FINAL YEAR TOACS

4/12/2019
 STATION 1
• A 62 yr old woman presented to us with
gradual onset of jaundice over last 3 months,
also complains of weight loss, pruritis and is
passing clay coloured stools. On examination
the is a bulge palpable in RHC. The labs show
Bilirubin of 13mg/dl, ALT=210, ALP=1250,
s.Amylase=67. Ultrasound shows a distended
gallbladder and CT shows a mass in head of
pancreas.
• What are the different imaging modalities used
to study the biliary system?..................3marks
• What is the significance of finding a palpable gall
bladder?...................................................2marks
• What is the definitive treatment for this type of
carcinoma if operable?...........................2marks
• How can u relieve the patient’s
symptoms?.............................................3marks
2.A Identify the radiograph….2marks
• B. what are your findings?.......4marks
• C. differential diagnosis?..........3marks
• D. How will you treat?..............1mark
3.A Identify the image…..2marks
B.What are the findings?.....3marks
C. Differential diagnosis?......................2 marks
D. treatment?....................3 marks
STATION 4.
a. Identify the radiograph…………….1
b. Findings?........................................3
c. Differential diagnosis?....................2
d. How will you differentiate a benign from
malignant stricture on barium study?.......2
e. How will you manage?
 STATION 5:

• Counsel a 40 yr old school teacher with ca

rectum within 2cm of anal verge for
permanent colostomy.