Bank Soalan Tahun 3 [Surgeri] 2009/2010

EMI

QUESTION 3

Cervical LN

Cystic hygroma

Haemangioma

Lipoma

Osteoma

Sebaceous cyst

Parotid adenoma

Tonix MNG

11. A 2 year old girl was brought to clinic by her mother,complained of neck swelling.Her
mother told the the swelling begin at 6 month old and progressively enlarge last 18 months.She
was asymptomatic.on examination there was large anterior neck swelling which is
transluminatted.

12. A 65 year old man complained of circular,smooth swelling of his right cheek.The swelling
was there 10 months ago and does not increasing in size.(ni cam x sure la plak,hehe).On
examination there was non tender,smooth,well defined mass 3x3cm in front of his right ear.

Acute Abdomen

A. Acute Appendicitis
B. Acute Pancreatitis
C. Adhesion Colic
D. Ischemic Bowel
E. Leaking Abdominal Aortic Aneursym
F. Mesenteric Adenitis
G. Perforated Gastric Ulcer
H. Ruptured Ectopic Pregnancy

Exco Akademik PERSIAP 2009/2010

 Bank Soalan Tahun 3 [Surgeri] 2009/2010

20. 79 year old male complained of severe central abdominal pain. On examination, he was
dehydrated, tachypnoec and generalized tenderness in central abdomen. ABG show metabolic
acidosis and serum lactate elevated

21. 25 year old Bangladesh male complained of sudden onset epigastric pain associated with
vomiting. On examination, he was febrile and dehydrated. Abdomen was rigid and tender on
palpation. No BS audible. Erect CXR shows presence of the gas under the diaphragm.

22. 75 year old female complained of sudden onset of severe back pain and collapsed. She
appeared pale, PR 130 bpm, BP 70/40 mmHg. Abdomen was distended and guarded. A tender
pulsatile mass palpable in the epigastric region

23. 20 year old female complained of sudden onset of RIF pain. LMP was 2 months prior to
episode. On examination, she was plae, tachypnoeic. Abdomen was tender in RIF region and
UPT was positive

24. 40 year old female with previous Caeserean section complained of 1 week history of colicky
abdominal pain associated with vomiting. On examination, vital signs normal. Abdomen was
distended and no feature of peritonitis. On auscultation, bowel sound was tinkling and mature
Pfenensteil scar was seen

25. 13 year old female complained of RIF pain and fever. LMP was 2 weeks before. On further
questioning, she was developed URTI 1 week prior to episode. T was 39C . Abdomen was soft
and mild tenderness and voluntary guarding in RIF. FBC shows lymphocytosis

KFQ

1. 60 year old male passing blood in urine for 2 days. It was fresh blood mixed with urine
and associated with dust. No abdominal pain, no fever and he is a chronic smoker
(a) 2 ddx (2m)
(b) 4 signs on PE (3m)
(c) 2 initial investigations and reasons. (4m)

(a) Provisional dx (2m)

(b) 3 biochemical ix (3m)
(c) Definitive mx for this pt (2m)
(d) 3 complications of this disease (3m)

QUESTION NO 3

69 year old elderly man presented with weak urinary stream,straining and terminal dribbling.

Exco Akademik PERSIAP 2009/2010

 Bank Soalan Tahun 3 [Surgeri] 2009/2010

He had no haematuria and no cloudy urine. He had previous bladder catheterization due to acute
urinary retention. Per rectal examination showed enlarged and firm prostate gland weighing
about 40 g.

i) State 3 differential diagnosis : (2m)

______________________________________________________________________________

______________________________________________________________________________

ii) State 4 basic investigations : (3m)

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

iii) List 3 complications from the problems mentioned above : (3m)

______________________________________________________________________________

______________________________________________________________________________

QUESTION NO 4

15 year old male with 2 days history of lower abdominal pain associated with vomiting. The pain
was colickyand start from periumbilical area and radiating to RIF. On examination, the T was
38C. There was localizing guarding at RIF with positive rebound tenderness

i) What is your diagnosis? 2m

______________________________________________________________________

Exco Akademik PERSIAP 2009/2010

 Bank Soalan Tahun 3 [Surgeri] 2009/2010

ii) State 4 biochemical investigations you want to do : (3m)

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

iii) What is your definitive management? (2m)

______________________________________________________________________________

______________________________________________________________

iv) What are the complications from the problems above? (3m)

OSCE SURGERY 2009/2010 GROUP II

1. History taking. Patients (23 years old, female, factory worker) complaints of right iliac
fossa pain main complaint. Students should obtain all history that relevant to RIF pain.
Diagnosis : acute appendicitis
2. PE breast examination. 3 palpable mass.
3. Consent on colonoscopy.
4. ABCDE for trauma.
5. Procedure : Male urinary catheter insertion.
6. Chest Xray on right tension pneumothorax. List 5 finding on the xray film and the basic
management.
7. Sengsteken blake more. Basic knowledge. Indication, procedure(3m) and
complication(4m)
8. Gatric ulcer perforation. Management.
9. PPD.

PPD

Exco Akademik PERSIAP 2009/2010

 Bank Soalan Tahun 3 [Surgeri] 2009/2010

A 24 year old man who was recently married complained of testicular enlargement for the last 4
months which progressively increased in size. It was painless. A diagnosis of testicular
carcinoma was made. He was planned for orchidectomy regarding his problem.

1) State 3 main concerns that you have to consider in this man regarding the orchidectomy.

i)_____________________________________________________________________

ii)____________________________________________________________________

iii)____________________________________________________________________

3 marks

His wife insisted to know about the operation that will be done to his husband. But, her husband
already informed the attending surgeon that he would not like anyone else to know about this
procedure.

2)Will you inform the wife regarding the procedure? State the reason.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________ 2 marks

3) State 3 psychosocial measures for this man to assist him for the future orchidectomy.

i)_____________________________________________________________________

ii)____________________________________________________________________

iii)____________________________________________________________________

Setinggi-tinggi penghargaan kepada pelajar tahun 3 kumpulan 2 yang telah menyumbang usaha

utk mengumpul soalan-soalan ini. Semoga Allah memberkati usaha kita dan dengan

penggunaan berterusan soalan ini dapat membantu rakan-rakan yang lain dan diri kita sendiri.

InsyaAllah.

Exco Akademik PERSIAP 2009/2010