Documenti di Didattica
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Compilation of
Questions for
Masters of General
Surgery
1st Edition
By
TABLE OF CONTENTS
ACKNOWLEDGEMENT
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15
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ACKNOWLEDGEMENT
I would like to take the opportunity to express my appreciation to those who have
contributed to the making of this question bank.
Any suggestions or comments can be emailed to me at zairulazwan@gmail.com .
All the best in the upcoming exams and dont forget to write to me about your viva
experience J.
Houseman
(egg)
Medical
Officer
(pupa)
Masters
Student
(larva)
2.
3.
Examiners pair 2:
UM and KKM
1.
Scenario: An elderly patient came in with abdominal pain. After history talking
and physical examination a diagnosis of perforated gastric ulcer were made.
a.
b.
c.
2.
3.
What is screening?
a.
b.
What screening tests are available and their sensitivity and specificity
of each test mentioned.
What is an acceptable screening test?
Examiners pair 3:
UM and external examiner
1.
What is shock?
2.
3.
4.
Scenario: An elderly man with diabetis mellitus and ischemic heart disease just
had surgery for bleeding ulcer, noted in ICU to have a BP 90/60 and PR
120bpm.
a.
b.
c.
5.
6.
7.
Examiners pair 4:
1.
2.
Examiners pair 5:
UKM and external examiner
1.
Scenario: A case of polytrauma, patient came to you with head injury. CT-scan
brain showed no intra-cerebral bleed.
a.
b.
c.
2.
3.
You are doing a complex laparoscopic surgery, which will be finishing in hours.
What are the complications related to prolonged pneumoperitoneum?
4.
5.
How do you manage a patient who came in casualty with burns injury?
How do you know the burn patient has inhalational injury?
What is the mechanism of fluid loss in burns patient?
Examiners pair 6:
1.
2.
3.
4.
5.
6.
7.
Statistic questions:
a.
b.
c.
d.
e.
Examiners pair 7:
UKM and KKM
1.
2.
Examiners pair 8:
UM and UKM
1.
2.
3.
Scenario: You saw a 50 years old patient in clinic with a pelvic mass plan for
surgery.
a.
Examiners pair 9:
KKM and UM
1.
2.
Tell me about surgical site infection rate for each type of wound.
3.
4.
5.
6.
Topic: MRSA.
a.
b.
7.
OPERATIVE TABLE
Examiners pair 1:
UKM and KKM
1.
2.
3.
Tell me ways of stopping bleeding from liver injury and how to manage it?
4.
Examiners pair 2:
UM & KKM
1.
2.
Tell me what will you consent this patient prior to surgery (axillary lymph node
dissection)?
3.
4.
5.
6.
Types of repair?
Why do you ligate the superficial epigastric vein?
If you are doing an obstructed inguinal hernia and on opening of the sac you see
blood coming out what will you do?
Examiners pair 3:
UKM and KKM
1.
2.
3.
You have a patient with stomach cancer, how do you perform a total
gastrectomy?
4.
5.
Describe how do you perform a small bowel resection for a small bowel
tumour?
PATHOLOGY TABLE
Examiners pair 1:
UKM and USM
1.
Image: Omphalocele.
a.
b.
c.
2.
3.
Image: Gangrenous lower limb with dry and wet areas due to snake bite.
a.
b.
c.
4.
Examiners pair 2:
UKM and Academy of Medicine
Candidates are required to describe the images, pathophysiology and brief management.
1.
2.
3.
4.
5.
Image: Perianal region with multiple external opening and previous scar
(complex fistula-in-ano).
6.
7.
Examiner pair 3:
USIM and UKM
1.
2.
Examiners pair 4:
UKM and Academy of Medicine
1.
2.
3.
4.
Examiners pair 1:
KKM and external examiner
1.
Scenario: A patient had undergone a control damage surgery last night. You are
reviewing this patient today and noted a low urine output:
a.
b.
2.
3.
4.
5.
6.
7.
8.
9.
Topic: Statistics.
a.
b.
c.
d.
11
What is mean?
What is median?
What is mod?
What are the advantages using median as compare to mean?
Examiners pair 2:
UPM, KKM and external examiner
1.
2.
What do you look for during your rounds the next day?
A few days later you noticed he developed fever. What do you think?
What are the signs to suggest an anastomotic leak?
What blood investigations would you order?
What imaging modalities would you request?
Why a ct-scan? What if patient developed an acute renal failure?
Lastly you decided to push him for surgery, intraoperative findings
revealed a gangrenous descending colon. What procedure will you
perform?
OPERATIVE TABLE
Examiners pair 1:
UKM and UM
1.
Scenario: You have seen a patient with varicose veins and plan for an elective
high saphenous vein ligation surgery.
a) What are the preoperative preparations?
b) What are the complications of this surgery?
c) Describe the postoperative care for this patient.
2.
Scenario: A patient came in with an acute intestinal obstruction due to a midtransverse colon tumour?
a)
b)
c)
d)
e)
f)
3.
13
PATHOLOGY TABLE
Examiners pair 1:
UM and USM
1.
2.
Scenario: 70 years old man came in with per-rectal bleeding. Whilst assessing
him, the patient developed torrential per-rectal bleed. You are preparing to take
him in for emergency total colectomy. Patients daughter came and asked about
i.
Her fathers prognosis and whether you can guarantee that his
father will recover.
b) You said no guarantee. Hearing this the daughter refuse to give consent
since her father is already old and unlikely to survive anyway.
i.
c)
So you would still want to proceed with emergency surgery. But her
daughter would not consent it (I suppose the patient could not give
consent for himself).
i.
What next?
d) You explained that you would get 2 consents from senior consultants
for the patient. But your anaesthetist would not agree to consent.
Furthermore, your anaesthetist is agreeable with the patients daughter,
that is, no need surgery.
i.
e)
What next?
15
i.
2.
Scenario: You are a senior consultant. Your elective operating theatre has listed
a 7 years old boy for herniotomy, a 70 years old diabetic man for some surgery,
and two other middle-aged ladies for operations too.
a)
f)
Can you prioritise the diabetic man instead, and if so, give your
reasons.
3.
4.
5.
Tell me about the grading of solid organ injury and how would you re-act to it.
6.
A patient with abdominal trauma came to you, how would you assess for
bleeding intra-abdominally and how this would influence your management.
a)
7.
8.
You commonly encounter surgical patients needing dialysis. Tell me, in what
situations would dialysis be required.
a)
You said renal failure. Can you tell me about renal failure, how you
would assess for it and what are the implications of renal failure?
You said haemodialysis through a femoral access. Tell me what are the
complications associated with central venous catheterization.
f)
Examiners pair 2:
USM and KKM
1.
2.
How to manage?
Talked about the erb and flow phase, what happen during these phase?
17
OPERATIVE TABLE
Examiners pair 1:
KKM and USM
1.
b.
c.
What sizes of Fogartys catheter would you prepare and how do you
prepare it?
d.
So you would obtain proximal and distal control. What would you be
using?
e.
So you said vascular loops. How do you apply them? Are you going to
use vascular clamps?
f.
g.
Hold on, before you perform the arteriotomy, would you not want
systemic heparinisation?
1.
h.
i.
j.
k.
l.
So you have opened up the vessel, and you said you will assess from
proximal inflow but usually there will be poor inflow anyway,
otherwise you will not end up with an acute limb ischaemia. What
catheter size would you choose for proximal embolectomy?
2.
n.
And how much air or water are you inflating the balloon catheter with?
o.
b.
c.
d.
So you have seen the ureter and you said that you want to apply distal
and proximal control. Is that really necessary?
e.
f.
g.
Now you have removed the stone, what else would you do?
h.
You said you want to insert a ureteric stent, which type and how do you
place it?
i.
Examiners pair 2:
KKM and UM
1.
Scenario: Patient came with an obstructed sigmoid tumour. You plan to bring
him in for emergency surgery.
2.
a.
How will you take consent for the surgery from this patient?
b.
c.
3.
19
Topic: Sutures.
a.
Definition.
b.
c.
Give example.
d.
e.
f.
PATHOLOGY TABLE
Examiners pair 1:
1.
b.
c.
d.
e.
2.
3.
4.
a.
b.
c.
d.
b.
c.
d.
Image: CT-scan of a cystic lesion of the right kidney, loss of architecture of the
left kidney.
a.
b.
c.
What treatment would you offer assuming that the contralateral kidney
is normal?
5.
b.
Examiners pair 2:
UKM and USM
1.
b) Causes of intussusception?
2.
4.
Image: Hip X-ray with multiple lytic lesion and pathological fracture neck of
femur.
a)
6.
What are the most likely primaries? (in men and women)
21
8.
If this were due to snakebite, what type of snake would cause it?