Today oman test ON 28/10

Examination

1 Hand with carpal tanel

2 Abd with cholecystitis

3 Critical ill pt in the ward with PE

4 thyroid

Hx

1 Back pain

2 Groin lump

Skills

1 exicion of mole

2 abcess drainage

Path

1 Perforated peptic ulcer with AF

2 parathyroid

3 ostoeomylitis

Anatomy

1 Skull foramina

2 shoulder

3 pancreas

comminication

1 Consent For OR

2 Telephon for Ischemic leg Critical care

1 Hematemesis

2 Crush onjury

‫عمان اليوم التاني‬

 Kuching 9/8/2017

Communication skills:

1-my consultant was called for emergency surgery and now in OR please speak to wife
of a patient with tense ascitis (DPL +ve for malignant cells),CT scan broken ,neart CT scan
40 miles away ,we well arrange US today . Lab results most of it normal.9 minutes with
the file for this information . Next station ,discuss this finding with anxous wife (break bad
news -plan-patient dont know about his diagnosis so its like hiddin diagnosis)

2-communication skills-telphone call ,refferal of patient 1st day post lap cholecystectomy
to hepatobillary proffessor as ERCP is not available in our hospital,my consultant is busy
ERCP is an alternative ,lap results increase billirubin and liver enzymes and wbcs
18,generlised abdominal pain ,US finding of free fluid in peritoneum , BP was 120/80. He
asked about BP and if patient on antibiotics and if he is stable or no.then he told that no
avialable bed and to contact bed cordinators.

3-examination :left ear loss of hearing post trauma .pls examine the ears and the relevet
CN ,he asked how to use otoscope without insert inside the patient ear .asked
diagnosis(conductive Hearing loss)DD for that. Investigation and how to conplete your
examination.

4-examination :right ankle joint after trauma painful lateral side DD ,lateral malleolus
fracture tratment ,pain killer,walking aid,blaster .

5-examination:pacemaker CVS examination ,ECG was their ,patient of left side (trick so u
start examine her from left side) no clear wound of pacemaker .

6-examination -left inguinal hernia and treatment

7-history :impotence patient on atenelol.

8-history:right knee pain ,post trauma

9-anatomy:cadever

A- :esophagous what is this and what type of epithleium (stratified squamus

epithelium,he asked keratinized or not keratinized?sain non. What is venous anastomosis
on its distal end?and what is the risk ? Left gastric and azygous,risk is esophogeal varices
B-what is this ?trachia bifurcation .at what level? T4. C-what is this?common carotid and
its branches ,show me carotis sinus and what function? Show me carotid body and
function? C-hypoglossal nerve D-submandiblar gland and where duct open E-parotid
gland and where duct open ?and what type of secretion? F:what is this :left subclavian
,branch of?arch of aorta. What is subclavain steal and what is symptoms?

10-anatomy-upper limb
 A:wrist drop B-what is this? Extensor digitorum C-EXTensor pollicis longus D-identify
snuff box and what is the boundries ?tenderness thier means?scaphoid fracture what we
worry?A vascular necrosis. E-name all carpal bone on bome mdel F-ulna and styloid
process.

11-skull foramina

and trigamenal gangelion location -he pointed on lateral side of sella tursica asking what
lies here?cavernous sinus and he asked about structuers pass through and asked about
cavernous sinus thrombosis C/F. -papilledema??he wants the cause is the meninges in
increased ICP . -middile cranial fossa boundries -ossicles found in which part of the ear? -
roof of middle ear?? - infection spread from middle ear to which part of brain?
(Temporal) how?thrugh tygmen tymani(osteomylitis of this bone) Where else it can
spread? Mastoid air cells.

12-pathology :

Crohns disease:

Picture of resected iliocecal valve with ascending colon (comment on vulve connventise
on the ilial side and tenia coli on the colonic side) is showed transmural involvment
,strecturs) He asked about macrocytic anaemia and B12 defeciny (as complications of ililal
resection) -what are the extral intestinal manfistations of Crohns?

13-hypothermia

in patient now is in the OR for ruptured AAA and lost 4 liters of blood,platlets only
50,high APTT,Hb is low. Define perioperative hypothermia? Type of hest loss?? How to
avoid hypothermia??NICE guidlines. What inection can decrease blood loss ?? Stages of
haemostasis??vasocostrection,paltlet aggrigation and coagulation cascade activation the
he asked is this going to occur in this case?no y?low platlets ..... What to give in this
case??platlets,Blood,FFP,crypoprecepitate. Stored blood for one month is deffecint in
what?? Platlets(as its half life is only 5 dYs) Complications of hypothermia in this case (he
wanted cardiac arrythmia)

14-acute pancreatitis ARDS station

15-breast Ca:

16-OR list 3 patients (amputaion-strangulated hernial repair -hartmans ) Arragne

acoording to emergency. Whats is hartmans procedure? The he took me to a model with
the OR list paper with me asked where is colostomy situated? LIF Where to place d

17.11.17 Bahrain
 1.Scenario unconscious patient MCA Apply ATLS airway , collar , breathing on Manican

2. Ordering pre-op list Diverticulitis with COPD MRSA + DM for amputation Strangulated
hernia with pacemaker and on heparin

3. Back pain history mechanical

4. Bleeding per rectum history

5. OGD consent 6.

Transfer patient to vascular surgeon

Examination

7. Knee

8. Spine

9. Submandibular

10. Acute appendicitis

Pathology

11. Cholangiocarcinoma

12. Ulcerative colitis

CC

13. Bloody diahrrea

14.ARF with hyperkalemia

15. Trauma

Anatomy

16. LL

-17 UL pectoral and shoulder girdle

 18. Thyroid :

Khartoum MRCS ed 27.11.2017

Anatomy:

1- cervical spine anatomy.

2- aorta and AAA.

3-lower leg dermatome and surface anatomy.

Pathology:

4- aortic stenosis +RHD+I.E.

5- basal cell carcinoma.

ASSCC:

6-Pregnant lady with cholecystotomy.

7- poly trauma,liver tear and tension pnum.

8- hypothermia.

History:

9- anxiety.

10-BPH

Phone call:

11- I TU registrar Communication with relative:

12-Anxious mother of a Child with R. Spleen.

Procedures:

13- naveus excision.

14- drainage of abscess.

Examination:
 15-AMTS.

16-lower limb ischemia.

17-PE CCrISP.

18-scrotal mass(hydrocele).

Varicose vein examination and treatment

Pulmonary embolism examination and treatment

Diverticulitis (perforated) examination and treatment

Anxiety, pre op anxiety before Laproscopic Cholecystectomy (history in Anesth clinic and
Investigations)

History taking of patient with difficult to pass urine (prostatomegaly) and Investigations
Telephone call to refer a patient to Anesthetist for ICU bed Informing

a Mother of a child went for surgery (splenectomy) without Mother consent (emergency
surgery)

Cervical bones and X-ray (anatomy)

Lower limb (leg) anatomy of muscles and nerves

Abdominal aorta (on human body) and branches (Anatomy)

Reduced venous return due to surgery (effect of symphatetic and parasympathetic)

Hypothermia and management

Rheumatic heart disease,

pathology and treatment Basal cell carcinoma,

pathology and treatment Shock,

management definition treatment Procedure for abscess

Procedure for excision biopsy

 : Anatomy Cervical spine, atypical and typical cervical spine. Atlas axis articulation and
ligament. Interprete cervical xray

Lower limb peroneus brevis and tertius attachment, function of gastronemius, tibialis ant
post, peroneus brevis/tertius, knee ankle reflex and nerve root. Nerve root for peroneal
nerve. Compartment of lower lim. Cutaneous innervation. of superficial,deep peroneal
nerve, great saphenous and sural nerve,s1 dermatome.

Aorta, surface landmark and vetebrae level of commencement and bifurcation, posterior
branch and, structure passing directly anterior to aorta, contribution of ivc, definition of
aaa and disection, lie of cleavage.

Critical care

open chole in 34 weeker pregnant lady, pro and cons, hypotensive and tachy during
operation, cause of hypotension. preload, factor that reduce venous return, measure to
improve venous return. Post op care, mechanicl vte prophylaxis

Preoperative hypothermia in lady awaiting laparotomy, causes and risk factor,

consequences of hypothermia, intraoperative measure to prevent hypothermia

Preoperative pt with mechanical valve, rheumatic heart, causes, infective endocarditis,

peripheral feature, mechanism, comman organism of ie Cardiac transplant matching

BCC diferrential dx, visible vessel due to vasodilatation, microscopic feature, spread
locally, if spread to LN how does it occur, 2 intraoperative measure to ensure adequate
margin being excise

Trauma, assess airway breathing, tension pneumothorax, management, shock, chest tube
etc

Incision and drainage of thigh abscess

Excision of mole

History taking,

bph, investigation n management Preop assessment pt complaining of occ chest

diacomfort palpitations numbness of hand.

Dx anxiety disorder

Communication Consult intensive care sp for preop preparation for pt plan for ex
laparotomy for perf viscus, reserve post op ITU bed Child fall from heigh suspect spleenic
injury went in for laparotomy consented by father, likely child abuse. Explain to patient's
mother regarding pt condition, disgnosis, indication of operation and answer questions.

Physical examination

Cranial nerve examination

Respi day 8 post laparotomy, SOB. Dx: PE

Abdomen: left iliac fossa pain ddx, ix, management

Chronic venous insufficiency,

varicose vein.

. Acute pancreatitis

2. Epidural haematoma

3. Temporal arteritis .

4. Clincal exam of spinal cladication .

5.Clinical exam of hernia .

6.Clinical exam of varicose vein .

7. History diarrhea

8. History knee pain .

9. Phone call trauma surgeon about rta with open fracture leg and absent pulse

10. Angry patient postponed arthroscopy .

11. Anatomy brachial plexus .

12. Anatomy leg muscle and compartment .

13. Pregnant cholecyctectomy .

14. Operation list .

15. Anatomy transpyloric plane cut section .

16 . Bicuspid aorta and valve replacement and infective endocarditis .

 17 atls airway management .

18. Clinical examination CVS As:

Procedural skills :

Knot tying

Ordering OT list

History:

Diarrhea (ibd)

Preoperative confusion

Examination :

Acute cholecystitis

Anastomotic leak

Submandibular

Hand examination

Pathology :

Polytrauma and transfusion

Parotid tumours

Asscc :

Pneumothorax and cv line insertion

Obstructive jaundice

Turp syndrome
 Anatomy :

Head & neck>>> skull formina, neuro anatomy,Id. Some neck structures on a manikin

Lower limb : popliteal fossa, hamstrings and more

Upper limb

KL 9 9 EXAM

EX ACUTE.CHOLE

COPD

BITEM HEMIANOP

BILAT VARICOSE VEINS

HX

UNILAT TOBSILLAR RNLRG

ANXIOUS PATIENT SOB

C.SKILL

CALL ITU REGIST PERFORATED ABDOMEN

OGD CONSENT

P.SKILLS

AIRWAY

FOLYES CATH

ANAT

POST THIGH MASS

HUMEROUS AND CERVICAL SPINE

ABD.AORTA AND ANEURYSM

 C.CARE

RTA ANG PNEUMTHRX LIVER TEAR

HYPOTHRYOIDISM DIC AND SPLENIC TEAR AND HYPERSENTIY

PATH

TESTICULAR TUMOR

BLOODY DO