INI CET Surgery Syllabus

Surgery syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Surgery in INI CET, not a summary of it.

1. 1

   General Surgery

   3 topics

   • Principles of surgery
     • Aseptic technique
     • Surgical instruments
     • Wound healing
     • Surgical complications
   • Preoperative evaluation
     • Patient assessment
     • Informed consent
     • Preoperative optimization
     • Risk stratification
   • Postoperative care
     • Monitoring
     • Pain management
     • Wound care
     • Prevention of surgical site infections
2. 2

   Gastrointestinal Surgery

   4 topics

   • Abdominal wall hernias
     • Inguinal hernia
     • Femoral hernia
     • Umbilical hernia
     • Incisional hernia
   • Esophageal disorders
     • Gastroesophageal reflux disease (GERD)
     • Esophageal cancer
     • Achalasia
     • Esophageal diverticula
   • Gastric and duodenal disorders
     • Peptic ulcer disease
     • Gastric cancer
     • Duodenal diverticula
   • Colorectal disorders
     • Colorectal cancer
     • Diverticular disease
     • Inflammatory bowel disease (Crohn's disease, ulcerative colitis)
     • Anorectal disorders (hemorrhoids, anal fissures)
3. 3

   Hepatobiliary Surgery

   3 topics

   • Gallbladder diseases
     • Cholelithiasis
     • Cholecystitis
     • Gallbladder polyps
     • Gallbladder cancer
   • Liver diseases
     • Hepatocellular carcinoma
     • Liver abscess
     • Hepatic cysts
     • Liver transplantation
   • Pancreatic diseases
     • Pancreatitis
     • Pancreatic cancer
     • Pancreatic pseudocysts
     • Pancreatic neuroendocrine tumors
4. 4

   Endocrine Surgery

   3 topics

   • Thyroid disorders
     • Thyroid nodules
     • Thyroid cancer
     • Graves' disease
     • Thyroidectomy
   • Parathyroid disorders
     • Primary hyperparathyroidism
     • Parathyroid adenoma
     • Parathyroidectomy
   • Adrenal disorders
     • Adrenal incidentaloma
     • Adrenal adenoma
     • Adrenal carcinoma
     • Adrenalectomy
5. 5

   Breast Surgery

   2 topics

   • Benign breast disorders
     • Fibroadenoma
     • Fibrocystic changes
     • Breast cysts
     • Breast pain
   • Breast cancer
     • Diagnosis
     • Staging
     • Lumpectomy
     • Mastectomy
     • Breast reconstruction
6. 6

   Vascular Surgery

   3 topics

   • Arterial diseases
     • Atherosclerosis
     • Peripheral arterial disease (PAD)
     • Abdominal aortic aneurysm (AAA)
     • Carotid artery disease
   • Venous diseases
     • Varicose veins
     • Deep vein thrombosis (DVT)
     • Venous insufficiency
     • Venous ulcers
   • Vascular access
     • Central venous catheterization
     • Arteriovenous fistula (AVF)
     • Arteriovenous graft (AVG) creation for hemodialysis
7. 7

   Trauma Surgery

   3 topics

   • Evaluation and management of trauma patients
     • Primary survey (ABCDE approach)
     • Secondary survey
     • Management of life-threatening injuries
   • Traumatic brain injury
     • Head injury classification (Glasgow Coma Scale, Traumatic Brain Injury Severity Score)
     • Intracranial hemorrhage
     • Surgical interventions (craniotomy, craniectomy)
   • Abdominal trauma
     • Blunt abdominal trauma
     • Penetrating abdominal trauma
     • Solid organ injuries (liver, spleen)
     • Hollow viscus injuries (bowel perforation)
8. 8

   Orthopedic Surgery

   3 topics

   • Fractures and Dislocations
     • Principles of fracture management (reduction, fixation)
     • Closed fractures
     • Open fractures
     • Common fractures
   • Joint Replacement Surgery
     • Total hip replacement (THR)
     • Total knee replacement (TKR)
     • Shoulder arthroplasty
   • Spine Surgery
     • Degenerative spine disorders
     • Spinal fusion
     • Laminectomy
9. 9

   Renal and ureteric disorders

   4 topics

   • Renal stones
   • Renal cell carcinoma
   • Ureteropelvic junction (UPJ) obstruction
   • Ureteral strictures
10. 10

    Pediatric Surgery

    2 topics

    • Neonatal surgery
      • Congenital anomalies (gastroschisis, omphalocele)
      • Congenital diaphragmatic hernia (CDH)
      • Esophageal atresia
    • Pediatric abdominal surgery
      • Appendicitis
      • Intussusception
      • Hirschsprung's disease
      • Pediatric tumors (Wilms tumor, neuroblastoma)

Surgery flashcards for INI CET

18 of 69 cards from the Surgery deck — real questions with worked answers.

1. What are the three phases of wound healing, in order?

   1) Inflammatory (hemostasis + inflammation, ~day 0-4); 2) Proliferative (fibroplasia, angiogenesis, epithelialization, ~day 4-21); 3) Maturation/remodeling (collagen type III replaced by type I, ~3 weeks to 1 year).

2. What is the difference between primary, secondary, and tertiary (delayed primary) wound healing?

   Primary: clean wound edges approximated immediately (sutures). Secondary: wound left open to heal by granulation, contraction, and epithelialization. Tertiary: wound initially left open (e.g., contaminated), then closed surgically after a few days once infection risk falls.

3. In the ASA physical status classification, what does ASA III denote?

   A patient with severe systemic disease that limits activity but is not incapacitating (e.g., poorly controlled diabetes/hypertension, stable angina, COPD).

4. According to surgical wound classification, give an example of each: clean, clean-contaminated, contaminated, dirty.

   Clean: elective hernia repair (no viscus entered). Clean-contaminated: elective cholecystectomy (controlled entry of GI/respiratory/GU tract). Contaminated: fresh traumatic wound, gross spillage from gut. Dirty: perforated viscus with established infection/pus, old traumatic wound with devitalized tissue.

5. What metabolic acid-base disturbance classically results from prolonged vomiting/NG suction (e.g., gastric outlet obstruction)?

   Hypokalemic, hypochloremic metabolic alkalosis with paradoxical aciduria.

6. When should prophylactic antibiotics be administered relative to surgical incision, and how long are they typically continued?

   Administer within 60 minutes before incision (within 120 min for vancomycin/fluoroquinolones); generally not continued beyond 24 hours postoperatively.

7. What is the most common cause of fever in the first 24-48 hours after surgery?

   Atelectasis (one of the '5 Ws'); managed with deep breathing, incentive spirometry, and early mobilization.

8. List the classic '5 Ws' of postoperative fever and their typical timing.

   Wind (atelectasis/pneumonia, day 1-2), Water (UTI, day 3-5), Wound (infection, day 5-7), Walking (DVT/PE, day 5+), Wonder drugs/abscess (drug fever or anastomotic leak/collection, day 7+).

9. What border defines the difference between a direct and an indirect inguinal hernia?

   Hesselbach's triangle: a DIRECT hernia bulges medial to the inferior epigastric vessels (through the triangle floor); an INDIRECT hernia passes lateral to the vessels through the deep inguinal ring into the spermatic cord.

10. What are the boundaries of Hesselbach's triangle?

    Medial: lateral border of rectus abdominis; Lateral/superolateral: inferior epigastric vessels; Inferior: inguinal ligament.

11. Define a Richter's hernia and why it is dangerous.

    A hernia in which only part of the antimesenteric circumference of the bowel wall is trapped in the defect. It can strangulate and necrose without causing complete obstruction, so it may present late with gangrene/perforation and few obstructive symptoms.

12. Which abdominal hernia has the highest risk of strangulation and is more common in women?

    Femoral hernia (passes below the inguinal ligament, medial to the femoral vein); its narrow rigid neck gives the highest strangulation rate.

13. What is the typical presentation and classic radiographic finding of achalasia?

    Progressive dysphagia to solids AND liquids, regurgitation; barium swallow shows a dilated esophagus with a smooth tapered 'bird's beak' at the gastroesophageal junction; manometry shows failure of LES relaxation with aperistalsis.

14. What is the difference between a Zenker's diverticulum and a traction (mid-esophageal) diverticulum?

    Zenker's is a false (pulsion) diverticulum through Killian's triangle in the upper esophagus, caused by cricopharyngeal dysfunction (halitosis, regurgitation of undigested food). Traction diverticula are true diverticula in the mid-esophagus from mediastinal inflammation (e.g., TB nodes) pulling the wall outward.

15. Which type of esophageal cancer is associated with Barrett's esophagus/GERD, and where does it typically occur?

    Adenocarcinoma, typically in the lower third/GE junction. (Squamous cell carcinoma, linked to smoking and alcohol, classically occurs in the upper/middle third.)

16. What organism causes most peptic ulcer disease, and what is the classic difference between gastric and duodenal ulcer pain with food?

    Helicobacter pylori. Duodenal ulcer pain is typically relieved by food (and worse when hungry/at night); gastric ulcer pain is typically worsened by food.

17. In surgery for a perforated duodenal ulcer, what is the standard operative management?

    Omental (Graham) patch closure of the perforation plus peritoneal lavage; followed by H. pylori eradication. Definitive ulcer surgery (e.g., vagotomy) is rarely needed now.

18. What is the most common location of a gastrinoma, and what triad/syndrome does it cause?

    The 'gastrinoma triangle' (junctions of cystic/CBD, 2nd/3rd duodenum, neck/body of pancreas). It causes Zollinger-Ellison syndrome: gastric acid hypersecretion, refractory/multiple peptic ulcers, and diarrhea.

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