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Now I have excellent material. Let me compile the complete guide:
📋 MBBS Table Viva - Drugs & Instruments (Complete Guide with Photos)
🔬 HOW TO ANSWER ANY INSTRUMENT IN TABLE VIVA
For every instrument, answer in this order:
- Identification - Name and type
- Handling - Which hand, how held
- Sterilization - Autoclave / Chemical
- Uses - Specific surgical uses
PART 1: SURGICAL INSTRUMENTS
🩺 HOLDING / GRASPING INSTRUMENTS
1. Sponge Holder (Rampley's Forceps)
| Feature | Details |
|---|---|
| Type | Ring-handled forceps with ring tip |
| Sterilization | Autoclave (134°C, 3 min) |
| Uses | Antiseptic skin painting, holding fundus of gallbladder (open cholecystectomy), holding cervix during cervical tear repair (OB-GYN), holding swabs/gauze |
2. Towel Clamp (Backhaus / Mayo's)
| Feature | Details |
|---|---|
| Type | Sharp-pointed, ring-handled clamp |
| Backhaus | Cross-tip, sharp points |
| Uses | Clamping towels during surgical draping, aligning fractured bone pieces during surgery |
3. Allis Tissue Forceps
| Feature | Details |
|---|---|
| Type | Multiple interlocking teeth at tip |
| Sterilization | Autoclave |
| Uses | Holding hard/firm tissues - skin edges, fascia, fibrous tissue. NOT for delicate organs |
4. Babcock's Forceps
| Feature | Details |
|---|---|
| Type | Atraumatic - fenestrated oval tip, NO teeth |
| Sterilization | Autoclave |
| Uses | Holding delicate tubular structures - appendix, ureter, fallopian tube, lymphatics, bowel. Less traumatic than Allis |
5. Kocher's (Ochsner) Forceps
| Feature | Details |
|---|---|
| Type | Heavy ratcheted forceps with transverse serrations + 1 tooth at tip |
| Sterilization | Autoclave |
| Uses | Holding tough structures - tendons, aponeurosis, fascia. Crushing appendix base before removal. Heavy tissue ligation |
6. Moynihan's (Curved Artery) Forceps
| Feature | Details |
|---|---|
| Type | Curved, ratcheted hemostatic forceps |
| Sterilization | Autoclave |
| Uses | Holding gallbladder fundus, vascular pedicles, clamping mesenteric vessels |
7. Lahey's Right Angle Forceps
| Feature | Details |
|---|---|
| Type | Right-angle tip, ratcheted |
| Sterilization | Autoclave |
| Uses | Dissecting Calot's triangle (cholecystectomy), passing ligatures under deep structures, around mesenteric vessels |
✂️ CUTTING INSTRUMENTS
8. BP Handle (Bard-Parker Handle)
| Feature | Details |
|---|---|
| Size 3 | For blades No. 10, 11, 12, 15 (small blades) |
| Size 4 | For blades No. 20, 21, 22, 23 (large blades) |
| Size 7 | Long, round handle - for inner organs/deep surgery |
| Uses | Holding surgical blade for incision, measuring specimen dimensions (tumors) |
Blade uses:
- No. 10 - general skin incisions
- No. 11 - stab incisions, abscess drainage
- No. 15 - fine curved cuts, plastic surgery
- No. 22 - large incisions (abdomen)
9. Surgical Scissors (Mayo vs. Metzenbaum)
| Feature | Mayo Scissors | Metzenbaum (Metz) |
|---|---|---|
| Build | Heavy/stout | Fine/delicate |
| Blade | Short, thick | Long, thin |
| Uses | Cutting tough fascia, sutures, dressings | Dissecting delicate tissues, planes, peritoneum |
10. Suture Cutting Scissors
| Feature | Details |
|---|---|
| Type | Short-bladed, angled |
| Uses | Cutting suture material after suturing (NOT dissection) |
🔒 HEMOSTATIC INSTRUMENTS
11. Hemostatic Artery Forceps (Spencer-Wells / Kelly's / Mosquito)
| Type | Size | Uses |
|---|---|---|
| Spencer-Wells | Medium | General hemostasis in abdomen |
| Kelly's | Medium | Urological procedures |
| Mosquito | Small | Fine vessels, pediatric surgery |
General uses: Hemorrhage control, holding ligature pedicles, clamping blood vessels before ligation
12. Desjardins Choledocholithotomy Forceps
| Feature | Details |
|---|---|
| Type | Long, angled, NO ratchet (by design) |
| Why no ratchet? | To prevent crushing of stones or bile duct |
| Uses | Removing stones from common bile duct (CBD), urinary bladder stones |
🪝 RETRACTORS
13. Langenbeck Retractor
| Feature | Details |
|---|---|
| Type | L-shaped, hand-held |
| Uses | Superficial wound retraction, thyroid surgery, general surface exposure |
14. Deaver's Retractor
| Feature | Details |
|---|---|
| Type | Large, curved, flat blade |
| Uses | Deep abdominal retraction (liver, spleen exposure), laparotomy |
15. Morris Retractor
| Feature | Details |
|---|---|
| Type | Double-ended flat retractor |
| Uses | Retracting wound edges in laparotomy |
🪡 SUTURING INSTRUMENTS
16. Needle Holder (Mayo-Hegar)
| Feature | Details |
|---|---|
| Type | Ratcheted, with cross-hatched jaws (no teeth = less trauma to needle) |
| Hold | Needle held at junction of middle 1/3 and distal 1/3 |
| Uses | Holding suture needle during suturing, knot-tying |
DISSECTION
17. Dissecting Forceps (Thumb Forceps)
| Type | Feature | Uses |
|---|---|---|
| Toothed | 1×2 teeth at tip | Skin, fascia, tough tissue |
| Non-toothed | Plain serrated | Delicate tissue, intestine, blood vessels |
Held in the NON-dominant (left) hand always.
PART 2: PHARMACOLOGY DRUG SPOTTERS (Table Viva)
🌿 SECTION A: DRUG SOURCES (Plant Origin)
Spotter 1: CINCHONA BARK
| Question | Answer |
|---|---|
| Drug source | Cinchona officinalis (bark) |
| Drugs obtained | Quinine, Quinidine |
| Uses | Malaria (Quinine), cardiac arrhythmias (Quinidine) |
Spotter 2: OPIUM POPPY (Papaver somniferum)
| Question | Answer |
|---|---|
| Drug source | Papaver somniferum (dried latex) |
| Active principles | Morphine, Codeine, Thebaine |
| Uses | Analgesic (morphine), antitussive (codeine), pre-anesthetic, antidiarrheal |
Spotter 3: FOXGLOVE (Digitalis purpurea)
| Question | Answer |
|---|---|
| Drug source | Digitalis purpurea / Digitalis lanata (leaves) |
| Drugs obtained | Digoxin, Digitoxin (cardiac glycosides) |
| Uses | Congestive heart failure, atrial fibrillation/flutter |
Spotter 4: VINCA / Madagascar Periwinkle
| Question | Answer |
|---|---|
| Drug source | Vinca rosea / Catharanthus roseus |
| Drugs obtained | Vincristine, Vinblastine |
| Uses | Anticancer - leukemia (vincristine), lymphoma (vinblastine) |
Spotter 5: CANNABIS / Hemp plant
| Question | Answer |
|---|---|
| Drug source | Cannabis sativa |
| Drugs obtained | THC (tetrahydrocannabinol), CBD (cannabidiol) |
| Uses | Antiemetic, neuropathic pain, appetite stimulation |
Spotter 6: RAUWOLFIA (Sarpagandha)
| Question | Answer |
|---|---|
| Drug source | Rauwolfia serpentina (root) |
| Drug obtained | Reserpine |
| Uses | Hypertension (historical), antipsychotic (depletes catecholamines) |
Spotter 7: ERGOT FUNGUS (Claviceps purpurea)
| Question | Answer |
|---|---|
| Drug source | Fungus on rye grain |
| Drugs obtained | Ergotamine, Ergometrine (Ergonovine) |
| Uses | Migraine (ergotamine), postpartum hemorrhage (ergometrine) |
Spotter 8: COCA PLANT (Erythroxylum coca)
| Question | Answer |
|---|---|
| Drug source | Erythroxylum coca (leaves) |
| Drug obtained | Cocaine |
| Uses | Local anesthetic (ENT surgeries), vasoconstriction |
Spotter 9: BELLADONNA / Deadly Nightshade
| Question | Answer |
|---|---|
| Drug source | Atropa belladonna (leaves, root) |
| Drugs obtained | Atropine, Hyoscine (Scopolamine) |
| Uses | Anticholinergic - pre-anesthesia, antispasmodic, mydriasis, organophosphate poisoning antidote |
🧪 SECTION B: DOSAGE FORMS (Drug Containers)
| Form | Description | Examples |
|---|---|---|
| Ampoule | Sealed glass, single dose, sterile | Morphine, Adrenaline injections |
| Vial | Rubber-stoppered, multiple doses | Insulin, Heparin |
| Tablet | Compressed powder, oral | Aspirin, Paracetamol |
| Capsule | Gelatin shell, oral | Omeprazole, Amoxicillin |
| Syrup | Aqueous sugar solution | Promethazine, ORS |
| Suspension | Undissolved particles in liquid - must shake | Antacid, Amoxicillin suspension |
| Aerosol/MDI | Pressurized inhaler | Salbutamol (asthma) |
| Suppository | Solid, melts at body temp, rectal/vaginal | Diclofenac, Glycerin |
| Transdermal patch | Drug delivered through skin | Fentanyl, Nitroglycerin |
| Ointment | Semisolid, oil base | Neomycin skin ointment |
⚠️ SECTION C: ADVERSE DRUG REACTIONS (ADRs) - Photo Spotters
| Condition (Spotter) | Drug Responsible |
|---|---|
| Fixed Drug Eruption (round, hyperpigmented patch) | Cotrimoxazole, NSAIDs, Tetracycline |
| Stevens-Johnson Syndrome (skin peeling, mucosa) | Carbamazepine, Allopurinol, Cotrimoxazole |
| Gynecomastia (male breast enlargement) | Spironolactone, Digoxin, Cimetidine |
| Gingival Hyperplasia (gum overgrowth) | Phenytoin, Cyclosporine, Nifedipine |
| Alopecia (hair loss) | Cyclophosphamide, Heparin, Carbimazole |
| Tardive Dyskinesia (involuntary movements) | Metoclopramide, Haloperidol, Chlorpromazine |
| Moon face / Buffalo hump (Cushingnoid) | Long-term Corticosteroids |
| Cushingoid features | Prednisolone, Dexamethasone |
🐀 SECTION D: EXPERIMENTAL ANIMALS & PHARMACOLOGY INSTRUMENTS
| Animal/Instrument | Used For |
|---|---|
| Rat / Mouse | Most drug testing, analgesic studies |
| Guinea pig | Anaphylaxis/allergy testing, bronchospasm |
| Rabbit | Pyrogen testing, ocular drug testing |
| Frog | Isolated heart preparation |
| Actophotometer | Measures locomotor activity (CNS depressants/stimulants) |
| Eddy's Hot Plate | Analgesic testing (thermal stimulus) |
| Organ Bath | Isolated tissue pharmacology (intestine, uterus) |
| Plethysmometer | Paw edema measurement for anti-inflammatory drugs |
| Rotarod apparatus | Muscle coordination testing (for sedative/hypnotics) |
🎯 QUICK VIVA TIPS
-
For instruments: Always state - Name → Type → Sterilization → Use. Sterilization for most surgical instruments = Autoclave (134°C, 18 psi, 3 min) or ETO (Ethylene Oxide) for heat-sensitive ones.
-
For drugs: Always state - Plant source → Genus species → Part used → Drug name → Therapeutic class → 2 uses.
-
Babcock vs Allis: Babcock = soft organs (gut, tube), Allis = firm tissue (skin, fascia). "Babcock = Bowel (delicate). Allis = Aponeurosis (tough)."
-
Ratchet purpose: Locks the instrument in closed position so it stays clamped without manual effort.
-
Why Desjardins has no ratchet: So you can feel the stone and avoid crushing the duct wall.
For a fantastic video guide on all these instruments:
And the full Pharmacology Spotters Slideshare has all the visual spotter slides used in actual MBBS practicals.
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