-----------------------------------------------------------------------Medicine Feedback !

* Question Were Based on Next Step in Management ...

1. For Example a person with achlasia had barium meal done ... What is
Next best management or Step ... ANS) Esophagomanometry
-----------------------------------------------------------------------Pedatrics (Feedback Before Exams)

the

Birth: OPV and BCG

6 Weeks

OPV 1, Penta

10 Weeks OPV 2, Penta 2

14 Weeks OPV 3, Penta 3
9 Months Measles
Pentavalent: Dpt, Hib, Hbv is included in it
Pneumococcal in EPI: Conjugate PCV in 10 and 13 is given at 6,10,14 weeks and t
hen 12-15 Months
Note: Pneumococcal is given concurrently with the pentavalent in the schedule
Labs at the end of kundi ... Growth and development in kaplan
Difference between whole cell and acellular pertussis vacinnes:
* Acellular has less side effects, less local and systemic reactions,fevers,seiz
ures
I DPT we give DaPT ,,, Note: EPI Gives DwPT while you can give DaPT if you wish
instead if you want less sideeffects
Subcutaneous Vaccines: Measles (MMRV)
* BCG in Intradermal
Pediatrics Last Year SEQ's: VSD, Vit A Deficiency And Toxicity, Thalassemia, ...
iron overload as toxicity for example
Strauss Therapy: For less than 2 years give 300 000 IU of Vit D3
For more than 2 years its 600,000 IU (Via IM)
and then do XRay wrist after a month
Regarding Diet Plan:
Calculate calories according to the expected weight and then make a plan
about what to include in breakfast,lunch dinner and 2 smacks in between
and then ask mother if the child is tolerating the feeds well
Apgar Score is done to check if Resuscitation is working

* At 3 or less for more than 5 minutes (Shows Asphyxia)

Intubate and Ventilate when patient is in distress or not breathing
Note: HPV Vaccine given at 9 Years Note: Makes can get it
11 Years: Males get the quadrivalent one and not the bivalent one
Both Males and females can get gardisik while note that bivalent is reserved for
females ... Cerverix is also used,
Note: Live attenuated includes polio, varicella, mmr, bcg
Note: Check out the classic triad of symptoms for foreign body in resp system.
DPG: Just review Nelson Essentials (According to him a lot of Mcq's were
asked from it.
-----------------------------------------------------------------------Recommended Books For Pediatrics ...
* Ace Pediatrics
* Basis Of pediatrics
* Kaplan Review
Rudolph Pediatrics ... MCQ's To Optimize Core Knowledge Application
-----------------------------------------------------------------------Pediatrics
Q1) Child with moderate dehydration due to chronic diarrheoa, he will not have .
.. Muscle hypotonia, iron def anemia
Q2) Child had DPT Vaccination done... got seizures...Causes:
... Diphtheria Vaccine, Pertussis Vaccine, Tetanus etc
Q3) Child 9 years old had sodium valroate due to epilepsy.Parents while
searching on internet got worried from its side effects !.... Risk Factors incre
ase for epilepsy in Age less than 2 years, Family Hx,
Q4) A child with migraine will have all except ... Neck rigidity, numbness in fe
ets, visual problems, avoidance of voice
Q5) Management of patient presenting with chlamydia infection (Primary)
... Penicillin, Cefotaxime, Vancomycin, Erythromycin
Q6) Patient with Cough, Sneezing, Experatory Wheeze, Hyperexpansion Of Lung ...
Broncholitis, epiglottitis, Asthma
Q7) Diarrhea with blood and water. Most common organism ...
... E.coli, Rotavirus
Q8) All can be given in hyperkalemia except ... Spironolactone
Q9) 18 Month old, what can we expect from the child ... Make 3 blocks from cubes
, make a circle, undress and button, walk steps,
Q10) Child able to untie shoe laces, walk stairs ...what age predicted
* 18M, 24M, 30M, 60M

Q11) A Child with down syndrome, what to advise parents

* 1/4 children can have it, child with die in 2nd decade, Will have resp
problems,
Q12) Turner Syndrome Has it ... Web Neck
Q13) What is not true regarding measles ...
Options: Killed vaccine, given in immunocompromised, given before 6 months, give
n oral
Q14) Kwashiorkor Not correct ... Edema, fatty liver, fatty changes in pancreas,
Q15) Regarding Down syndrome
... Height crosses 95th percentile, web neck, Cranio Tabes,
Q16) Cause of large head ... 1cm greater than normal
... Craniosyntosis, Fetal alcohol syndrome, post maturity,
Q17) Cause for Retinopathy in newborn
... small for gestation age, diabetic mother, post maturity, Torch Infec
Q18) Child with UTI ... What is not correct
... UTI is the most presenting symptom in jaundice, there are 100,000
in urine D/R, Casts can diagnose it correctly, E.coli most common

E.coli

Q19) Most loss of iron reasons

ABO Incompatibility, Physiologic jaundice,
Q20) Spherocytosis ...
* Symptoms releived with splenectomy, its hereditary A.R,
Q21) Patient with low platlets in question, had post viral resp infection,develo
ped petechial rash which was treated.what could be the cause
...Idiopathic thrombocytopenic purpura, Aplastic Anemia,
pura

Thrombocytopenic pur

Q22) Patient had seizures lasting for 4 minutes each, has been having this for 3
months...given benzodiazepines,fluids,antibiotics but case still refractory ...
Complex partial seizures ?
Q23) What is first feature in leukemia ... Fever, bleeding, Anemia,
Q24) Patient drowned in pool, was resusitated.was brought to the ER,
What to manage ... Hypokalemia + Hyponatriemia, Hypernatriemia, Hyponatriemia, A
cidosis + , Anser Most likely: Acidosis
Q25) Patient with SSPE, what could be the reason ... Measles, Mumps,
Tetanus, Chicken Pox, Herpes
Q26) Patient with rickets has the following except:

... Craniotabes, rosary spots, Short stature

Q27) A child with septic arthritis ... Which is correct
* Aspiration of knee, Bone scan,
Q28) A child with meningomylocele ... Which is not correct
* Can get infected, bone issues unknown, urinary symptoms,
Q29) Child after weaning at 9 months developed loose stools, is
, get infections tests .. Chloride sweat test, breath test,

dehydrated

Q30) Child with loose stools for 3 months ... Small bowel biopsy,
mysial, Chloride sweat test

Endo

Q31) Iron chelatings ... EDTA,

Q32) While treating child for hypernatriemia, suddenly devloped fits ...
ses: changes in sodium, Changes in calcium, changes in pottasium,
Changes in glucose levels.

cau

Q33) Child with pleural effusion, has consolidation at the upper lobe of
ght lung, other symptoms ... cause TB

ri

Q34) Child born to mother having TB, What to do ... Breast milk + BCG,
Breast milk + Isoniazid, Express milk+ BCG, Oral Feeds + BCG
Q35) Difference between cow and breast milk ... Protein, Lactose,
otassium, Chloride ... Answer: Lactose

Sodium, P

Q36) Child with retention of urine for 24hrs, edema, abdomen distended,
dilated vessels Management ... IV Furosemide + Albuumin, IV Albumin
IV Furosemide, IV Saline
Q37) Regarding goats milk, what is deficient ... Folic acid, iron
Q38) A child has ptosis when looking up (Gaze) for more than 30
s ... Check Endomysial, Enzymes ?,

second

Q39) A child living in a farm presented with Fatigue, Lacrimation, Salivation, s

eizures, confusion ... Diagnosis is Organophosphate poisoning ... other options:
Digoxin Toxicity.
Q40)
-----------------------------------------------------------------------SAQ's
--------Scenario: A child having respiratory distress, pain in chest, clubbing in nails,
bp 150/90, has sounds in left lower sternum
* Diagnosis: Infective Endocarditis
* Infective Organisms 3
* Associated conditions with it
* Management:

Scenario: Child with diarrhoea for long time. Anemia is present as seen
in labs HB-6g/dl, MCV-55%, Platlets 450,000 etc
*
*
*
*
*

What is the disorder ... Iron Deficiency Anemia

Identify 2 causes from which you base your diagnosis
Grading according to IMCI
Steps in management
What test will you perform

Scenario: Celiac Disease Scenario ... Malnourished child, dehydrated,

* What is your diagnosis
* What advise will you gove the parents
* Diagnostic Tests
Scenario:
-----------------------------------------------------------------------Surgery Exam Students Feedback
*
*
*
*
*
*

Do Liver and spleen trauma

Thyroid and parathyroid
Para is MEN 1 75 %
Pneumothorx, Tension Pneumo
Indications Or Criteria For Thorocostomy
Do Pre,Post Op Management from Churchil, Pain Management

Note: Thoracotomy is done if chest tube drains more than 1.5 litres of blood or
200ml per hour
SAQ on Head of femur fracture
Management of burns like creams, fluids etc and type of scar formation
Like linear and keloid
Fronstnip and frostbit
Silver nitrate is given in deep and effective against all organisms except pseud
omonas (0.5%) while silver sulphidiazine is given superficial
Do parkland, subdural, epidural and subarachnoid,icp,hydroceph (OSCE)
Esophageal and breast tumors
Flail chest ... Greater than 3 ribs fracture in 2 or more adjacent places
In abdominal trauma diagnostic peritoneal lavage is
In Trauma esp do Pneumo, Hemo and flail chest
Breast Conservation is partial mastectomy and sinb or and if needed followed by
breast irradiation
We can always prefer mastectomy.adj radio can be given but radio has no such ro
le for dcis and adjuvant can prevent the recurrence
If its less than 2 cm with no nodes you can do lumpectomy with tumor free margin
or mastectomy

Limit of resecting normal margin is 10mm (Theres a book by Washman )

Wide local excision is the same thing
Birad score is important
Normal urine output is O.5ml Per Kg Per hour in adults or 500 ml per day
In skin BCC and SCC and malignant melanoma
-----------------------------------------------------------------------Surgery MCQ Feedback
-----------------------------------------------------------------------Q1) Colles Fracture ... Which Nerve is affected .. Distal end of radius
proximal end of radius, ulnar, axillary
Q2) Patient Could contract wrist in humerus fracture.which nerve is affected. ..
. Median nerve, Radial nerve, ulnar nerve
Q3) Female patient with bleeding from nipple on one side. No Lump, No
nodes, Negative ultrasound ... causes Intraductal papilloma,
duct ectasia, cystic duct
Q4) A 40 year old female patient with palpable lump on lower right side
cm, What is it ? phylloides Tumor, sebaceous cyst,

lymph

2X2

Q5) Cells involved in healing of wound ... Fibroblasts,

Q6) At the time of stress the body undergoes ... increased insulin production, e
pinephrine, adrenaline and noradenaline, glucose is utilized
Q7) Wound contracts by how much time ... 1 week, 1 month, 6 month
Q8) Patient presents with multiples sites of pus drainage, has fever
what to do ... Admit, Give IV Fluids, Surgical Excision, At home
Q9) Patient with TB of the Hip ... what changes expected ... Moth Eaten,
Fracture of neck
Q10) Cause of superior vena cava syndrome ... Bronchial carcinoma,
Q11) Patient with Fracture of Ulna and distal radius .. Monteggia, Scaphoid, Gaz
elli fracture
Q12) Patient with epidural hemorrhage ... Crescent seen in CT, Due to middle men
ingeal artery
Q13) A Patient who has hyper echoic renal, with pain in abdomen, has slurred spe
ech ... Hypokalemia, hyperkalemia, hyponatriemia
Q14) A patient who has fever and has distended abdomen ... Due to Anaerobic orga
nisms, gram +, Gram Q15) A patient with +ve Ultrasound findings of liver ... What to do ?
IV Antibiotics, drain under u/s guidance or CT Guidance
Q16) A patient who is taking anticoagulations, was to have emergency surgery ...
What to do ? Give Oral Pottasium, Parenteral Pottasium, Dialysis.

Q17) A Patient with enlarged thyroid.mother says she wants cosmetic improvement
of her child.Investigation Showed no findings. What would be your next step in m
anagement... Wait, give iodine salts, thyroidectomy
Q18) A Child with fracure of the metaphysis of toe, which is undisplaced
what to do ? ... Give Plaster below the knee, POP + Analgesics, Admit and ma
nipulate under G.A
Q19) Regarding fracture of scaphoid bone ... avascular necrosis, Snuff Box
Q20) A Man with single thyroid nodule which has enlarged,with ipsilateral cervic
al nodes ...papillary carcinoma, follicular carcinoma,
follicular adenoma
Q21) An adult person having complaints of dysphagia to solids ... most likely du
e to ? Achlasia, Malignant Tumor of esophagus, benign tumor of esophagus
Q22) Most common organism involved with infection of wound ... pseudomonas, e.co
li, ?
Q23) Patient getting transfusion, later getting shivering and tachycardia ... A
) Stop transfusion and cross match blood
Q24) Time to give antiobiotics for a patient undergoing surgery ... At the time
of giving anesthesia to 5 days Postop
Q25) Patient with pelvic and rib fracture after car accident... Now presents wit
h altered mental status.could be due to ... Fat Embolism. Pneumothorax, epidural
hematoma.
Q26) Patient came to ER after road accident. Pulse is 110 , bp 100/ ? .
What to do ... Give IV Fluids, Blood transfusion.
Q27) Thyroid Swelling moves with skin ... Reason ? Fascia Transversalis,
Q28) In patient with sepsis, Low PT & PTT ...Give Fresh Frozen Plasma,
Packed Red Cells...
Q29) A Patient presents with achlasia, what to do ? Surgery, Laproscopic
Esophagectomy,
Q30) A Patient with prev surgery done for Inguinal hernia, now comes after 2 yea
rs with hernia bilaterally . What to do ?
... Laproscopic mesh on right side and , laproscopic mesh bilaterally,
Q31) in Post Op Patients we give ... 2 Litres Dextrose and 1 litre Normal saline
Q32) A woman with mobile lump, No lymph nodes involved ... Fibroadenoma
Q33) Following is true for a spiral fracture ... Fracture line is twice the tran
sverse diameter of that bone
Q34) Kubylen Fracture ...
Q35) What is essential for wound healing ... Vitamin C, Vit D ...
Q36) A patient with strangulated hernia. what is the next step ...

Initial Resus then Surgery, Initial Surgery than resus ?

Q37) A Woman taking steroids now complains of headache , distended abdomen ...
Cushing, Conn Syndrome,
Q38) A Female patient who had C-Section done came after 4 days with Fever, Diste
ntion of abdomen ? Biliary peritonitis ???
Q39) Case Scenario .. With Raised Temperature ???
Q40) In which of the following is prophylatic antibiotic not needed...
Thyroidectomy,mastectomy,hemicolectomy,cholecystectomy
Q41) Following is true of a spiral fracture ... Fracture line is twice the trans
verse diameter of that bone
-----------------------------------------------------------------------Feedback: PROF EXAM's
* Medicine P1: 50 % , P2: 30 %
* Pediatrics: 20 %
* Surgery P1: 30 %, P2: 25 %
-----------------------------------------------------------------------Surgery Feedback !
* For Acute Cholecystitis: Early or intermediate within 48 hrs ... If not then w
ait for interval for 6 weeks and give antibiotics and then do
cholecystectomy. Cause after 48 hrs adhesions develop and then you cannot operat
e.
Note: Clostridium Perfringens is involved in forneir gangrene
In Surgery Last Year OSCE:
Real Cases on Varicose Veins, Inguinal Hernia, Testicular Examination !
-----------------------------------------------------------------------Medicine Clinicals Feedback ! Before Examination
*
*
*
*
*
*
*
*
*

Do All Examinations
Hepatitis
Hypertension & D.M
SLE
Asthma
Copd
Malaria & Dengue
Do atleast infectious and metabolic disease
Multiple Sclerosis

Study From Kaplan

-----------------------------------------------------------------------Feedback Of Medicine Clinicals ! After Exams
Cases: COPD Patient.Do Resp Exam, Make sure you do Trachea and Stabilize
head with Left Hand.COPD Findings and investigations with Findings.
Do Spleen Palpation.What is Massive Speen and what happens in it.
What is C.T disorder in AR.
Study Marfans, Turner, Mitral Valve Prolapse.

Asterexus. Choreas
Do Complete Cardio Exam including JVP and Peripheral Pulses ... And Findings.
Total Consultants 3 who will take your viva.
A Patient had mitral murmur with raised JVP.Other room had TB, MVP and Hepatic E
ncephalopathy
Feedback: They dont check your text knowledge but rather the clinicals, Examinat
ions. Please bring your Own BP Appratus, rulers and everything.
Learn how to describe your findings.In the end they will barely ask 2 questions
.
It is theoretical.Just do bedside.Causes and postivie findings.All you have to d
o in front of the examiners.No history, start with command
To Trochlear Nerve, Kernigs. Fluid Thrill, Palpate spleen
So it seems there are 2 rooms. One in which the examiner will ask you to do Clin
icals in front of him and the other room in which there would be relevant questi
ons pertaining to it by another consultant.
So in Total there were 3 Case Based Beds. 2 Proper Case Based and 1 Random (Cond
ucted By Jilani) ... In Other Rooms of other groups people were asked to take sh
ort Hx, Examination, diagnosis, Lab Reports and treatment ... just come early so
inorder to get to know the cases early
Viva in 5 - 10 Minutes
3 Cases In Total ... With Examination ... Short Hx, And Related Viva
except for the Random Case By Jilani. Cases will be disclosed if you come early.
Focus on examinations and dds
Jilani asked about:
Ankle clonus, ankle jerk and its nerve root, consensual light reflex, spleen pal
pation, direct versus consensual nerve supply loss in each
meningitis examination
In the heart case: Precordium exam, describe the type of apex beat like tapping,
heaving.. take the pulse and describe it (Rate rhythm volume character), Check
JVP.How much si it.Differentials of raised JVP
Where will you hear aortic regurgitation murmur
Dengue case came during viva.
Jilani asked grades of splenomegaly, causes, length of trachea
One external disputed about making patient at 45 Degrees for precordium and JVP.
Pleural fluid Dr ?

During Command of Anterior chest Exam, asked why i didnt examine the hand.Rememb
er while palpating the trachea keep your left hand on the head of the patient to
stabilize the head.
SUmmary of all rheumatology
Tests of COPD
An examiner said PFT's say 5 start kartey hain
-----------------------------------------------------------------------Pediatric Exam OSCE (Feedback Before Exam)
* Hx For Anemia, Feverm Diarrhea, Bloody Diarrhea, Cough/Dyspnea, Fever
its and counselling.

and f

* S/C Emphysema in Child X-Ray

* Case Scnario: In An unvaccinated Child of 2.5 years.What vaccines to
give: Pentavalent, POV1,PCV1, Rotavirus
* In a Picture .... R is pneumothorax, Mediastinum Shift, Heart and
Mediastinum is on the left.
Perfect Chart For Development Milestones ... Suprapubic Catheter Checklist,
* Steps of Neonatal Resuscitation
* Old & New ORS Composition
* Umer has shared Low osmolarity ORS in his Notes
* Calorie Chart
Paeds OSCE spots last years
Status asthmaticus - counsel a child's parents who has been discharged from the
ICU Interactive
(post hospital release management plan) inform school teache
Cranial nerve 7 examination
History for pallor
Cerebral palsy counsel the parent
Perform NG intubation
BCG vaccination complications, contraindications, dosage, percentage of people p
rotected, site of administration (interactive) figure out vaccines from bottle
Immunization static- list 2 live attenuated, list 2 killed, list 2 IM, list egg
allergy vaccines
Teratology of Fallot
Pneumonia x Ray, findings, investigations, treatment, prevention
ARDS X ray
Mumps, complications, prevention (picture)
Chicken pox what does the rash look like, prevention, complications (pitcure)
growth chart OFC int
Neonatal Resuscitation int
Perform Catheterization male and female suprapubic int
Suprapubic catherisation
Diarrhea risk factors, which plan will u apply child came with bloody diarrhea,
history vaccinations (int)
Counselling for diabetes, relevant questions (int) type 1 probably

GROUP C Paeds spots:

1. Mild persistent asthma counselling
2. SLE (picture)
3. Neonatal jaundice history
4. OFC on growth chart + causes of macro/microcephaly
5. TOF counselling
6. Examination of peripheral pulses
7. Diaphragmatic hernia x Ray
8. Autosomal recessive trait pedigree
9. Thalassemia counselling
10. MMC
11. LP procedure
12. Pleural effusion x Ray
Stauss Therapy:
Apart from 300000/600000 ... Give 400 Iu/Day for 3 Months, Give calcium and phos
phate supplements
And repeat X-Ray within a month.If no healing lines repeat therapy.
Skills: LP Needle, Male And Femakle Catheterization, NG, ETT (Part Of Neonatal R
esuscitation),Suprapubic Catheterization,
Important Topics:
* Asthma, Celiac,TOF, Hirschsprung, Malnutrition, Prematurity,
* Hx Of Pallor .. Will be Intraventricular hemorrhage
* Encephalitis will have focal neurological deficits
* Neonatal Resus: 3:1 Compressions:Breath 30Sec
* Infants 30:1
* Symmetrical Growth: Head and body are normal size
* Assymetrical Growth: Head not according to body size
Important OSCE Stations:
* Diet Chart
* Anthropometry Measurements (Plot on graph)
* Rickets on X-Ray
* Kwashiokor/Marasmus
* Electrolyte Imbalanace
* Breast Feeding
-----------------------------------------------------------------------Pediatrics Exams OSCE (Feedback After Exams)
It was entirely interactive this time ... No written spots:
*
*
*
*

MRI showing maybe Infarct

Alpha Thalasemmia Spot
Polio Vaccine Spot
Hyperkalemia on ECG (Had to describe Findings + Diagnosis, Management)

*
*
*
*
*
*
*
*
*
*

Chest X-Ray Showing Foreign Body (Had to describe + Management)

LP Needle Procedure
Down Syndrome Scenario (Counselling + Questions)
Hematuria History Taking
2 Year Child with Diarrhea (Management + How much wt gain in gm/Day)
Wt for Age & Ht for age chart, had to explain findings, Formula for
normal wt, calories req
Positive Flow Meter (Procedure + Uses)
Perform Pulses Exam With Your Findings
Perform Cerebellum Exam
Case on Hypothyroidism (Relevant Q's on what we will find on Exam)

Clinicals:
*
*
*
*
*

Abdomen Exam (Had Hepatosplenomegaly)

Reflexes Station
Pulses Station
Cerebral Palsy Station
Hydrocephalus Station

Grading of Reflexes, Power, Tenderness were asked

* Anemia Station
-----------------------------------------------------------------------Surgery OSCE Exam (Feedback Before Exam)
1. Some Terminologies:
* Aantein is intestines, lubluba is pancreas, pitta is gallbladder, jigar is liv
er, tilli is spleen, Rectum is pakhanay ka raasta, Kidney is
Gurda
* Anastomosis is Jor
* Colostomy is
Counselling on Diabetic Foot, APR, Stoma, Breaking bad news.
Example: pakhane ke raste paet se bandiya hai Jor laga ke OR
pakhane ka rasta pait k diwar k sath banta hai and pakhana thaili mein ata hai.
Note: Mutabadal rasta mean all routes
Note: In X-Ray shifting of gastric bubble medially indicated splenic injury
* Different Incisions: Thyroidectomy incision, Stenotomy incision,
Kocher, transverse, laminectomy, piloidal sinus, ileostomy, cholostomy, tube
s left after CABG for drainage (Both Tubes)
* X-Ray with emphysema and flail chest ... In Flail Chest there is atleast 3 fra
ctured ribs with 2 or more fractures per rib
(As shown on the right side)
* Stove chest is a rare form of flail chest in which theres chest wall collapse
and very high mortality. ... ie 3 contiguous rib fractures and pulmonary contus
ion as in flail bit it also has lung collapse.
Note: You can see clear Bowel Loops in diaphramatic hernia

* In Pleural effusion you see meniscus sign

* Parts Of Colostomy Bag: Bag and wafer ... You can also say Wafer Clip collec
ting bag.
* Note: In cerebral palsy you check the nasolabial fold and drooping.
* Redivac Drain Extremely Important ... It is for draining from
tissues or superficial tissues.

subcutaneous

* Why its under water seal for chest drain ... So that water acts as a
valve.

one way

* Shafiq Q's: Herniotomy, Thyroidectomy and mastectomy

* Redivac drain is used in closed spaces, and its basically a vaccum drain used
in surgeries to prevent fluid collection esp blood collection
* X-Ray on Ortho can come .. with defect, presentation and treatment
* Breast Cancer Counselling:
* Introduce yourself, Ask what the patient knows about herself, Tell her
further gently and discuss treatment options stage wise.Also tell
about breast reconstruction and follow up visits
* Surgically releving an obstruction:
Ans) Shock, Pyrexia, basically any signs of strangulated Obstruction
-----------------------------------------------------------------------Surgery PROF Exams Leaked Stations
T- Tube Cholangiogram ... Its in Dr Shafiq Presentation
For Pneumoperitoneum, two methods Open and closed technique ... Closed is with v
erees and open is through incision.
Carbondioxide ... with complications like easy dissovility, port hernia
bile leakage, clip slippage, bile peritonitis, cbd injury, perforation of gallbl
adder, conversion to open cholecystectomy
C.I: COPD And CHF
Specific to Lap chole complications include Verees Needle injury, hemorrhage, po
st cholecystectomy syndrome and ileus
Check out berger and kingslay method
-----------------------------------------------------------------------PROF OSCE Feedback (After Exams)
*
*
*
*
*
*
*
*

Hydatid Cyst
Breast Pathology & Management
Pyloric Stenosis
Fracture Of The Next Of The Femur
Suturing
Meningomylocele
Apply A Collar
LogBk Vivia ... Cholecystectomy

* Sebaceous Cyst
* Hydronephrosis
* Urethral Rupture
* APR Counselling
* Hypothyroid
* Instruments
* Pneumothorax
----------------------------------------------------------------------------------------------------------------------------------------------Surgery Clinical Feedback By Students
* Ahmad Fawad: Woman with Jaundice with RUQ Mass, Said she is fat so do
superficial palpation and tell me how will you find mass on examination.If you
cant really palpate it.Asked Courvoisier ask treatment asked kidney palpation.A
sked how will you know if mass is in bowel or liver on examination.
* Bushra: Paraumblical hernia.examine Treatment.complications of surgery, Types
of mesh.complications of mesh.if a woman wants to get pregnant will you and how
will you repair.
* External: Thyroid Examination.How will you differentiate between retrosternal
on examination.Treatment, tests complications of thyroid complications of surger
y.
One Student said we will percuss ... please check on this.
* Dr Shafiq: Chronic Intestinal Obstruction with colostomy bag.Why is there a ba
g.There is a scar Mark below the umblicus.Dont forget that.
What to ask in history, he wasnot passing stools for the past one month even pas
sing flatus. Examination of umblical hernia
* Above the clavicle theres swelling ... do the examination.give D/D's and biops
ies ... Asked why do you do all these examinations.the rationalle behind it.
* Room 2:
* Aunty has diffuse goitre.How will you tell if its retrosternal.Do percussion o
n the sternum.Palpate for the lower border while you tell the patient to swallow
.and raise the hands. Diagnosis
Relevant hx if its toxic or not
Treatment: PTU Doses
For ahmad fawad: Kidney mass moves on inspiration.spleen, kidney and liver moves
.
For bushra dont forget to make the patient cough on inspection and palpation.
* Rectal ca patient with end colostomy, renal/liver ca, supraclavicular lymph no
des
* Dr Shafiq: How do we know we can reverse hartmans, what is blummer shelf. How
is it formed ... Its basically peritoneal metastasis which can be felt on DRE.it
feels like a shelf
* Abdominal Mass Retroperitoneal, Thyroid Mass, Supraclavicular Lymph Nodes, Sto
ma, Ventra Hernia

* Patient is well hydrated in obstructive jaundice to prevent hepatorenal syndro

me
----------------------------- The End :) -------------------------------