FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2016

POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
RURAL SURGERY
PAPER II
RURAL/D/16/44/II
Time 3 hours
Max. Marks 100
Important instructions:
• Attempt all questions in order.
• Each question carries 10 marks.
• Read the question carefully and answer to the point neatly and legibly.
• Do not leave any blank pages between two answers.
• Indicate the question number correctly for the answer in the margin space.
• Answer all the parts of a single question together.
• Start the answer to a question on a fresh page or leave adequate space between two answers.
• Draw table/diagrams/flowcharts wherever appropriate.
Write short notes on:
1. A 35 year old chronic smoker presented to emergency with history
of fall from stairs. On examination, he had fracture of 8th to 11th
ribs on left side. Write the investigation, initial management and
indications of operative management.

2. A 45 year old lady presented with painless lump in left iliac fossa.
Give differential diagnosis. How will you investigate this patient?
What are the indications of emergency surgery in a case of
carcinoma descending colon?

3. A 50 year old male factory worker presented with non healing ulcer
over medial aspect of leg. On examination, he had few dilated
veins. Mention differential diagnosis, investigations and
management of the patient.

4. A 25 year old female patient presented with haematemesis.
Enumerate the differential diagnosis. Give an outline of her
management.
4+6
5. A 40 year old male with history of recurrent urethral discharge
presented with acute retention of urine. Briefly describe the
differential diagnosis, investigations and management.

6. Classify fistula-in-ano.
Investigations and management of fistula-in-ano.
4+6
7. A 30 year old male presented with swelling left side of scrotum.
Write the steps of clinical examination, differential diagnosis and
management algorithm.

8. A 40 year old male recently diagnosed as a case of liver abscess
presented with sudden severe respiratory distress. Enumerate the
causes of respiratory distress in this patient. Briefly describe
investigations and management.

P.T.O.
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2016

POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
RURAL SURGERY
PAPER II
9. Enumerate the causes of dysphagia.
Management of corrosive injury of esophagus.
4+6
10. An 18 year old patient with history of fever for 14 day presented
with pain abdomen for last two days. On examination, there were
features of peritonitis. Enumerate the possible causes. Briefly
describe the investigations and management.