TOACS

SURGICAL TRAINEES -2ND YEAR NOV.2009

General instructions:
Stations 10
Time
- 6 min per station
Marks - 10 marks for each station
Skills: Any combination from following examples
A-Cognitive,
I. Analysis of case histories and making d/d
II. Interpretation of lab reports and imaging studies
III. Making spot diagnosis, giving d/d and suggesting
investigations
IV. Analysis of clinical problems and suggesting treatment
B-psychomotor,
I. Clinical examination,
II. Suturing techniques
III. Catheterization
IV. Insertion of cvp
V. Application oc cervcical support
VI. Establishing airways
VII. Performing tracheostomy
VIII. Performing veine section
IX. Insertion of chest tube
X. Preparing an underwater-seal bottle
XI. Application of splint to a broken leg
XII. Application of external fixator
XIII. Application of skeletal traction
XIV. Application of tension sutures/abdominal mass closure
XV. Insertion of supra-pubic catheter
C-Affective
a- Braking news- Telling about histopathology report of
malignancy
Telling about near terminal state of an
elderly
b-Communications
Taking high risk consent in emergency situation
Discussing treatment option for gall stone
disease

TOACS

[specimen]

no

SURGICAL TRAINEES -2ND YEAR NOV.2009

min
Skill: Analysis of case history

Scenario:

Stations
Time-6
Marks-10

Questions:

TOACS

Stations no

SURGICAL TRAINEES -2ND YEAR NOV.2009

min
Skill: Analysis of case history

Scenario:

case history of a forty years old lady

Time-6
Marks-10

Questions:
1.
2.
3.
4.
5.
6.

What is your most probable diagnosis

What investigations are necessary for confirmation of diagnosis
What are surgical treatment options
What preoperative complications are expected
Enumerate three important post op complications
What are late surgical complications

TOACS

Stations no

2
SURGICAL TRAINEES -2ND YEAR NOV.2009
min
Skill: spot diagnosis

Scenario:

an x-ray picture is shown

Time-6
Marks-10

Questions:
Marks
1) What is your most probable diagnosis?
1
2) What investigations are necessary for assessment of this case?
2
3) Enumerate immediate treatment measures
2
4) If you decide to operate and find an ileocaecal mass, what
surgical
option you have to treat it.?
2
5) Enumerate three important post op complications
2
6) What are late surgical complications?
1

TOACS

Stations no
ND

SURGICAL TRAINEES -2 YEAR NOV.2009

min
Skill: Analysis of case history

Scenario:

Time-6
Marks-10

An x-ray picture is shown

Questions:
Marks
1.
2.
3.
4.
5.
6.

What is your diagnosis?

Give three cause of this lesion
What are surgical treatment options
What preoperative complications are expected
Enumerate three important post op complications
What are late surgical complications

2
2
2
1
1
2

TOACS

[specimen]

Stations

no
SURGICAL TRAINEES -2ND YEAR NOV.2009
min
Skill: Spot diagnosis

Scenario:

Time-6
Marks-10

Picture of a new born baby is shown.She has

presented with
h/o failure to pass meconium.

Questions:
Marks
1) What is your diagnosis
2
2) What are the main types of this disorder
2
3) How will you differentiate between different types
2
4) What is the surgical treatment suitable for majority of
such cases
2

5) Enumerate the surgical methods for definitive

management 2

TOACS

[specimen]

Stations

no
SURGICAL TRAINEES -2ND YEAR NOV.2009
min
Skill: Identification of a medical device
10

Time-6
Marks-

Scenario:

Questions:
Marks
1) What is the Name of this device?
2) What is its main use ?
3) How will you select its size for individual case?
2

2
2

4) Name two complications associated with its use

2
5) How long can it be kept in continuous use?
2

TOACS

[specimen]

no

SURGICAL TRAINEES -2ND YEAR NOV.2009

min
Skill: Analysis of case history

Stations
Time-6
Marks-10

Scenario:

Picture of a lady with neck swelling is shown. She has

the swelling for last 18 years .Now she has developed palpitations
and feels very apprehensive.

Questions:
Marks
1) What does the picture show?

2)
3)
4)
5)

What is your diagnosis?

2
Enumerate the lab and imaging test advisable in this case
2
What are the risks during surgery ?
2
What is thyrotoxic crisis?
2

TOACS

Stations no

SURGICAL TRAINEES -2ND YEAR NOV.2009

min
Skill: Spot diagnosis

Scenario:

Time-6
Marks-10

Picture of a lady in her early forties is shown.

Questions:
Marks
1) Give three differential diagnoses
2
2) What is your main diagnosis?
2

3) What is extent the disease process?

2
4) How will you proceed with this case?
4

TOACS
no

Stations

SURGICAL TRAINEES -2ND YEAR NOV.2009

min
Skill: Analysis of a contrast study

Scenario:
habits

Time-6
Marks-10

Contrast study of a 60 years old man is shown.

He has presented with recent change in bowel

Questions:
Marks
1) Describe the findings in this study
2
2) What is yur diagnosis?
2
3) Give three d/d
2
4) What are the surgical options in emergency
2
5) How will you mange it as elective case
2

TOACS
no

SURGICAL TRAINEES -2ND YEAR NOV.2009

min
Skill: Analysis of case history

Scenario:

Per operative picture of a case of intestinal

obstruction is shown
Caecum was the center of pathology

Stations
Time-6
Marks-10

Questions:
Marks
1) What is the most likely pathology?
3
2) What are the operative option to treat it?
3
3) What are the demerits and demerits of treatment
Options
4

TOACS

[specimen]

no

SURGICAL TRAINEES -2ND YEAR NOV.2009

min
Skill: Analysis of case history

Scenario:

Stations
Time-6
Marks-10

Questions:

TOACS

[specimen]

Stations

no
SURGICAL TRAINEES -2ND YEAR NOV.2009
min
Skill: Analysis of case history

Scenario:

Time-6
Marks-10

Questions:

TOACS

[specimen]

Stations

no
SURGICAL TRAINEES -2ND YEAR NOV.2009
min
Skill: Analysis of case history

Scenario:

Questions:

Time-6
Marks-10