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    Surgery Toacs APRIL 2012: Hassaan Bari Aga Khan University

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    Syed
    This document outlines the stations and scenarios presented in a surgery exam called TOACS. It describes 15 stations, including static stations requiring written answers and interactive stations with clinical scenarios. The scenarios covered a range of medical conditions and surgical topics, including urinary bladder stones, anaphylactic shock, inguinal hernias, breast abscesses, compartment syndrome, intussusception, trucut biopsies, breast cancer counseling, hernia repair, chest trauma, pancreatic pseudocysts, GERD, gastric outlet obstruction, facial swelling, and hydatid cyst of the chest. Examiners asked questions about diagnosis, management, complications, and related anatomy or pathophysiology for each scenario.

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    © All Rights Reserved
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    Surgery Toacs APRIL 2012: Hassaan Bari Aga Khan University

    Uploaded by

    Syed
    151 views18 pages
    This document outlines the stations and scenarios presented in a surgery exam called TOACS. It describes 15 stations, including static stations requiring written answers and interactive stations with clinical scenarios. The scenarios covered a range of medical conditions and surgical topics, including urinary bladder stones, anaphylactic shock, inguinal hernias, breast abscesses, compartment syndrome, intussusception, trucut biopsies, breast cancer counseling, hernia repair, chest trauma, pancreatic pseudocysts, GERD, gastric outlet obstruction, facial swelling, and hydatid cyst of the chest. Examiners asked questions about diagnosis, management, complications, and related anatomy or pathophysiology for each scenario.

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    Imm Fcps Surgery Toacs 2012

    Original Title

    IMM TOACS

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    This document outlines the stations and scenarios presented in a surgery exam called TOACS. It describes 15 stations, including static stations requiring written answers and interactive stations with clinical scenarios. The scenarios covered a range of medical conditions and surgical topics, including urinary bladder stones, anaphylactic shock, inguinal hernias, breast abscesses, compartment syndrome, intussusception, trucut biopsies, breast cancer counseling, hernia repair, chest trauma, pancreatic pseudocysts, GERD, gastric outlet obstruction, facial swelling, and hydatid cyst of the chest. Examiners asked questions about diagnosis, management, complications, and related anatomy or pathophysiology for each scenario.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    151 views18 pages

    Surgery Toacs APRIL 2012: Hassaan Bari Aga Khan University

    Uploaded by

    Syed
    This document outlines the stations and scenarios presented in a surgery exam called TOACS. It describes 15 stations, including static stations requiring written answers and interactive stations with clinical scenarios. The scenarios covered a range of medical conditions and surgical topics, including urinary bladder stones, anaphylactic shock, inguinal hernias, breast abscesses, compartment syndrome, intussusception, trucut biopsies, breast cancer counseling, hernia repair, chest trauma, pancreatic pseudocysts, GERD, gastric outlet obstruction, facial swelling, and hydatid cyst of the chest. Examiners asked questions about diagnosis, management, complications, and related anatomy or pathophysiology for each scenario.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 18

    SURGERY TOACS

    APRIL 2012
    Hassaan Bari
    Aga Khan University
    Dept of Surgery - AKUH
    • Total stations – 15
    • 8 .. Static Stations – Blue
    • 7 .. Interactive Stations - Green

    • Each station had a score of 10 in total …


    • subdivided as per questions asked in the scenario or examiner …

    • Nearly 5 minutes on each station .. There was no break in


    between the stations (no rest stations) …

    • For each static station .. a separate answer sheet was given and
    we had to put roll number and station number on each and
    every one of them !!!!!

    Rules of the game …


    Dept of Surgery - AKUH
    • An elderly male with history of
    hematuria …

    • What it is ? (Vesical calculus)


    • What are the types of stone ?
    • How will you manage ?
    • transurethral cystolitholapaxy,
    • percutaneous suprapubic
    cystolitholapaxy
    • open suprapubic cystotomy
    • What is the new development in its
    management ?
    • Laparoscopic extraperitoneal approach

    Urinary bladder stone


    Dept of Surgery - AKUH
    • Scenario – one of your friends got a Bee stung …
    suddenly he is having difficulty in breathing ..

    • What will u do ….. ?


    • What is the most important step of management… ?
    (Brnochodialators, epinephrine)
    • Which cells are involved & name the mediator …. ?
    (mast cells)
    • What type of reaction it is …. ? (type I)

    Anaphylactic shock
    Dept of Surgery - AKUH
    • Scenario – A patient underwent laparoscopic inguinal
    hernia repair … Now he is complaining of numbness
    in RT upper thigh …

    • Which nerve is involved .. Lateral cutaneous nerve of


    thigh …
    • What is TEP/TAPP ?
    • What are the boundaries of Triangle of pain ?
    • What are the boundaries of Triangle of doom ?

    Laparoscopic inguinal hernia


    Dept of Surgery - AKUH
    Laparoscopic inguinal hernia
    Dept of Surgery - AKUH
    • Scenario – A middle age lactating
    female came with history of fever
    & painful swelling of left breast ?

    • What is it ?
    • How will u manage ?
    • What are the causative organisms ?

    Breast abscess
    Dept of Surgery - AKUH
    • Scenario – A young male with
    history of RTA 2 hours back
    … presented in ER with
    severe pain in Rt leg …. The
    x-ray shows …

    • What is this patient having ?


    • How will u manage ?
    • What are the complications if
    not treated ?

    Compartment syndrome
    Dept of Surgery - AKUH
    • Scenario – a 4 months child
    develops abdominal pain,
    distension & vomiting’s with
    passage of jelly currant stool …

    • What it is ?
    • What is the name of investigation
    shown ?
    • How will u manage ?
    • When will you decide for surgery ?
    • Procedure name ?

    Intussusception
    Dept of Surgery - AKUH
    • Perform trucut biopsy on breast (apple)
    • What are the complications ?

    Trucut biopsy
    Dept of Surgery - AKUH
    • Scenario – A 35 years old female recently diagnosed to
    have left breast Ca … (Stage III) Counsel her regarding
    breast conservation therapy …

    • Queries regarding
    • 5 steps approach
    • built repo
    • pt understanding of disease
    • your counseling or breaking bad news
    • empathize
    • conclude
    • adjuvant chemotherapy …
    • AXLND … ?
    • Usage of left arm post surgery ? …

    Counseling-BCT
    Dept of Surgery - AKUH
    • Inguinal Hernia repair ….

    • Steps
    • Complications
    • Different types of repair … which is the best one ?

    Log book
    Dept of Surgery - AKUH
    • Scenario – A young male with RTA … blunt chest
    injury .. Landed in ER with severe dyspnea …

    • What differentials will come in your mind … ?


    • How will you diagnose/exclude them … ?
    • How will u manage each of them … ?

    Chest Trauma
    Dept of Surgery - AKUH
    • Scenario – A 35 years old male with history of
    epigastric pain and vomiting …. He was admitted
    with similar complain few days back …

    • What it is .. ?
    • How will u manage .. ?
    • What are the complications if not treated ?

    Pancreatic Pseudocyst
    Dept of Surgery - AKUH
    • Scenario – A middle age male
    with 2 weeks history of
    regurgitation and severe
    epigastric burning pain ..
    Underwent UGI Endoscopy …

    • What it is … ?
    • How will u manage … ?
    • What are the complications … ?

    GERD
    Dept of Surgery - AKUH
    • Scenario - A 65 years old female
    with history of weight loss,
    multiple vomiting's & abdominal
    distension …

    • What it is .. ?
    • How will you manage .. ?
    • What are the fluid requirements
    according to weight ?
    • What is paradoxical aciduria .. and
    how will u manage it ?

    Gastric outlet obstruction


    Dept of Surgery - AKUH
    • Scenario – A middle age male with
    history of swelling as shown in figure ..

    • What are the differentials ?


    • How will you approach for diagnosis .. ?
    • How will you manage ?
    • What is freys syndrome ? ..(Sweating
    while eating)
    • Which nerve involved .. ? (AT nerve)

    Facial/Neck Swelling
    Dept of Surgery - AKUH
    • A 36 years old farmer came to
    clinic with history of cough &
    hemoptysis … CXR was done …

    • What are the differentials ?


    • What it is ?
    • What investigations will you do ?
    • What are the management options
    ? ….

    Hydatid cyst of Chest


    Dept of Surgery - AKUH

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