asked me the method of sterilization of it.
Principle of autoclaving.
And that's all. And I must say that
THE MOST IMP THING IS TO TAKE 6HR SLEEP AND BREAKFAST BEFORE VIVA.
Allah be with u all.

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