SRB's Clinical Methods in SURGERY
VIDEO LIST FOR QR CODES
Access the Videos by Scanning the QR Code Inside
S.No. | Video Title | Chapter No. | Page No. |
|---|---|---|---|
1. | General Examination | 1 | 11 |
2. | Examination of Ulcer | 3 | 64 |
3. | Examination of Swelling | 4 | 94 |
4. | Examination in Peripheral Vascular Disease | 6 | 158 |
5. | Examination of Varicose Veins | 7 | 184 |
6. | Examination of Lymphatic System | 8 | 205 |
7. | Examination of Oral Lesions-Ulcer | 11 | 239 |
8. | Examination of Salivary Glands | 14 | 282 |
9. | Examination of Neck Swelling | 15 | 299 |
10. | Examination of Thyroid | 16 | 321 |
11. | Examination of Breast | 17 | 342 |
12. | Examination of Hernia | 18 | 370 |
13. | Examination of Scrotal Swelling | 19 | 390 |
14. | Examination of Abdominal Mass | 23 | 448 |
SRB's Clinical Methods in SURGERY
As per the Competency-based Medical Education Curriculum (NMC)
Fourth Edition
Sriram Bhat M
MS (General Surgery) FRCS (Glasgow)
Professor and Head Department of Surgery Kasturba Medical College Mangalore, Karnataka, India
Honorary Surgeon Government Wenlock District Hospital Mangalore, Dakshina Kannada, Karnataka, India
meera_sriram2003@yahoo.com
Forewords
CR Ballal
Narayanaswamy Srinivasan
Harish Rao
Sribatsa Kumar Mohapatra
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SRB's Clinical Methods in Surgery
First Edition: 2010
Second Edition: 2015
Third Edition: 2019
Fourth Edition: 2023
9789354658686
Printed at India
College where I had my undergraduation, postgraduation and surgical professional career till date, i.e.,
Kasturba Medical College and Government Wenlock District Hospital, Mangalore, Karnataka, India
and My beloved wife Dr Meera Sriram and my daughter Miss Ananya
Bhargav Vyas MS (General Surgery)
Assistant Professor
Department of Surgery
Kasturba Medical College
Mangalore, Karnataka, India
Meera Karanth P (Meera Sriram) MD
Gynecologist
Light House Poly Clinic
Mangalore, Karnataka, India
She has contributed Chapter 24—Approaches and Examination in Rectal and Vaginal Problems
Narayanaswamy Srinivasan MS FRCS (Glasgow)
Medical Superintendent
Fathima Institute of Medical Sciences
Kadapa, Andhra Pradesh, India
Former Dean and Director
Bangalore Medical College and Research Institute
Bengaluru, Karnataka, India
His innovative invention—'Srinivasan costal sign’ is published in this book
Sribatsa Kumar Mohapatra MS FRCS DNB
Veer Surendra Sai Medical College
Burla, Odisha, India
He has contributed his new approaches in breast and abdomen examination—an innovative triple ABC technique (Sribatsa Mohapatra Clinical Technique) for clinical breast examination (CBE) for breast disorders and a cricketing approach to the abdomen and stethoscope sign in acute appendicitis.
Foreword
Dr Sriram Bhat M, Professor of Surgery, Kasturba Medical College (KMC), Mangalore, Karnataka, India, is a very popular teacher and I have known him for more than three decades. He has always been interested in teaching and his emphasis was on the fundamentals of good clinical examination. At a time when imaging and other methods of investigations are becoming popular than methodical and a well-executed clinical examination, a well-written book on clinical surgery is most welcome. Dr Bhat has tried to emphasize as very systemic examination so that one could arrive at a working diagnosis at the end of a good history and physical examination. The value of this book has been enhanced by a very large number of highly illustrative pictorial descriptions. Unfortunately, the number and the variety of patients in many teaching hospitals across the country are unfavorable as far as undergraduates and postgraduates are concerned. I am sure, this book will find a place in the armamentarium of all the students.
Dr Bhat is already the author of a popular textbook of surgery. I have no hesitation to believe that on clinical surgery will be equally popular.
CR Ballal MS
Professor Emeritus
Department of Surgery
Mangalore, Karnataka, India
Foreword
When Professor Sriram Bhat M, from Kasturba Medical College (KMC), Mangalore, Karnataka, India, has requested me to write a foreword for the current edition of his clinical book SRB's Clinical Methods in Surgery, I readily accepted it because I know him since few years if not personally because of his popular well-known book SRB's Manual of Surgery and SRB's Clinical Methods in Surgery, first edition and regular communications through phone and e-mail.
This book carries its own merit by lucid presentation, detailed methods of clinical examinations with excellent clinical photographs and illustrations. Even though present era is of imaging, this book stresses the need for proper clinical examination to clinch the proper diagnosis, treatment plans and during follow-up. This book has covered all topics including clinical examination in orthopedics. As by his request, I have given permission to publish the sign which I have invented, i.e., ‘Srinivasan costal sign’ and I also felt it is my honor to get the sign published in SRB's Clinical Methods in Surgery, current edition.
This book will become probably an essential one to all undergraduates and postgraduates to get a clear idea of clinical methods. Accompanying online videos contain clinical examinations of all important topics with background voice explanation of the author.
This is also very useful to practicing clinicians and surgeons worldwide to understand the surgical conditions and to achieve proper clinical diagnosis.
I appreciate dedication and determination of Professor Sriram Bhat M in bringing out the current edition of SRB's Clinical Methods in Surgery and wish him a grand success and also recommend this clinical book to all undergraduates, postgraduates and clinicians to make use of it in clinical practice or learning or in examinations.
Narayanaswamy Srinivasan MS FRCS (Glasgow)
Medical Superintendent
Fathima Institute of Medical Sciences
Kadapa, Andhra Pradesh, India
Former Dean and Director
Bangalore Medical College and Research Institute
Bengaluru, Karnataka, India
Foreword
“Observe, record, tabulate, and communicate. Use your five senses. Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone you can become an expert”.
—Sir William Osler
Great advice from a doyen of the past. Today, in the age of ultrasound, CT, MRI and PET scans, clinical examination seems redundant. Yet with all the available sophistry, we seem to be making more mistakes than in the past. We have made diagnosis a costly exercise. In our mad rush towards super-specialization, the art of history taking and eliciting clinical signs is rapidly fading. Yet many times, it is not the scans that help us come to the conclusion nor battery of tests but simple old-fashioned clinical examination.
Dr Sriram Bhat M has been working tirelessly to preserve and perpetuate this art for the past several years. The result is this new and improved version of his clinical textbook. I am sure enthusiasts of this subject will delight in reading and learning from this book. It is a great privilege to be writing the foreword for this book that is virtually a Bible amongst surgical students both in India and abroad. The text is lucidly written, explanations are brought to current levels of knowledge and the illustrations and photographs are of superb quality. This book is a must read for the undergraduates and postgraduates of surgery so that they can be better clinicians.
“From inability to leave well alone; from too much zeal for the new and contempt for what is old; from putting knowledge before wisdom and science before art, and cleverness before common sense; from treating patients as cases; and from making the cure of the disease more grievous than the endurance of the same, Good Lord, deliver us”.
—Sir Robert Hutchinson
There in lies the gist of what this book is trying to do. For the sake of clinical surgery I wish this book all the best and many many reprints in the coming years.
Harish Rao MS
Professor and Ex-Head
Department of Surgery
Kasturba Medical College
Mangalore, Karnataka, India
Foreword
“Diagnosis is not the end but the beginning of practice” – said Martin Fischer. This is an ideal advice by a legend.
When Professor Sriram Bhat M requested me to write foreword to his upcoming current edition of the SRB's Clinical Methods in Surgery, I certainly accepted. I know him very well through his different books in surgical fields which are authentic, informative and very useful. His book, SRB's Clinical Methods in Surgery is exceptionally methodical and it gives in detail methodology to approach a patient clinically with history taking, clinical examination and final clinical diagnosis with differential diagnoses. I had great opportunity to express my views in few topics. This book has covered all clinical examination methods with analytical approach, topic-wise with brief ideas about different clinical conditions. It also includes X-rays, instruments and surgical pathology which are useful for students during their practical examination.
I would say it is an outstanding and remarkable contribution by Professor Sriram Bhat and I have no hesitation in recommending this book to all undergraduate and postgraduate students, and medical teachers engaged in knowledge transfer. It is said no stones should be left unturned for a proper diagnosis, and this book gives the clues in a simple way of how to turn those difficult stones. This book will be very useful to practicing surgeons as a clinical guide.
I affectionately and wholeheartedly wish Professor Bhat a great success in this endeavor.
Sribatsa Kumar Mohapatra
MBBS MS Dip NB FRCS (Edin)
Professor of Surgery
Veer Surendra Sai Institute of Medical Sciences and Research
Burla, Odisha, India
Preface to the Fourth Edition
It is now four years third edition of SRB's Clinical Methods in Surgery has released with good acceptance from students and faculties altogether. But I sincerely thought further editions are sure a need due to change in trend of examination pattern and incoming new CBME syllabus. I did a lot of changes in the upcoming fourth edition. Unnecessary lengthy discussions are removed. Most of the subjects topics in each chapter are put in table format briefly, so that students can quickly go through the clinical conditions whenever needed in the ward or outpatient room. Relevant CBME numbers are highlighted in each chapter. Many photos are deleted to avoid repetitions; many are replaced with new one. Text and illustrations are made in such a way that those students while reading will have continuous flow of thoughts with lucid language. Important clinical topics are added with newer high definition clinical video demonstrations of examining the patients which will be very useful to students to understand the clinical methods of examination of the patient. Differential diagnoses are discussed in each topic in an orderly passion. X-rays, instruments, pathology specimens are discussed. Orthopedic topics in relation to clinical examination are briefly covered.
Clinical knowledge is essential knowledge in treating surgical patients in spite of availability of high technology investigations. Final decision of treatment and probability of outcome is decided purely by analysis, clinical applications and correlations. Old quote is—“Never let the skin stand between you and the diagnosis” which means clinical examination is so important in finalising the clinical diagnosis and taking decision.
I hope this newer edition of the clinical book will be very useful to practicing surgeons, all students including undergraduate and postgraduates and all surgical faculties of different teaching institutions.
Healthy constructive criticisms by beloved readers are very well accepted to improve the quality of the book.
Sriram Bhat Muguli
Preface to the First Edition
It was my long time dream to bring out a good surgical clinical book for undergraduates, postgraduates and practicing surgeons. Even though I have written surgical manual for students of MBBS, Dental and Nursing category, I had an aspiration to write an adequate sufficient clinical book which can cover all category of students who need to learn clinical surgery properly. I have covered every aspect of clinical surgery with good illustrations in all chapters. This contains methods of basic clinical surgery for medical students. Clinical approaches, clinical analysis and clinical diagnosis with differential diagnosis are discussed in each chapter. However, therapeutic aspects, controversies and recent advances are not a part of this book. Students who want to learn in detail in these aspects are requested to refer to my textbook SRB's Manual of Surgery, 3rd edition or any other surgical books of their choice. I have taken enough care to discuss different clinical methods and signs. I have also referred standard clinical books and surgery books prior to writing this book. Many methods and signs which are old are well accepted but still many methods are controversial. But whatever given in this are commonly followed one; individual opinions and controversies are not highlighted here.
I hope this book will be useful for all those who are keen to learn clinical surgery.
I sincerely appreciate everyone who has helped me. I thank M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, for their support to bring out this book.
Any constructive criticisms are most welcome.
Sriram Bhat M
Acknowledgments
I am happy to bring out the fourth edition of SRB's Clinical Methods in Surgery after four years of the previous edition. This is due to constant help and support of many.
I thank our Chancellor, Dr Ramdas M Pai; Mrs Vasanthi Pai, Trustee, MAHE Trust, Manipal; Dr Ranjan Pai, CEO, MEMG; Pro- Chancellor Dr HS Ballal; Vice-Chancellor of Manipal Academy of Higher Education (MAHE), Lt. Gen. Dr MD Venkatesh, Pro-Vice- Chancellor, Dr Venkatraya Prabhu, and Dr Dilip G Naik.
My immense thanks to my beloved Dean-Professor, Unnikrishnan; Associated Deans Professor, Shrikala Baliga; Professor Suresh Kumar Shetty, Professor Pramod Kumar.
I thank my beloved teacher, a great clinician and senior surgeon, Professor Dr CR Ballal, Mangalore for accepting my request to give foreword to this clinical book. I owe a lot to him.
I thank Professor Narayanaswamy Srinivasan, Former Dean and Director, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, Presently Medical Superintendent, Fathima Institute of Medical Sciences, Kadapa, Andhra Pradesh for writing foreword to this book and contributing to the book with ‘Srinivasan costal sign’.
I always remember my senior teachers, Professor Suresh Kamath and Professor K Prakash Rao, Dr Jayaprakash Rao for their constant help. I thank Professor GG Laxman Prabhu, Urologist, Kasturba Medical College, Mangalore, Karnataka.
I thank Professor Dr Sribatsa Kumar Mohapatra, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Odisha, contributed his new approaches in breast and abdomen examination—An innovative triple ABC technique (Sribatsa Mohapatra Clinical Technique) for clinical breast examination (CBE) for breast disorders and A cricketing approach to the abdomen.
I thank Professor Ramlingam, Kamineni Institute of Medical Sciences, Narketpally for contributing with many photographs. I thank many other senior consultants and professors in different medical colleges across the country for contributing towards this in the form of opinions, photos and corrections.
I thank many professors and teachers, who guided, corrected, helped me and contributed in different forms like clinical photos towards this edition of the book.
Earlier and current Professors, Department of Surgery, Kasturba Medical College, Mangalore namely Dr BM Nayak, Dr Thangam Varghese, Dr Jayaram Shenoy, Dr Anand Kini, Dr Harish Rao, Dr Ramachandra Pai, Dr SP Rai, Dr Yogish Kumar, Dr Shivananda Prabhu H, Dr Rajesh Ballal, Dr Manohar Pai and Dr Ashfaque Mohammad are always supportive for my work and are worth to be remembered always.
I am grateful to all my teachers and colleagues in surgery department who directly or indirectly helped me to bring out book.
I need thank specifically—Dr Bhargav Vyas AN, my Assistant Professor, Department of Surgery, Kasturba Medical College, Mangalore, Dr Balodi Divya Maheshbhai, Senior Resident and Dr Gopal, Postgraduate, who have helped me with real affection in all editing, collecting photos, taking videos. I really owe them a lot.
I appreciate District Medical Officer and Resident Medical Officer of Government Wenlock District Hospital, Mangalore for their kind help.
I will never forget my close associates Dr Ganapathy, Director, Mangala Hospital, Kadri, Mangalore; Dr Ashok Pandith, Consultant Urologist, Yenepoya Speciality Hospital, Kodialbail, Mangalore for their affectionate help and encouragement in all my endeavors. They always stood with me in my difficulties.
I thank Dr Poornachandra Tejashri, Dr Shibumon MM, Dr Rahul Bhat, Dr Kalpana Sridhar, Dr Keshava Prasad, Dr Sunilkumar Shetty, Dr Sunil Matt, Dr Jawahar BK, Dr Achaleshwar Dayal, Dr Ashok Hegde, Dr Devidas Shetty, Dr Venkatesh Sanjeeva, Dr Sunil, Dr Harish Nayak, Dr Subraya Kamath and Dr Nandakishore, for their help in various aspects.
I thank my friends Dr Manjunath Shenoy, Urologist; Dr Jagadish for his contributions to photos and X-rays and opinion on dental and faciomaxillary topics; Dr Harsharaj, Orthopedician, Mangalore, and Dr Ishwarakeerthi, Spine specialist, Mangalore for their help. I thank Dr Balasaraswathy, Consultant Dermatologist, Mangalore for providing rare photos.
My wife Dr Meera Karanth helped me day and night in editing this new book and without her help this could not have been possible. My beloved daughter Ananya helped me in drawing and diagrams artistically. I enjoy her love and affection towards me.
I thank all my students especially postgraduates of surgery department who were helping regularly in bringing out this second edition.
Words are not sufficient to remember all my patients who are the main material for the book. I pray for their good health always.
I am very grateful to the whole team of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, who helped and guided me, Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Dr Madhu Choudhary (Director–Educational Publishing), Ms Pooja Bhandari (Production Head), Ms Sunita Katla (Executive Assistant to Group Chairman and Publishing Manager), Ms Samina Khan (Executive Assistant to Director–Educational Publishing), Dr Aditya Tayal (Development Editor), Mr Rajesh Sharma (Production Coordinator), Ms Seema Dogra (Cover Visualizer), Ms Geeta Shirvastava (Proofreader), Mr Deep Kumar Dogra (Typesetter), Mr Gopal Singh (Graphic Designer) and their team members, for all their support to work in this project and make it a success. Without their cooperation, I could not have completed this project.
Competency Table
Number | The student should be able to | Core (Y/N) | Chapter number | Page Number |
|---|---|---|---|---|
SU1.3 | Describe basic concepts of perioperative care | Y | 2 | 43 |
SU6.1 | Define and describe the etiology and pathogenesis of surgical infections | Y | 3, 4, 5, 27, 28 | 57, 88, 143, 511, 517 |
SU6.2 | Enumerate prophylactic and therapeutic antibiotics plan appropriate management | Y | 3 | 57 |
SU9.1 | Choose appropriate biochemical, microbiological, pathological, imaging investigations and interpret the investigative data in a surgical patient | Y | 2, 42, 43 | 43, 624, 633 |
SU9.2 | Biological basis for early detection of cancer and multidisciplinary approach in management of cancer | Y | 2, 42 | 43, 624 |
SU9.3 | Communicate the results of surgical investigations and counsel the patient appropriately | Y | 2 | 43 |
SU14.2 | Describe surgical approaches, incisions and the use of appropriate instruments in surgery in general | Y | 41 | 609 |
SU14.3 | Describe the materials and methods used for surgical wound closure and anastomosis (sutures, knots and needles) | Y | 41 | 609 |
SU17.4 | Describe pathophysiology, mechanism of head injuries | Y | 32 | 533 |
SU17.5 | Describe clinical features for neurological assessment and GCS in head injuries | Y | 32 | 533 |
SU17.6 | Chose appropriate investigations and discuss the principles of management of head injuries | Y | 32 | 533 |
SU17.7 | Describe the clinical features of soft tissue injuries. Chose appropriate investigations and discuss the principles of management | Y | 10 | 234 |
SU17.8 | Describe the pathophysiology of chest injuries | Y | 33, 34 | 537, 540 |
SU17.9 | Describe the clinical features and principles of management of chest injuries | Y | 33, 34 | 537, 540 |
SU17.10 | Demonstrate airway maintenance. Recognize and manage tension pneumothorax, hemothorax and flail chest in simulated environment | Y | 33, 34 | 537, 540 |
SU18.1 | Describe the pathogenesis, clinical features and management of various cutaneous and subcutaneous infections | Y | 4 | 88 |
SU18.2 | Classify skin tumors | Y | 4 | 88 |
Differentiate different skin tumors and discuss their management | ||||
SU18.3 | Describe and demonstrate the clinical examination of surgical patient including swelling and order relevant investigation for diagnosis. Describe and discuss appropriate treatment plan | Y | 4 | 88 |
SU19.1 | Describe the etiology and classification of cleft lip and palate | Y | 12, 29 | 266, 520 |
SU19.2 | Describe the principles of reconstruction of cleft lip and palate | Y | 12, 29 | 266, 520 |
SU20.1 | Describe etiopathogenesis of oral cancer symptoms and signs of oropharyngeal cancer | Y | 11 | 238 |
SU20.2 | Enumerate the appropriate investigations and discuss the principles of treatment | Y | 11 | 238 |
SU21.1 | Describe surgical anatomy of the salivary glands, pathology, and clinical presentation of disorders of salivary glands | Y | 14 | 280 |
SU21.2 | Enumerate the appropriate investigations and describe the principles of treatment of disorders of salivary glands | Y | 14 | 280 |
SU22.1 | Describe the applied anatomy and physiology of thyroid | Y | 16 | 317 |
SU22.2 | Describe the etiopathogenesis of thyroidal swellings | Y | 16 | 317 |
SU22.3 | Demonstrate and document the correct clinical examination of thyroid swellings and discus the differential diagnosis and their management | Y | 16 | 317 |
SU22.4 | Describe the clinical features, classification and principles of management of thyroid cancer | Y | 16 | 317 |
SU22.5 | Describe the applied anatomy of parathyroid | Y | 16 | 317 |
SU22.6 | Describe and discuss the clinical features of hypo - and hyperparathyroidism and the principles of their management | Y | 16 | 317 |
SU24.1 | Describe the clinical features, principles of investigation, prognosis and management of pancreatitis | Y | 21, 22 | 411, 432 |
SU24.2 | Describe the clinical features, principles of investigation, prognosis and management of pancreatic endocrine tumors | Y | 21 | 411 |
SU24.3 | Describe the principles of investigation and management of pancreatic disorders including pancreatitis and endocrine tumors | Y | 21, 22 | 411, 432 |
SU25.1 | Describe applied anatomy and appropriate investigations for breast disease | Y | 17 | 340 |
SU25.2 | Describe the etiopathogenesis, clinical features and principles of management of benign breast disease including infections of the breast | Y | 17 | 340 |
SU25.3 | Describe the etiopathogenesis, clinical features, investigations and principles of treatment of benign and malignant tumors of breast | Y | 17 | 340 |
SU25.4 | Counsel the patient and obtain informed consent for treatment of malignant conditions of the breast | Y | 17 | 340 |
SU25.5 | Demonstrate the correct technique to palpate the breast for breast swelling in a mannequin or equivalent | Y | 17 | 340 |
SU26.3 | Describe the clinical features of mediastinal diseases and the principles of management | Y | 31 | 529 |
SU26.4 | Describe the etiology, pathogenesis, clinical features of tumors of lung and the principles of management | Y | 31 | 529 |
SU27.1 | Describe the etiopathogenesis, clinical features, investigations and principles of treatment of occlusive arterial disease | Y | 6 | 153 |
SU27.2 | Demonstrate the correct examination of the vascular system and enumerate and describe the investigation of vascular disease | Y | 6 | 153 |
SU27.3 | Describe clinical features, investigations and principles of management of vasospastic disorders | Y | 6 | 153 |
SU27.4 | Describe the types of gangrene and principles of amputation | Y | 6 | 153 |
SU27.5 | Describe the applied anatomy of venous system of lower limb | Y | 7 | 181 |
SU27.6 | Describe pathophysiology, clinical features, investigations and principles of management of DVT and varicose veins | Y | 7 | 181 |
SU27.7 | Describe pathophysiology, clinical features, investigations and principles of management of lymph edema, lymphangitis and lymphomas | Y | 8 | 201 |
SU27.8 | Demonstrate the correct examination of the lymphatic system | Y | 8 | 201 |
SU28.5 | Describe the applied anatomy and physiology of esophagus | Y | 25 | 488 |
SU28.6 | Describe the clinical features, investigations and principles of management of benign and malignant disorders of esophagus | Y | 25 | 488 |
SU28.7 | Describe the applied anatomy and physiology of stomach | Y | 21 | 411 |
SU28.8 | Describe and discuss the etiology, the clinical features, investigations and principles of management of congenital hypertrophic pyloric stenosis, peptic ulcer disease, carcinoma stomach | Y | 21 | 411 |
SU28.9 | Demonstrate the correct technique of examination of a patient with disorders of the stomach | Y | 21, 22 | 411, 432 |
SU28.10 | Describe the applied anatomy of liver. Describe the clinical features, investigations and principles of management of liver abscess, hydatid disease, injuries and tumors of the liver | Y | 21, 22 | 411, 432 |
SU28.12 | Describe the applied anatomy of biliary system. Describe the clinical features, investigations and principles of management of diseases of biliary system | Y | 21 | 411 |
SU28.13 | Describe the applied anatomy of small and large intestine | Y | 21 | 411 |
SU28.15 | Describe the clinical features, investigations and principles of management of diseases of Appendix including appendicitis and its complications | Y | 22 | 432 |
SU28.16 | Describe applied anatomy including congenital anomalies of the rectum and anal canal | Y | 24 | 472 |
SU28.17 | Describe the clinical features, investigations and principles of management of common anorectal diseases | Y | 24 | 472 |
SU28.18 | Describe and demonstrate clinical examination of abdomen. Order relevant investigations. Describe and discuss appropriate treatment plan | Y | 22, 23 | 432, 446 |
SU29.1 | Describe the causes, investigations and principles of management of hematuria | Y | 26 | 493 |
SU29.2 | Describe the clinical features, investigations and principles of management of congenital anomalies of genitourinary system | Y | 26 | 493 |
SU29.3 | Describe the clinical features, investigations and principles of management of urinary tract infections | Y | 26 | 493 |
SU29.4 | Describe the clinical features, investigations and principles of management of hydronephrosis | Y | 26 | 493 |
SU29.5 | Describe the clinical features, investigations and principles of management of renal calculi | Y | 26 | 493 |
SU29.6 | Describe the clinical features, investigations and principles of management of renal tumors | Y | 26 | 493 |
SU29.7 | Describe the principles of management of acute and chronic retention of urine | Y | 26 | 493 |
SU29.8 | Describe the clinical features, investigations and principles of management of bladder cancer | Y | 26 | 493 |
SU29.9 | Describe the clinical features, investigations and principles of management of disorders of prostate | Y | 26 | 493 |
SU29.10 | Demonstrate a digital rectal examination of the prostate in a mannequin or equivalent | Y | 26 | 493 |
SU29.11 | Describe clinical features, investigations and management of urethral strictures | Y | 26 | 493 |
SU30.1 | Describe the clinical features, investigations and principles of management of phimosis, paraphimosis and carcinoma penis | Y | 20 | 403 |
SU30.2 | Describe the applied anatomy clinical features, investigations and principles of management of undescended testis | Y | 19 | 387 |
SU30.3 | Describe the applied anatomy clinical features, investigations and principles of management of epidydimo-orchitis | Y | 19 | 387 |
SU30.4 | Describe the applied anatomy clinical features, investigations and principles of management of varicocele | Y | 19 | 387 |
SU30.5 | Describe the applied anatomy, clinical features, investigations and principles of management of hydrocele | Y | 19 | 387 |
SU30.6 | Describe classification, clinical features, investigations and principles of management of tumors of testis | Y | 19 | 387 |
Integrations | ||||
AN10.6 | Explain the anatomical basis of clinical features of Erb's palsy and Klumpke's paralysis | N | 8, 9 | 201, 220 |
AN10.7 | Explain anatomical basis of enlarged axillary lymph nodes | N | 8 | 201 |
AN12.8 | Describe anatomical basis of clawhand | Y | 9 | 220 |
AN12.10 | Explain infection of fascial spaces of palm | N | 10, 27 | 234, 511 |
AN12.11 | Identify, describe and demonstrate important muscle groups of dorsal forearm with attachments, nerve supply and actions | Y | 9, 10 | 220, 234 |
AN12.12 | Identify and describe origin, course, relations, branches (or tributaries), termination of important nerves and vessels of back of forearm | Y | 9 | 220 |
AN12.13 | Describe the anatomical basis of wrist drop | Y | 9 | 220 |
AN12.14 | Identify and describe compartments deep to extensor retinaculum | Y | 10 | 234 |
AN15.3 | Describe and demonstrate boundaries, floor, roof and contents of femoral triangle | Y | 18 | 366 |
AN15.4 | Explain anatomical basis of psoas abscess and femoral hernia | N | 18 | 366 |
AN18.3 | Explain the anatomical basis of foot drop | Y | 9 | 220 |
AN19.3 | Explain the concept of “peripheral heart” | Y | 7 | 181 |
AN20.4 | Explain anatomical basis of enlarged inguinal lymph nodes | N | 8 | 201 |
AN20.5 | Explain anatomical basis of varicose veins and deep vein thrombosis | Y | 7 | 181 |
AN20.9 | Identify and demonstrate palpation of vessels (femoral, popliteal, dorsalis pedis, post tibial), mid inguinal point, surface projection of: femoral nerve, saphenous opening, sciatic, tibial, common peroneal and deep peroneal nerve, great and small saphenous veins | Y | 6, 7 | 153, 181 |
AN23.7 | Mention the extent, relations and applied anatomy of lymphatic duct | Y | 8 | 201 |
AN28.10 | Explain the anatomical basis of Frey's syndrome | N | 14 | 280 |
AN29.2 | Explain anatomical basis of Erb's and Klumpke's palsy | Y | 9 | 220 |
AN30.1 | Describe the cranial fossae and identify related structures | Y | 12, 13, 30 | 266, 275, 524 |
AN30.2 | Describe and identify major foramina with structures passing through them | Y | 12, 13, 30 | 266, 275, 524 |
AN33.2 | Describe and demonstrate attachments, direction of fibers, nerve supply and actions of muscles of mastication | Y | 12, 13 | 266, 275 |
AN33.4 | Explain the clinical significance of pterygoid venous plexus | Y | 12, 13 | 266, 275 |
AN33.5 | Describe the features of dislocation of temporomandibular joint | N | 12, 13 | 266, 275 |
AN34.1 | Describe and demonstrate the morphology, relations and nerve supply of submandibular salivary gland and submandibular ganglion | Y | 14 | 280 |
AN34.2 | Describe the basis of formation of submandibular stones | N | 14 | 280 |
AN35.5 | Describe and demonstrate extent, drainage and applied anatomy of cervical lymph nodes | Y | 8, 15 | 201, 298 |
AN35.9 | Describe the clinical features of compression of subclavian artery and lower trunk of brachial plexus by cervical rib | N | 15 | 298 |
AN43.5 | Demonstrate; 1) Testing of muscles of facial expression, extraocular muscles, muscles of mastication, 2) Palpation of carotid arteries, facial artery, superficial temporal artery, 3) Location of internal and external jugular veins, 4) Location of hyoid bone, thyroid cartilage and cricoid cartilage with their vertebral levels | Y | 15 | 298 |
AN44.1 | Describe and demonstrate the planes (transpyloric, transtubercular, subcostal, lateral vertical, linea alba, linea semilunaris), regions and quadrants of abdomen | Y | 23 | 446 |
AN44.4 | Describe and demonstrate extent, boundaries, contents of inguinal canal including Hesselbach's triangle | Y | 18 | 366 |
AN44.5 | Explain the anatomical basis of inguinal hernia | Y | 18 | 366 |
AN44.6 | Describe and demonstrate attachments of muscles of anterior abdominal wall | Y | 23 | 446 |
AN46.4 | Explain the anatomical basis of varicocele | N | 19 | 387 |
AN46.5 | Explain the anatomical basis of phimosis and circumcision | N | 20 | 403 |
AN47.1 | Describe and identify boundaries and recesses of lesser and greater sac | Y | 21 | 411 |
AN47.2 | Name and identify various peritoneal folds and pouches with its explanation | Y | 21 | 411 |
AN47.3 | Explain anatomical basis of ascites and peritonitis | N | 22 | 432 |
AN47.4 | Explain anatomical basis of subphrenic abscess | N | 22 | 432 |
AN47.5 | Describe and demonstrate major viscera of abdomen under following headings (anatomical position, external and internal features, important peritoneal and other relations, blood supply, nerve supply, lymphatic drainage and applied aspects) | Y | 21, 23 | 411, 446 |
AN47.7 | Mention the clinical importance of Calot's triangle | N | 21 | 411 |
AN48.8 | Mention the structures palpable during vaginal and rectal examination | N | 24 | 472 |
AN52.6 | Describe the development and congenital anomalies of foregut, midgut and hindgut | Y | 21 | 411 |
AN52.7 | Describe the development of urinary system | Y | 26 | 493 |
AN55.1 | Demonstrate the surface marking of regions and planes of abdomen, superficial inguinal ring, deep inguinal ring, McBurney's point, renal angle and Murphy's point | Y | 23 | 446 |
AN55.2 | Demonstrate the surface projections of stomach, liver, fundus of gallbladder, spleen, duodenum, pancreas, ileocecal junction, Kidneys and root of mesentery | Y | 21, 23 | 411, 446 |
PA19.1 | Enumerate the causes and describe the differentiating features of lymphadenopathy | Y | 8, 15 | 201, 298 |
PA19.2 | Describe the pathogenesis and pathology of tuberculous lymphadenitis | Y | 8, 15 | 201, 298 |
PA19.4 | Describe and discuss the pathogenesis pathology and the differentiating features of Hodgkin's and non-Hodgkin's lymphoma | Y | 8 | 201 |
PA19.5 | Identify and describe the features of Hodgkin's lymphoma in a gross and microscopic specimen | Y | 8 | 201 |
PA19.6 | Enumerate and differentiate the causes of splenomegaly | Y | 21, 23 | 411, 446 |
PA24.4 | Describe and etiology and pathogenesis and pathologic features of carcinoma of the stomach | Y | 21, 23 | 411, 446 |
PA24.5 | Describe and etiology and pathogenesis and pathologic features of tuberculosis of the intestine | N | 21 | 411 |
PA24.6 | Describe and etiology and pathogenesis and pathologic and distinguishing features of inflammatory bowel disease | Y | 21 | 411 |
PA24.7 | Describe the etiology and pathogenesis and pathologic and distinguishing features of carcinoma of the colon | Y | 21, 23 | 411, 446 |
PA25.2 | Describe the pathophysiology and pathologic changes seen in hepatic failure and their clinical manifestations, complications and consequences | Y | 21 | 411 |
PA25.4 | Describe the pathophysiology, pathology and progression of alcoholic liver disease including cirrhosis | Y | 21, 23 | 411, 446 |
PA25.5 | Describe the etiology, pathogenesis and complications of portal hypertension | Y | 21 | 411 |
PA29.2 | Describe the pathogenesis, pathology, presenting and distinguishing features, diagnostic tests, progression and spread of carcinoma of the penis | Y | 20 | 403 |
PA29.3 | Describe the pathogenesis, pathology, hormonal dependency, presenting and distinguishing features, urologic findings and diagnostic tests of benign prostatic hyperplasia | Y | 26 | 493 |
PA29.4 | Describe the pathogenesis, pathology, hormonal dependency, presenting and distinguishing features, diagnostic tests, progression and spread of carcinoma of the prostate | Y | 26 | 493 |
PA29.5 | Describe the etiology, pathogenesis, pathology and progression of prostatitis | N | 26 | 493 |
PA32.6 | Describe the etiology, pathogenesis, manifestations, laboratory, morphologic features, complications and metastases of pancreatic cancer | N | 23 | 446 |
MI7.1 | Describe the etio-pathogenesis and discuss the laboratory diagnosis of infections of genitourinary system | Y | 26 | 493 |
AS3.1 | Describe the principles of preoperative evaluation | Y | 2 | 43 |
AS3.2 | Elicit, present and document an appropriate history including medication history in a patient undergoing surgery as it pertains to a preoperative anesthetic evaluation | Y | 2 | 43 |
AS3.3 | Demonstrate and document an appropriate clinical examination in a patient undergoing General Surgery | Y | 1 | 1 |
AS3.4 | Choose and interpret appropriate testing for patients undergoing surgery | Y | 1, 2 | 1, 43 |
AS3.5 | Determine the readiness for General Surgery in a patient based on the preoperative evaluation | Y | 2 | 43 |
IM5.8 | Describe and discuss the pathophysiology, clinical evolution and complications of cholelithiasis and cholecystitis | Y | 22, 23 | 432, 446 |
IM12.9 | Order and interpret diagnostic testing based on the clinical diagnosis including CBC, thyroid function tests and ECG and radio iodine uptake and scan | Y | 2 | 43 |
IM13.7 | Elicit document and present a history that will help establish the etiology of cancer and includes the appropriate risk factors, duration and evolution | Y | 1 | 1 |
IM15.5 | Perform, demonstrate and document a physical examination based on the history that includes general examination, volume assessment and appropriate abdominal examination | Y | 22 | 432 |
PE21.14 | Recognize common surgical conditions of the abdomen and genitourinary system and enumerate the indications for referral including acute and subacute intestinal obstruction, appendicitis pancreatitis perforation intussusception, phimosis, undescended testis, chordee, hypospadiasis, torsion testis, hernia hydrocele, vulval synechiae | Y | 20 | 403 |
OR4.1 | Describe and discuss the clinical features, investigation and principles of management of tuberculosis affecting major joints (Hip, Knee) including cold abscess and caries spine | Y | 40 | 598 |