6. Prepare the patient for and know the procedure of doing X-Ray Chest, Abdomen, KUB, Bones, IVU, barium studies, ultrasound and other imaging investigations.
7. Understands the principles of pre-operative preparations,Sterilization/Disinfection techniques.
8. Understand principles of wound care, Skin Suturing and Suture Removal, Incision and Drainage of Superficial Abscesses, Excision of Small Soft Tissue Lumps, Needle Biopsies, Aspiration of localized fluids, etc.
9. Have observed common surgical procedures Lymph node biopsy, appendectomy hernia repair cholecystectomy, breast/thyroid surgery laparotomy, anastomoses Incision drainage heamorrhoids and perianal surgeries, treatment of Fracture/ Dislocation and Methods of General/Local Anaesthesia.
10. Apply Bandage and Splint/POP cast to the patient‟s limbs.
11. understand use of Surgical instruments and sutures
12. Gastric surgery for morbid obesity
13. Splenectomy indications and complications C3
5- Attitude/Affect/Values to be inculcated
1. Demonstrate polite and gentle patient handling.
2. Observes Aseptic Techniques.
3. Keeps confidentiality of the patient.
4. Uphold medical ethics.
5. Anesthesia, pain relief, critical and ambulatory care
6- Basic life support (BLS) LUMP/SWELLING (general)
1. Congenital
2. Traumatic
3. Inflammatory
4. Neoplastic
7- STOMATITIS
1. General causes
2. Debility
3. Anemia
4. Vitamins deficiency
5. Blood disease
6. Drugs
7. Autoimmune mechanism
8. Secondary syphilis
Local
1. Poorly fitting denture
2. Infections
3. Trauma
4. Foot and mouth disease
9- NECK SWELLING
1. Lymphadenapathy (Inflammatory), acute and chronic
2. Chronic granulomatous
3. Neoplastic benign/malignant
4. Lymphatic leukemia
5. Autoimmune disorders
6. Lipoma
7. Neurofibroma
8. Sebaceous cyst
9. Sublingual dermoid
10. Thyroglossal cyst
11. Salivary Glands: calculi, enlargement (benign/malignant)
12. Thyroid gland enlargement
13. Branchial cysts, sinus or fistula
14. Cystic hygroma
15. Carotid artery tumor
10- BREAST LUMP
1. Cystic:
2. Solid: benign, atypical and malignant
3. Breast Imaging
4. Breast Biopsies
5. Breast Conserving Surgery / wide/ local excision
6. Sentinel Lymph Node Biopsy or Axillary Clearance
7. Adjuvant /systemic therapies
11-GYNAECOMASTIA BREAST PAIN NIPPLE DISCHARGE
1. From surface: Paget‟s disease, eczema psoriasis
2. Bright red: duct papilloma/carcinoma
3. Dark/altered: papilloma
4. Blood stained with cyst: intracystic carcinoma
5. Clear yellow/serous with lump: benign breast diseases (fibrocystic)
6. Thick green: ductectasia
7. Purulent: Infection
8. Milky: insufficient suppression of lactation or prolactinoma
12- DYSPHAGIA
i) Extrinsic pressure
1. Enlarged thyroid
2. Pharyngeal pouch
3. Aortic aneurysm
4. Abnormal aortic arch
5. Mediastinal tumors
6. Parapharyngeal hiatus hernia
ii) Abnormalities of the wall
1. Stricture
2. Post traumatic
3. Benign and malignant lesions
4. Corrosives
5. Crohn‟s disease
6. Post radiotherapy
7. Diverticulum
8. Scleroderma
9. Achalasia
10. Diffuse esophageal spasm
11. Post-surgical complications
iii) Abnormalities within the lumen
1. Foreign bodies
2. Webs
3. Schatzki‟s ring
13- GASTRO-OESOPHAGEAL REFLUX DISEASE UPPER GI BLEEDING C3, P1 (Oesophageal, Gastric and Duodenal)
1. Ulcers
2. Erosions
3. Mallory-Weiss tear
4. Oesophageal varices
5. Tumour
6. Vascular lesions
14- PAIN ABDOMEN
(a)-Adults
1. Appendicitis (C3P1)
2. Gastric carcinoma, primary gastric lymphoma, gastro-intestinal stromal tumors
3. Acute colonic diverticulitis
4. Perforated peptic ulcer
5. Acute cholecystitis
6. Cholelithiasis and its Complications C3P2
7. Liver abscess
8. Intestinal obstruction (small and large bowel) C3
9. Ureteric colic
10. Dyspepsia
11. Acute, and Chronic pancreatitis C3
12. Inflammatory bowel disease
13. Regional ileitis
14. Meckel‟s diverticulum
15. Rectus sheath haematoma
16. Peritonitis, abscesses C3P1
(b)- Elderly
1. Colorectal cancer
2. Vascular disease (mesenteric infarct/ ruptured aortic aneurysm)
3. Medical causes (diabetic ketoacidosis / Porphyria)
(c)-Children
1. Appendicitis
2. Non-specific abdominal pain
3. Mesenteric adenitis
4. Intussusception
5. Urinary tract infection
6. Hernia
7. Upper respiratory tract infection
(d)-Women
1. Pelvic inflammatory disease
2. Ovarian cyst
3. Ectopic pregnancy
(e)-Extra abdominal causes
1. Parietal conditions like cellulitis etc.
2. Thoracic conditions like pleurisy, pneumonia, pneumothorax, pericarditis, angina etc.
3. Retroperitoneal
4. Diseases of spine
5. General diseases
(f)-Anal Pain
1. Haemorrhoids C3P2
2. Pilonidal Sinus C3P2
3. Perianal Abscess P2
4. Perianal Fistulae P2
5. Anal Fissure P2
15- ABDOMINAL MASS
1. Incisional Hernia. C3P2
2. Right Hypochondrial
3. Parietal swellings
4. Intra-abdominal swellings arising from liver C3: liver abscess, hydatid cyst, malignancy (hepatoma and secondaries), gall bladder, subphrenic space, pylorus of stomach and duodenum, hepatic flexure of colon, right kidney and right
5. adrenal gland
6. Epigastrium
7. Parietal swellings: hernia
8. Intra-abdominal swellings: liver and subphrenic space, pylorus of stomach and duodenum, transverse colon, pancreas , omentum, abdominal aorta, lymph nodes and retroperitoneal sarcoma etc.
9. Left Hypochondrial
10. Intra-abdominal swellings from spleen, stomach, left lobe of liver, sub-phrenic space, splenic flexure, left kidney and adrenals.
11. Lumbar region
12. Ascending and descending colon, right and left kidneys
13. Umbilical
14. Umbilical Polyp
15. Hernia (Umbilical and para-umbilical) C3P2
16. Rectus sheath haematoma, abscess and desmoids tumor
17. Small bowel and mesentery; cysts, L nodes, matted coils of gut
18. Retroperitoneal growths
19. Right Iliac
20. Appendicular Mass
21. Ileo-caecal tuberculosis
22. Amoebic typhlitis
23. Crohn‟s Disease
24. Carcinoma caecum
25. Impaction of round worms
26. Lymph nodes
27. Iliac or iliopsoas abscess
28. Hypogastric
29. Urachal cyst
30. Urinary bladder
31. Uterus
32. Fallopian tubes and ovaries, cysts and tumors
33. Ruptured ectopic pregnancy
34. Cyst broad ligament
35. Pelvic abscess
36. Left Iliac Region
37. Diverticulitis
38. Carcinoma
16- LOWER GI BLEEDING C3
1. Colorectal carcinoma (C3 P1)
2. Ulcerative colitis (C3) and Crohn‟s Disease (C3)
3. Diverticulitis (C2)
4. Mesenteric vascular occlusion (C3)
5. Polyps
6. Rectal prolapse
7. Gross upper GI Bleeding
8. Meckel‟s diverticulits (C3)
9. Colitis amoebic/bacterial (C2)
10. Idiopathic ulcers
11. Haemorrhoids /anal fissure (C3P2)
12. Idiopathic proctitis
13. Behavioural trauma
14. Kaposi‟s sarcoma
15. Cytomegalovirus (CMV)
16. Herpes Simplex Virus (HSV)
17- FAECAL INCONTINENCE C3 OBSTRUCTIVE (Surgical) JAUNDICE C3
1. Lumen
2. Gall stones
3. In the wall
4. Strictures benign/ malignant (Cholangiocarcinoma) C3
5. Sclerosing cholangitis
6. Outside the wall
7. Pancreatic (benign, malignant Tumors C2), ampullary hepatic
18- INGUINOSCROTAL SWELLING C3P2
1. Inguinal hernia
2. Femoral swellings
3. Encysted hydrocele of cord
4. Varicocele
5. Lymphangiactasis
6. Funiculitis
7. Diffuse lipoma of cord
8. Inflammatory thickening of cord
9. Malignant extension of testis (including testicular malignancy C3P2)
10. Undescended and/or Ectopic testis C3P1
11. Retractile testis
12. Torsion of testis
13. Enlarged lymph nodes
14. Abscess
20- HAEMATURIA C3
(a)-Renal
1. Carcinoma of kidney
2. Carcinoma of renal pelvis
3. Stones
4. Trauma
5. Intrinsic renal disease, e.g, Glomerulonephritis
6. Polycystic kidney
7. Tuberculosis
8. Arterio-venous malformations
(b)-Ureteric
1. Carcinoma of urothelium
2. Stone
(c)_Bladder
1. Carcinoma of bladder
2. Stone
3. Trauma
4. Cystitis
5. Schistosomiasis
(d)-Prostate
1. Carcinoma of prostate C3
2. Benign prostatic hyperplasia C3
3. Prostatitis
(e)-Urethra
1. Carcinoma of urothelium
2. Stone
3. Trauma C3
4. Urethritis
5. Stricture
(f)-Others
Blood dyscrasias and Coagulopathies
21- URINARY RETENTION
1. Mechanical
2. Urinary bladder stone C3, tumor, clot and bladder neck contracture and sequelae (reflux and hydronephrosis C3)
3. Prostate: abscess, stone and prostatic enlargement benign/ malignant C3P1.
4. Urethra: stricture, stone, rupture, congenital valves, foreign body, acute urethritis, growth and pin hole meatus
5. Prepuce; phimosis
6. From outside: pregnancy, fibroids, ovarian cysts, carcinoma of cervix, uterus, rectum and pelvic growth.
7. Neurogenic:
8. Spinal cord diseases
9. Injuries and diseases of spine
10. Miscellaneous
22- PRIAPISM/ ERECTILE DYSFUNCTION C1 URINARY INCONTINENCE C3 MALE INFERTILITY C2 RECONSTRUCTIVE SURGERY
1. Principles of skin coverage C3
2. Common benign and malignant skin lesions. C3
3. Burns, principles of management C3P1
4. cleft lip and palate C2
5. epi/hypospadia C2
24-NEUROSURGERY C3
1. Raised intracranial pressure/ hydrocephalus
2. Introduction to intracranial infections
3. Introduction to intracranial tumors
4. Peripheral nerve Injuries C3P1
25-PAEDIATRIC SURGERY
1. Paediatric Tumours C3
2. Neonatal surgical problems C3
3. Tracheoesophageal malformations C3
4. Pyloric stenosis C3
5. Hirschprung‟s disease C3
6. Imperforate anus C3P1
7. Intestinal obstruction C3 (Intussusception C3P1)
8. Foreign body (Aspirated or Ingested) C3P1
26- PAINFUL/COLD /ULCERATED LIMB
1. Large artery occlusion: acute (embolic), chronic (atherosclerotic)
2. Small arteries occlusion: Buerger‟s Disease, Raynaud‟s Disease, embolism, Diabetes, Scleroderma and physical agents.
3. Diabetic foot C3P2
4. Vascular afflictions and limb Ischemia C3P1
5. Varicosities C3P2
6. Deep venous thrombosis and complications C3P1
7. Peripheral neuropathies
28-Skills
1. Perform,:
2. Provide First Aid: Resuscitation (ABC) of Polytrauma, CPR.
3. Insert Intra-venous cannula,
4. Collect samples of blood, urine, stool, sputum, pus swab etc.
5. Insert Naso-gastric tube,
6. Catheterize male and female patients.
7. Prepare the patient for and know the procedure of doing X-Ray Chest, Abdomen, KUB, Bones, IVU, barium studies, ultrasound and other imaging investigations.
8. Apply Bandage and Splint/POP cast to the patient‟s limbs
9. Should have observed
10. Chest intubation and
11. Paracentesis.
12. CV-line insertion
13. Cut-down of veins.
14. Common surgical procedures: lymph node biopsy, appendectomy, hernia repair, cholecystectomy, breast/ thyroid surgery, laparotomy, anastomoses, Incision, drainage, haeamorrhoid surgical techniques and perianal surgeries,
15. Treatment of Fracture / Dislocation
16. Methods of General / Local Anaesthesia.
17. Understands the principles of:
18. Pre-operative preparations, Sterilization/Disinfection techniques.
19. Wound care, Skin Suturing and Suture Removal, Incision and Drainage of Superficial Abscesses, Aspiration of localized fluids,
20. Excision of Small Soft Tissue Lumps, Needle Biopsies, etc.
21. Order and interpret renal tract investigative tests P2
29- Attitude / Affect / Values to be inculcated
1. Demonstrate polite and gentle patient handling.
2. Observes Aseptic Techniques.
3. Maintain patient confidentiality.
4. Uphold medical ethics.