EOP BATCH 40

OBG
(i) Group A
MEQ: pre-eclampsia

(ii) Group B
MEQ: uterine prolapse
OSCE: outlet forceps(label the part, indication and contraindication), ctg
(normal, early, late deceleration, next step: fetal scalp ph (<7.2= emergency c-
section)

(iii) Group C
MEQ: Post date pregnancy , contraception, sterilization

(iv) Group D
MEQ: Gestational hypertension
OSCE: *same as group B*

(v) Group E
MEQ: Post date pregnancy
32, G2P1 came for antenatal check up. LMP:7/2/2020, EDD: 14/11/2020. She
came cross her EDD by 6 days. No complications till now. Worried and anxious
about baby.
 2 relevant history to confirm her crossed EDD
 2 relevant investigations for foetal wellbeing
 Bio physical profile done, 5 components of BPP
 What is modified biophysical profile
 Pelvic examination done, bishop score was 6, findings assessed in
bishop’s score
 Next step of management with justification
 Upon counselling for induction with PG, patient don’t want prostin. What
are other method of induction for this patient
 Which is the best method among the methods mentioned
 She is considering IUCD, explain 4 MOA of IUCD
 What is ideal time to insert cu-t IUCD
 Mention 2 complication following insertion of IUCD
OSCE:N/A
(vi) Group F
MEQ: ectopic pregnancy
OSCE: N/A

ORTHO

(i) Group A
MEQ: fracture of shaft of femur

(ii) Group B
MEQ: Posterior hip dislocation

(iii) Group C
MEQ: Open fracture of tibia

(iv) Group D
MEQ: Displaced neck of femur secondary to post traumatic
postmenopausal osteoporosis

(v) Group E
MEQ: fracture of neck of femur

(vi) Group F
MEQ: Posterior hip dislocation
MEDICINE

(i) Group A
MEQ: Silent MI+ stroke
Mid-posting: N/A (mcq)

(ii) Group B
MEQ: stroke
Mid posting: N/A (MCQ)
OSPE: SLE, cerebellar dysfunction (finger-nose test), parkinson,
parasternal heave, CKD, nephrotic syndrome, bp apparatus, bell’s palsy,

(iii) Group C
MEQ: Pancoast tumour, horner syndrome, stroke
OSPE: JVP, hemiplegic gait, megaloblastic anemia, SLE, ptosis, peak
expiratory flow meter, lung ca xray, rheumatoid arthritis xray, spider
naevi
SAQ: ECG (atrial fib)

(iv) Group D
MEQ: ischemic stroke, facial palsy
Mid-posting: DKA, pneumonia, cellulitis

(v) Group E
MEQ: ACS

(vi) Group F
MEQ: N/A (only saq and mcq)
PAEDIATRICS

(i) Group A
MEQ: Beta Thalassemia, Infective endocarditis, viral crop+xray (steeple
sign), nephrotic syndrome
OSPE: Cerebral Palsy (crouching gait), TOF(x-ray), Hand-Foot and Mouth
Disease, seborrheic dermatitis/yeast rash on armpit

(ii) Group B
MEQ: epilepsy+CP, measles
OSPE: DMD, honey crusted lesion (impetigo), haemarthrosis, lobar
pneumonia(xray)

(iii) Group C
MEQ: measles (immunization schedule), scabies, acute
glomerulonephritis
OSPE: erythema infectiosum, scissoring gait (spastic diplegic CP), eczema,
lobar pneumonia

(iv) Group D
MEQ: mumps, rheumatic heart disease
OSPE: seborrheic dermatitis

(v) Group E
MEQ: HSP, down’s syndrome
OSPE: can’t remember
(vi) Group F
MEQ: failure to thrive, ASD
OSPE: can’t remember
SURGERY

(i) Group A
MEQ: breast carcinoma, acute appendicitis
OSPE: incisional hernia, venous ulcer

(ii) Group B
MEQ: breast carcinoma, acute pancreatitis
OSPE: basal cell carcinoma, air under the diaphragm/pneumoperitoneum

(iii) Group C
MEQ: breast carcinoma
A 50- year- old lady has come to the breast clinic with complaints of self-
detected 2cmsx2cms size, painless, hard lump in her right breast for the
past 2 months.

Q1. Write any other FOUR questions you will ask to get a provisional
diagnosis.        (2 marks)
Q2. Name any THREE relevant local clinical examinations you will perform
in this patient.  (3 marks)
On examination, the lump is mobile. No axillary lymph nodes are
palpable. Mammography is done for the patient.
Q3. What are the different grades of mammography?     (3 marks)
Q4. Name TWO investigations you will do to confirm the diagnosis of the
lump.        (2 marks)
It is suspicious for malignancy. FNAC is done.
Q.5. Write any TWO disadvantages of FNAC in diagnosing breast
carcinoma.         (2 marks)
Q6. Name the investigation you will do to know the axillary node
involvement.       (1 mark)
She was diagnosed as carcinoma of breast.
Q7. Name any TWO investigations you will do to stage the carcinoma.       
(2 marks)
Q8. Name TWO common types of invasive carcinoma of breast.  (2 marks)
No evidence of distant metastasis. Sentinel node biopsy is negative for
axillary lymph node metastasis. The histopathological examination (HPE)
of the specimen is positive for oestrogen (ER).
Q.9.What is the stage of this disease?            (1 mark)
Q.10. Name the treatment in this patient.         (1 mark)
Q.11. Define adjuvant and neo-adjuvant therapy.  (1 mark)

OSPE: perforated ulcer

(iv) Group D
MEQ: Thyroid (thyrotoxicosis)
OSCE: small bowel obstruction

(v) Group E
MEQ: breast carcinoma
OSPE: air under the diaphragm

(vi) Group F
MEQ: choledocholithiasis
OSPE: thyroid, hernia
BATCH 39 EOP

Group A
 Medicine : TB, emergencies related to unconscious patient,
stroke, aspiration pneumonia, DIC and Sepsis, Hyperkalemia and
AKI
 OBG : Down’s syndrome screening, Pre-eclampsia , trichomoniasis
 Orthopedics : inter trochanteric fracture
 Surgery : acute pancreatitis, hyperthyroidism
 Pediatrics :
 Com Med : N/A

Group B
 Medicine : (AF-Stroke-Aspiration Pneumonia- AKI),TB , STEMI
leading to complication of acute left heart failure, diabetes
ketoacidosis
 OBG : CTG + Induction of labour, management of 3rd stage of
labour, uterine fibroids
 Orthopedics : posterior dislocation of hip
 Surgery : acute pancreatitis, intestinal obstruction
 Pediatrics : growth chart interpretation+Thalessemia, Measles

Group C
 Medicine : bell’s palsy, TB with pleural effusion, IE ,Chronic renal
failure, hyperkalemia,
 OBG : hyperemesis gravidarum, VBAC, Threatened Preterm
labour, fibroid
 Orthopedics : fracture of the mid shaft femur,
 Surgery :
 Pediatrics : Cerebral Palsy , Kawasaki disease

Group D
 Medicine : COPD w/ type 2 respiratory failure complicating to
pneumothorax, CCF due to mitral stenosis, AF, Stroke and
Aspiration Pneumonia
 OBG : Antenatal Care Placenta Previa w/ previous LSCS and tubal
ligation methods
 Orthopedics :
 Surgery : Acute pancreatitis, Breast carcinoma
 Pediatrics : Measles, Down’s Syndrome
 Group E
 Medicine : mitral valve stenosis + CCF and DM with pleural
effusion, renal failure & cerebral hemorrhage
 OBG :
 Orthopedics : fracture neck of femur
 Surgery : Rectal carcinoma and hyperthyroidism
 Pediatrics : HSP and meningitis

Group F
 Medicine :TIA(facial nerve palsy + hemiparesis) + aspiration
pneumonia + DKA
 OBG : Management of subfertility, Management of Hyperemesis
gravidarum, DCDA twins and management of labour for twins,
PPH management
 Orthopedics : open tibial fracture with non union.
 Surgery : breast Ca, ascending cholangitis
 Pediatrics : nephrotic syndrome, kawasaki

39 P2S1
OSCE

 Surgery:
1) UTI or stone (passive station) . It was a case scenario. (comment on
data,dx,rx)
2) instruments (Foley's catheter, they asked indication and identification
and complication) , needle holder and hemostatic forceps- difference and
uses, Ryle’s tube- indentify, indications and how to confirm correct
isnertion)
3) pneumoperitoneum(air under the diaphragm) xray (identify and
mention conditions, examination findings)
4) carbuncle picture (4 signs, 4 symptoms, differential diagnosis, risk
factors, rx)

 Medicine
1) CVS examination (PR,JVP,including murmur)
2) facial nerve palsy video. It was UMN? Type lesion I think. Features of
UMN lesion and causes
3) pancoast tumor xray with bronchial breath sounds (audio). They asked
findings on examination
4) hepatitis history taking
 OBG
1) Pap smear active station
2) Counselling IUFD
3) trichomoniasis, candidiasis, bacterial vaginosis (dx,discharge
description, microscopic findings, rx)

 Paeds
1) CNS lower limb examination
2) pneumonia xray if im not mistaken
3) plot growth chart and measure head circumference (plotting,
comment, etiology, measurement)

 Commed
1. CM (A) - Case study (RCT) (Decide which study design, why, 2*2
table)
2. CM (P) - Positive predictive value calculation, Differences between
screening test and diagnostic test, Benefits of screening test
3. CM (P) - Epi Info (study design, 2*2 table, Comment on the result-
OR, 95%CI)
 Ortho
1) compartment syndrome ( dx, 4 signs, clinical test, ix, initial
management, rx, prevention during rx)
2) colle's fracture(deformity, dx, xray findings, carpal tunnel syndrome
(dx, 2 clinical test, IX, rx)
3) knee examination (active)

 MEQ

1. Medicine
-Cardiac failure (Hx, ECG, CXR, Rx, Complications)

2. Ortho
-Fracture of clavicle (Hx, Ex findings, Rx, Complications)

3. Obg
-Gestational diabetes (Risk factors, Dx, Rx, Comment on BSP,
Complications)

4. Paediatrics
-Beta-thalassemia (DDx, Rx, Side effects, Iron chelator)
 5. Com Med
-Mealses
- Propagated epidermic curve (Identify, Characteristics)
- Calculate Prevalence, Incidence
- Comment on OR, 95%CI
-vaccine efficacy
6. Surgery
-colorectal carcinoma (Hx, Ex findings, Rx, Complications)

 MCQ

(i) Medicine
1. Hyperkalemia on ECG
2. Blood supply of SA node
3. Electrolyte imbalance
4. Electrolyte imbalance
5. Monoarticular arthritis
6. Bronchiectasis
7. Clubbing
8. Carpopedal spasm seen in which electrolyte imbalance
9. Asymmetrical arthritis
10. X-linked dominant disease, chances of affected father inherited to hid daughter
11. Central chest pain
12. Chest pain 3months after pelvic fracture
13. How to assess synthetic function of liver within 24hrs
14. Pain and early morning stiffness... what’s the complications
15. Evaluation for acute asthmatic attack
16. Clinical scenarios

(ii) Surgery
1. Feeding gastrostomy
2. Splenectomy
3. Nerve preserving total parotidectomy
4. Concertina effect in X-ray indicates
5. Donor for renal transplant
6. Sigmoid volvulus
7. Management for asymptomatic renal stone
8. Disease screening for donor blood
9. Treatment for oesophageal achalasia
10. What structure or defects can be seen using ERCP except
11. Investigation for perforated peptic ulcer
12. Secondary brain injury
13. Shock
14. Complications of undescended testis not including
15. Organism causes amoebic liver abscess (protozoa)
16. Total parental nutrition given in
17. What to identify in splenectomy to avoid pancreas (lineo-renal ligament)
18. Prophylactic antibiotics given in
19. Type of edge in case of diabetic ulcer
20. Which cannot be used as peripheral venous nutrition
21. Contraindications for varicose vein surgery
22. Pain at rest, so ABPI should be at....
23. Buerger disease

(iii) Pediatrics
1. Karyotyping
2. IV adrenaline
3. Croup
4. Intermittent diarrhoea, no blood, no fever and vomiting
5. Gower sign seen in
6. Fungal infection

(iv) O&G
1. Placenta previa

(v) Orthopedics
1. Egawa test for which muscles
2. Epiphyseal bone tumor
3. Median nerve
4. Gustilo classification

(vi) Com med

1. Calculation of coefficient of variation
2. Chlorination
3. Strongest radiation

(vii) Psychiatry
1. Dissociative fugue
2. ?Apraxia
3. Schizophrenia
4. Posturing
5. Classical conditioning
6. Depression
7. Delusion
 (vii) ENT
1. Meniere disease
2. Discharge from ears
3. Wave seen in audiometry
4. Artery supply in Little’s area

(viii) Ophthalmology
1. Satellite lesion seen in
2. Glaucoma
3. Catatact
4. Optic neuritis
5. Eye muscle nerve supply

BATCH 38

P2S1 MeQ

 Medicine:
- infective endocarditis underlying ccf
1. 6 revelant hx
2. 2 dd
3. 4 pic(clubbing, palmar erythema/osler nodes?, retinal haemorrhage, pansystolic
murmur)
4. Clinical diagnosis
5. 2 investigation
6. Management of patient
7. 2 other complication of tricuspid infection
8.
9. What indication for sugery

 Paediatrics
- pyelonephritis (ckd)with recurrent uti
1. 4 other urinary symptoms
2. Interpret inx
3. 2 dd
4.
5. 2 urinary + 2 others
6.
 Com med:
- Type 2 diabetes mellitus
1. prevalance
2. incidence
3. 2 risk factor
4. 2 primoidal survey
5. cohort study
6. RR + calculate with interpret
7. death cert part 1(a,b,c) & 2
8. interpret table

 Surgery:
- Right ductal ca with rt pleural effusion mid to lower lobe
1. 4 revelant hx of breast lump
2. 4 revelant hx
3. 1 diagnosis
4. 2 dd
5. 2 imaging inx
6. X ray finding - rt pleural effusion mid - lower lobe
7. Staging (TNM) based on info - T2N2M1
8.
9. Treatment option
10.
11. 2 Counselling

 Obg:
- PCOS (irregular menses for 2-3 mo, acne + excess facial hair)
1. Provisional d + reason
2. Interpret x ray - pcos + ring of pearl
3. Treatment option
4. 1 inx + 3 others
5. Semen analysis interpret
6. 1 other imaging - hsg
7. histerosaphingram(bitubal) 1norm 1 abnorm
8. 2 counselling

 Ortho:
- ant dislocation of rt head of humerus
1. 4 dd
2. 5 clinical sign
3. 3 clinical signs from pic
4. diagnosis
5. 4 test
6. nerve + muscle
 7. x ray - ap + axillary x ray of...
8. Interpret radiography of both view (ap + axillary)
9. 2 injuries associated with
10. reduction method
11. method + duration after reduction
12. 1 complication

BATCH 37 P2S1

 Med: bronchial asthma

 Surgery: gastric Ca
 Ortho: post. Dislocation of hip
 Com med: cholera and case control
 Paeds: measels
 Obg: GDM

SUPPLE P2S1

o Med: Diabetes ketoacidosis

o Surgery: ca Breast
o Ortho: fracture neck fo femur
o Com med: maternal health indicator and cross sectional
o Paeds: Down syndrome with VSD
o ObG: Recurrence pregnancy loss