#Kathmandu University
BIRAT MEDICAL COLLEGE
Budhiganga-02, Tankisinuwari, Morang
Level: Final MBBS (Batch: 2021)
Semester: 8th
Examination: End-Semester
Subject: Surgery & Allied Subject (Paper-II)
Time: 2 hrs. 30 mins.
Date: March 17, 2026
Marks: 50
#INSTRUCTION TO THE CANDIDATE
Answer each section in a separate answer book.
Write brief, relevant and legible answers.
Illustrate your answer with well labeled diagrams where required.
All questions are compulsory.
#SECTION ‘B’
#Short Answer Questions [30 marks]
#Surgery
Define empyema thoracis. Mention the stages of empyema thoracis. Write boundaries of triangle of safety. [1+3+2=6]
#Orthopedics
a. Describe the clinical features and treatment of chronic osteomyelitis. [3]
b. Enumerate four malignant tumors of bone. Describe clinical features and X-ray findings of osteosarcoma. [1+2=3]
#Anesthesiology
Outline adult basic life support (BLS) steps. Mention reversible causes of cardiac arrest (Hs and Ts). [3+3=6]
#Radiology
Mention the direct and indirect radiographic signs of lung atelectasis. [6]
#Dental
Define Panfacial fracture. A patient with maxillofacial trauma comes to Emergency Room (ER), what will you do in Primary Survey and Resuscitation according to Advanced Trauma Life Support (ATLS) course. [1+5=6]
#SECTION ‘C’
#Problem Based Questions / Modified Essay Questions [2Q × 10 = 20 marks]
#Problem I [General Surgery]
A 47-year-old male comes to BMCTH SOPD with complaints of ulcer around the right medial malleolus for last 6 months. On local examination of right lower limb there are multiple dilated, tortuous veins in medial aspect leg above the ankle up to the upper thigh.
a. What is your probable diagnosis? [1]
b. How will you investigate this case? [4]
c. How will you manage this case? [3]
d. Name the complication of this disease. [2]
#Problem II [Orthopedics]
A 70 years old female presented to emergency department after she slipped and fell in her bathroom, following which she had pain in her right hip joint region and difficulty in walking.
a. What are the two possible diagnoses? [1]
b. What are the differences in clinical features between these two conditions. [2]
On examination, her affected lower limb was abducted and slightly externally rotated and tenderness was present in Scarpa’s triangle.
c. What is the most probable diagnosis? [1]
d. How will you classify this fracture? [2]
e. How will you manage this case? [2]
f. What are possible complications of this fracture? [2]