Osce surgery

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Osce surgery

  1. 1. OSCE-Surgery
  2. 3. <ul><li>Burns on legs </li></ul><ul><li>4 complications </li></ul><ul><li>local </li></ul><ul><li>-wound contractures </li></ul><ul><li>-scarring (full thickness) </li></ul><ul><li>general </li></ul><ul><li>-infection </li></ul><ul><li>-shock </li></ul><ul><li>-renal failure from initial hypovolemia d2 plasma loss </li></ul><ul><li>-psychological disturbance </li></ul>
  3. 5. <ul><li>Breast Ca with ulcer </li></ul><ul><li>Describe </li></ul><ul><li>T staging of TNM </li></ul><ul><li>-T1:<2 </li></ul><ul><li>-T2:2-5 </li></ul><ul><li>-T3:>5 </li></ul><ul><li>-T4:skin invasion/chest wall/ both </li></ul><ul><li>Clinical type of breast Ca (4 marks) </li></ul><ul><li>-Phylloides tumour </li></ul><ul><li>-Invasive ductal Ca </li></ul><ul><li>-ductal Ca in situ </li></ul><ul><li>-medullary Ca </li></ul>
  4. 7. <ul><li>Thyroid lump-multinodular goiter </li></ul><ul><li>Ix before operation </li></ul><ul><li>-TFT </li></ul><ul><li>-ultrasound </li></ul><ul><li>-thyroid isotope scan </li></ul><ul><li>-FNAC </li></ul><ul><li>2 presenting features </li></ul><ul><li>Local mass efffects: </li></ul><ul><li>-stridor </li></ul><ul><li>-dyspnoea </li></ul><ul><li>-dysphagic </li></ul><ul><li>-SVC obstruciton </li></ul>
  5. 9. <ul><li>Polycystic kidney </li></ul><ul><li>2 symptoms: </li></ul><ul><li>-haematuria </li></ul><ul><li>-loin discomfort </li></ul><ul><li>-hypertension </li></ul><ul><li>2 associated symptoms: </li></ul><ul><li>-berry aneurysm </li></ul><ul><li>-liver cyst </li></ul>
  6. 11. <ul><li>Marjolin ulcer </li></ul><ul><li>Long standing venous ulcer- squamous cell carcinoma </li></ul>
  7. 13. <ul><li>Neck Swelling </li></ul><ul><li>Describe (6 marks) </li></ul><ul><li>2 differentials (2 marks) </li></ul><ul><li>-goitre </li></ul><ul><li>-throglossal cyst </li></ul><ul><li>-lipoma </li></ul><ul><li>What would you ask patient to do (2 marks) </li></ul><ul><li>-swallow saliva-goitre </li></ul><ul><li>-protrude tounge-thyroglossal cyst </li></ul>
  8. 14. <ul><ul><li>Carcinoma of the breast (a) and (b) Characteristic skin dimpling over breast carcinomas. This may be a subtle sign and only be visible in tangential light. (c) Nipple retraction and widespread 'peau d'orange' resulting from a large central breast carcinoma. Peau d'orange is caused by a combination of cutaneous infiltration by tumour and skin oedema (and occasionally by infection). Locally advanced breast cancer may cause distortion of the breast. The colour change and ulceration are uncommonly seen and only occur in neglected cases. Note also the puncture wound of a core biopsy (arrowed). There was no obvious axillary node enlargement. </li></ul></ul>
  9. 15. <ul><li>Pic of pt with left breast Ca </li></ul><ul><li>Describe (5 marks) </li></ul><ul><li>Diagnosis (2 marks) </li></ul><ul><li>-breast ca </li></ul><ul><li>3 investigations for this patient (3 marks) </li></ul><ul><li>-clinical </li></ul><ul><li>-radiological-u/s (<35 yrs old) ,mammography(>35 yrs old) </li></ul><ul><li>-cytopathology- Fine Needle Aspiration Cytology </li></ul>
  10. 17. 4th degree haemorrhoids
  11. 18. <ul><li>40 yrs old, male with anal pain </li></ul><ul><li>Diagnosis: hemorrhoid 3◦ </li></ul><ul><li>4 causes: </li></ul><ul><li>-constipation with prolonged straining </li></ul><ul><li>-congestion from a pelvic tumour </li></ul><ul><li>-pregnancy </li></ul><ul><li>-portal hypertension </li></ul><ul><li>-CCF </li></ul>

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