Clinical Cases/Operations seen during the postings

PY3.2- First posting – Ward cases seen- (Minimum 8 cases):

S.No. Hosp. No Age Gender Diagnosis Learning points

Signature
Head of the Unit
 PY3.2- 1st posting – OT cases seen- (Minimum 8 cases):

S.No. Hosp. No Age Gender Diagnosis Operation

Signature
Head of the Unit
 PY3.2- Second posting – Ward cases seen- (Minimum 8 cases):

S.No. Hosp. No Age Gender Diagnosis Learning points

Signature
Head of the Unit
 PY3.2- Second posting – OT cases seen- (Minimum 8 cases):

S.No. Hosp. No Age Gender Diagnosis Operation

Signature
Head of the Unit
Clinical Case Records
Cases to be clerked during the Surgery Ward Postings with detailed case
sheets

Sl Diagnosis Main Grade Page No

No Competency
1 Diabetic Foot Ulcer SU5.2
2 PAOD SU27.2 ___
3 Varicose Veins SU27.2 ___
4 Hernia SU28.2 ___
5 Thyroid SU22.3
6 Breast Carcinoma SU25.3
7 Obstructive Jaundice SU28.9
8 Mass per Abdomen SU28.18
9 Lymph Node / Neck SU27.8
Swellings
10 Miscellaneous Swellings SU18.3

Signature of the HOD

10
Case 1- Diabetic Foot Ulcer 1(a)
Learning Objectives-

SU5.2 Elicit, document 5.2.1.In a clinical setting the student is asked to take a proper
and present a history and conduct examination of wound.
history in a
patient with
wounds 5.2.2.The student must know to differentiate clinically between
healing, non healing and spreading ulcers and must design
management plan for the same.

5.2.3.The student must be able to document the findings in the

manner prescribed according to standardised clinical manual of
surgery.

SU9.3 Communicate the SU9.3.1.At the end of session student should be able to interpret routine blood
results of surgical investigations done for surgical patients
investigations
and counsel the
patient
appropriately SU9.3.4. At the end of session student should be able to counsel the patient
results of the above mentioned investigations

Name of the Patient:

Age: Sex: Date:

Hospital No.: Discussed by:

Occupation:
Residence:

Chief complaints & Duration:

 1(b)
H/O Present illness:
 1(c)
Past History:

Personal History (including drug & allergy):

Family History:

Social and Occupational History:

General Examination:
 1(d)
Local/Systemic Examination (Draw line diagrams wherever required):
 1(e)
Local/Systemic Examination (Draw line diagrams wherever required) cont…:
 1(f)
Other systems:

Provisional diagnosis:

Investigations done and reports:

 1(g)
Write your understanding of the role of foot x-ray and wound swab in the management of foot ulcers.
Include a note on the steps to take a wound swab, and a descriptive interpretation of the report of this
patient.

Treatment Offered:

Course in the hospital:

 1(h)
Discussion (Minimum 1.5 pages of non-theory clinical learning points to be explained by the student):
 1(i)

Faculty feedback to student about this case (With grading):

*Grading: Below (B) expectations

Meets (M) expectations
Exceeds (E)expectations Signature
Clinical Instructor
Case 2- PAOD 2(a)

Learning Objectives- SU27.2, SU9.3

SU27.2 Demonstrate SU27.2.1 Thorough clinical examination of a case of

the correct PAOD
examination
of vascular SU27.2.2 Know how to proceed and investigate
system appropriately
SU9.3 Describe the SU9.3.3. At the end of session student should be able to
investigation interpret venous and arterial doppler
of Vascular
disease
Communicate
and counsel 4.4.1. At the end of the session the student must be able to
patients and demonstrate how to communicate and counsel patients and
families on family about the outcome and rehabilitation
SU4.4 the outcome
and
rehabilitation
demonstrating
empathy and
care.

Name of the Patient:

Age: Sex: Date:

Hospital No.: Discussed by:

Occupation:
Residence:

Chief complaints & Duration:

 2(b)
H/O Present illness:
 2(c)
Past History:

Personal History (including drug & allergy):

Family History:

Social and Occupational History:

General Examination:
 2(d)
Local/Systemic Examination (Draw line diagrams wherever required):
 2(e)
Local/Systemic Examination (Draw line diagrams wherever required) cont…:
 2(f)
Other systems:

Provisional diagnosis:

Course in the hospital:

Investigations done and reports (Explain the significance)- Minimum ½ page:

 2(g)
Treatment Offered:

Explain how you would demonstrate empathy towards this patient if they were to undergo lower limb
amputation followed by rehabilitation for the PVD (Minimum 3/4th page)
 2(h)
Discussion (Minimum 1.5 pages of non-theory clinical learning points to be explained by the student):
 2(i)

Faculty feedback to student about this case (With grading):

*Grading: Below (B) expectations

Meets (M) expectations
Exceeds (E)expectations Signature
Clinical Instructor
Case 3- Varicose Veins 3(a)

Learning Objectives- SU27.2, SU9.3

SU27.2 Demonstrate SU27.2.1 Thorough clinical examination of a case of

the correct Varicose Veins
examination
of vascular SU27.2.2 Know how to proceed and investigate
system appropriately
SU9.3 Describe the SU9.3.3. At the end of session student should be able to
investigation interpret venous doppler
of Vascular
disease

Name of the Patient:

Age: Sex: Date:

Hospital No.: Discussed by:

Occupation:
Residence:

Chief complaints & Duration:

H/O Present illness:

3(b)
 3(c)
Past History:

Personal History (including drug & allergy):

Family History:

Social and Occupational History:

General Examination:
 3(d)
Local/Systemic Examination (Draw line diagrams wherever required):
 3(e)
Local/Systemic Examination (Draw line diagrams wherever required) cont…:
 3(f)
Other systems:

Provisional diagnosis:

Investigations done and reports (Explain the significance):

 3(g)
Treatment Offered:

Course in the hospital:

Explain the role of doppler studies in vascular disease (arterial & venous diseases separately) and the
interpretation of the reports towards the management of these patients.
 3(h)

Discussion (Minimum 1.5 pages of non-theory clinical learning points to be explained by the student):
 3(i)

Faculty feedback to student about this case (With grading):

*Grading: Below (B) expectations

Meets (M) expectations
Exceeds (E)expectations Signature
Clinical Instructor
 Case 4- Hernia 4(a)
Learning Objectives- SU28.2

28.2.1 Identify the common hernial orifices of

anterior abdominal wall in relation to bony prominence
and surface markings.
28.2.2 Demonstrate Carnet test and SLR test to
determine the plain of swelling in anterior abdominal wall
swellings.
Demonstrate the correct 28.2.3 Demonstrate reducibility in anterior abdominal
technique to examine the wall hernias.
SU28.2 patients with hernia & 28.2.4 To follow correct steps in performing a cough
identify different types of impulse test.
hernia.
28.2.5 Correctly perform Get above the swelling test
to differentiate a purely scrotal and inguinoscrotal
swelling.
28.2.6 Demonstrate the maneuver of Deep ring
occlusion test and differentiate a direct and indirect hernia

Demonstrate At the end of session student should be able to

professionalism and
empathy to the patient SU8.2.1 define informed consent and elaborate the
SU 8.2 undergoing surgery information that needs to be disclosed in informed
consent

SU8.2.2 Discuss the moral and legal boundaries and

practical difficulties of informed consent

Name of the Patient:

Age: Sex: Date:

Hospital No.: Discussed by:

Occupation:
Residence:

Chief complaints & Duration:

 4(b)
H/O Present illness:
 4(c)
Past History:

Personal History (including drug & allergy):

Family History:

Social and Occupational History:

General Examination:
 4(d)
Local/Systemic Examination (Draw line diagrams wherever required):
 4(e)
Local/Systemic Examination (Draw line diagrams wherever required) cont…:

4(f)
Other systems:

Provisional diagnosis:

Investigations done and reports:

 4(g)
Treatment Offered:

Course in the hospital:

Discuss the process of consenting this patient, including the pros and cons of various options
available.(Min ½ page)
 4(h)
Discussion (Minimum 1.5 pages of non-theory clinical learning points to be explained by the student):
 4(i)

Faculty feedback to student about this case (With grading):

*Grading: Below (B) expectations

Meets (M) expectations
Exceeds (E)expectations Signature
Clinical Instructor
Case 5- Thyroid- SU22.3 5(a)

Learning Objectives
Demonstrate SU22.3.1 - Describe the thyroid swelling with respect to inspection, palpation,
and percussion and auscultation
document the SU22.3.2 - Discuss and demonstrate the clinical examination of thyroid gland
correct
clinical
examination SU22.3.3 - Describe the eye signs of Thyrotoxicosis and demonstrate them
of thyroid
SU22.3 swellings and SU22.3.4 - Discuss clinical features and differential diagnosis of midline neck
discuss the swelling
differential SU22.3.5 - Describe the signs and symptoms of Thyrotoxicosis and differentiate
diagnosis and between primary and secondary
their SU22.3.6 - Select appropriate investigations for thyroid swelling
management
SU22.3.7 - Discuss various treatment modalities of benign thyroid conditions

Describe the SU10.2.1. Describe the importance of autonomy in good surgical practice
steps and
SU10.2.2. Discuss The moral and legal boundaries and practical difficulties
SU 10.2 obtain
of informed consent
informed
SU10.2.3.Describe the process of comprehensive consent
consent in a
simulated SU10.2.4 Demonstrate the process of informed consent
environment SU10.2.5.Document an informed consent

Name of the Patient:

Age: Sex: Date:

Hospital No.: Discussed by:

Occupation:
Residence:

Chief complaints & Duration:

18
 5(b)
H/O Present illness:
 5(c)
Past History:

Personal History (including drug & allergy):

Family History:

Social and Occupational History:

General Examination:
 5(d)

Local/Systemic Examination (Draw line diagrams wherever required):

 5(e)
Local/Systemic Examination (Draw line diagrams wherever required) cont…:
 5(f)
Other systems:

Provisional diagnosis:

Investigations done and reports (Explain the significance):

 5(g)
Treatment Offered:

Course in the hospital:

Discuss the process of consent taking for total thyroidectomy in this patient. Give special emphasis to
the possible surgical complications and how you will convey the chances of these to the patient and
their attenders. (Minimum 1 page)
 5(h)

Discussion (Minimum 1.5 pages of non-theory clinical learning points to be explained by the student):
 5(i)

Faculty feedback to student about this case (With grading):

*Grading: Below (B) expectations

Meets (M) expectations Signature
Exceeds (E)expectations Clinical Instructor
Case 6- Breast Carcinoma- SU25.3, SU25.4 6(a)

SU25.3 Describe the etiopathogenesis, Know the aetiology, pathology, clinical features, investigations
clinical features, Investigations and treatment of carcinoma breast.
and principles of treatment of
benign and malignant tumours Know the differential diagnosis of carcinoma breast
of breast.
SU25.4 Counsel the patient and obtain SU25.4.1 Able to counsel the patient empathetically that she is
informed consent for treatment suffering from malignancy of the breast
of malignant conditions of the SU25.4.2 Able to counsel the patient for MRM
breast

SU25.4.3 Able to counsel the patient for BCS

SU25.4.4 Able to counsel the patient need of neodjuvant /

adjuvant chemo- radiotherapy / hormonal therapy

SU25.4.5 precautions and effects of each modality

Name of the Patient:

Age: Sex: Date:

Hospital No.: Discussed by:

Occupation:
Residence:

Chief complaints & Duration:

H/O Present illness:

6(b)
 6(c)
Past History:

Personal History (including drug & allergy):

Family History:

Social and Occupational History:

General Examination:
 6(d)
Local/Systemic Examination (Draw line diagrams wherever required):
 6(e)
Local/Systemic Examination (Draw line diagrams wherever required) cont…:
 6(f)
Other systems:

Provisional diagnosis:

Investigations done and reports (Explain the significance):

 6(g)

Treatment Offered (All modalities):

Course in the hospital:

 6(h)
Explain the nuances in counselling this lady for the planned treatment modalities. (1 full page)
 6(i)
Discussion (Minimum 1.5 pages of non-theory clinical learning points to be explained by the student):
Faculty feedback to student about this case (With grading):

*Grading: Below (B) expectations

Meets (M) expectations Signature
Exceeds (E)expectations Clinical Instructor
Case 7- Obstructive Jaundice 7(a)

SU28.9 Describe and SU28.18.1 At the end of session student should be able to identify and
demonstrate clinical demonstrate clinical findings during examination of abdomen.
examination of SU28.18.2 At the end of session student should be able to describe the
abdomen. Order relevant investigations to be done in a case of abdominal pathology
relevant investigations.
Describe and discuss SU28.18.3 At the end of session student should be able to describe the
appropriate treatment principles of management of abdominal pathology
plan
SU9.3 Communicate the SU9.3.2.At the end of session student should be able to interpret x-ray
results of surgical abdomen ,chest and barium studies
investigations and SU9.3.4. At the end of session student should be able to counsel the
counsel the patient patient results of the above mentioned investigations
appropriately

Communicate and 2.3.1.In our hospital we follow SPIKES protocol (SETTING -

counsel patients and PERCEPTION - INVITATION - KNOWLEDGE - EMPATHY -
families about the SUMMARY) in delivering sensitive news to patient and patient's
treatment and family.
prognosis of shock
SU2.3 demonstrating
empathy and care

Name of the Patient:

Age: Sex: Date:

Hospital No.: Discussed by:

Occupation:
Residence:

Chief complaints & Duration:

H/O Present illness:
7(b)
 7(c)
Past History:

Personal History (including drug & allergy):

Family History:

Social and Occupational History:

General Examination:
 7(d)
Local/Systemic Examination (Draw line diagrams wherever required):
 7(e)
Local/Systemic Examination (Draw line diagrams wherever required) cont…:

7(f)
Other systems:

Provisional diagnosis:

Investigations done and reports (Explain the significance):

 7(g)
Treatment Offered (All modalities):

Course in the hospital:

Post-operatively after a major abdominal surgery, the patient developed ventilator associated
pneumonia leading to sepsis with MODS. The patient has had a prolonged ICU stay and the prognosis
is poor. It is time to discuss the benefits and issues of continuing care. How will you go about it? (1 full
page)
 7(h)

Discussion (Minimum 1.5 pages of non-theory clinical learning points to be explained by the student):
 7(i)

Faculty feedback to student about this case (With grading):

*Grading: Below (B) expectations

Meets (M) expectations Signature
Exceeds (E)expectations Clinical Instructor
Case 8- Mass per Abdomen 8(a)

SU28.9 Demonstrate the correct SU28.9.1 At the end of session student should be able to identify and
technique of demonstrate clinical findings in a patient suspected to have disorder of
examination of a patient stomach and GOO
with disorders of the SU28.9.2 At the end of session student should be able to describe the
stomach. relevant investigations to be done in a patient suspected to have disorder
of stomach and GOO
SU28.18 Describe and SU28.18.4 At the end of session student should be able to identify and
demonstrate clinical demonstrate clinical findings in an enlarged stomach, liver, spleen,
examination of pancreas, renal and colonic mass
abdomen. Order SU28.18.5 At the end of session student should be able to enumerate
relevant investigations. causes for enlarged stomach, liver, pancreas, renal and colonic mass
Describe and discuss
SU28.18.6 At the end of session student should be able to discuss
appropriate treatment
appropriate treatment plan for stomach, liver, gall bladder, spleen ,
plan
pancreas, renal and colonic mass.

Name of the Patient:

Age: Sex: Date:

Hospital No.: Discussed by:

Occupation:
Residence:

Chief complaints & Duration:

H/O Present illness:
8(b)
 8(c)
Past History:

Personal History (including drug & allergy):

Family History:

Social and Occupational History:

General Examination:
 8(d)
Local/Systemic Examination (Draw line diagrams wherever required):
 8(e)
Local/Systemic Examination (Draw line diagrams wherever required) cont…:
 8(f)
Other systems:

Provisional diagnosis:

Investigations done and reports (Explain the significance):

 8(g)
Treatment Offered (All modalities):

Course in the hospital:

Explain the process of TNM staging of a colonic mass through various laboratory, imaging and
procedural modalities. (min 1 page)
 8(h)

Discussion (Minimum 1.5 pages of non-theory clinical learning points to be explained by the student):
 8(i)

Faculty feedback to student about this case (With grading):

*Grading: Below (B) expectations

Meets (M) expectations Signature
Exceeds (E)expectations Clinical Instructor
Case 9- Lymph Node/ Neck swellings- SU18.3/ SU27.8 9(a)

SU27.8 Demonstrate the correct examination

of the lymphatic system

SU9.3 Communicate the results of surgical SU9.3.2.At the end of session

investigations and counsel the student should be able to
patient appropriately interpret x-ray abdomen ,chest
and barium studies and
ultrasound

Name of the Patient:

Age: Sex: Date:

Hospital No.: Discussed by:

Occupation:
Residence:

Chief complaints & Duration:

H/O Present illness:
9(b)

Past History:
 9(c)
Personal History (including drug & allergy):

Family History:

Social and Occupational History:

General Examination:
 9(d)
Local/Systemic Examination (Draw line diagrams wherever required):
 9(e)
Other systems:

Provisional diagnosis:

Investigations done and reports (Explain the significance):

 9(f)
Treatment Offered (All modalities):

Course in the hospital:

Explain the role of FNAC and its image guided modalities in improving the efficacy of pre-operative
diagnosis of neck swellings. (min 1 page)
 9(g)

Discussion (Minimum 1.5 pages of non-theory clinical learning points to be explained by the student):
 9(h)

Faculty feedback to student about this case (With grading):

*Grading: Below (B) expectations

Meets (M) expectations Signature
Exceeds (E)expectations Clinical Instructor
Case 10- Miscellaneous Swellings- SU18.3 10(a)

SU18.3 Describe and SU18.3.1 – Elicit and discuss relevant history of swelling.
demonstrate the
clinical examination SU18.3.2 – Demonstrate inspectory findings in case of
of surgical patient swelling
including swelling SU18.3.3 – Demonstrates palpatory findings in case of
and order relevant swelling
investigation for
diagnosis. Describe SU18.3.4 – Discuss and differentiate various kinds of
and discuss swelling including lipoma, sebaceous cyst, dermoid cyst,
appropriate neurofibroma.
treatment plan SU18.3.5 – Enumerates the various investigations and
treatment modalities.

SU9.3 Communicate the SU9.3.1.At the end of session student should be able to
results of surgical interpret routine blood investigations done for surgical
investigations and patients
counsel the patient
appropriately

Name of the Patient:

Age: Sex: Date:

Hospital No.: Discussed by:

Occupation:
Residence:

Chief complaints & Duration:

H/O Present illness:
10(b)

Past History:
 10(c)
Personal History (including drug & allergy):

Family History:

Social and Occupational History:

General Examination:
 10(d)
Local/Systemic Examination (Draw line diagrams wherever required):
 10(e)
Other systems:

Provisional diagnosis:

Investigations done and reports (Explain the significance):

 10(f)
Treatment Offered (All modalities):

Course in the hospital:

Explain the different routine pre-operative blood investigations done before surgery. (min 1
page)
 10(g)

Discussion (Minimum 1.5 pages of non-theory clinical learning points to be explained by the
student):
 10(h)

Faculty feedback to student about this case (With grading):

*Grading: Below (B) expectations

Meets (M) expectations
Exceeds (E)expectations Signature
Clinical Instructor