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    QUESTION NO 4 :

    List of options:

    Epigastric hernia
    Spigelian hernia
    Femoral hernia
    Pantaloons hernia
    Umbilical hernia
    Inguinal hernia
    Divarication of recti
    Incisional hernia
    Obturator hernia
    Hiatus hernia


    Please select the most likely diagnosis in the following patients

    You may choose each option once, more than once or not at all.


    A) A 72 year old man who attends the out-patients department with a long standing lump in the right groin which is easily reducible and superior to the pubic tubercle

                          


    B) A 45 year old lady is found to have a large lump in the epigastrium with a positive cough impulse. She does not have any significant past medical or surgical history.

                          


    C) A twenty nine year old soldier is referred with recurrent upper abdominal pains and on examination there is a small 2cm X 2 cm lump in the epigastrium. It is slightly tender and cough impulse is absent.

                          


    D) A 55-year old male patient referred by his GP with a large lump in the epigastrium with a positive cough impulse. He is known to have Hypertension, COPD and had an emergency repair of leaking abdominal aortic aneurysm six years ago.

                          


    E) A 37 year old lady presented to the emergency department with an irreducible left groin lump associated with severe pain. On examination the lump is pear shaped, below and lateral to the pubic tubercle.

                          

                          
Question By Mr. Dev Mittapalli MBBS, MRCS(Eng).     


 
 
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