NEET PG Surgery Flashcards

24 sample cards from the Surgery deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. What receptor subtypes guide breast cancer therapy, and what defines triple-negative breast cancer?

   ER, PR, and HER2/neu. Triple-negative (ER-, PR-, HER2-) cancer does not respond to hormonal or trastuzumab therapy, is more aggressive, and is associated with BRCA1 mutations.

2. What is Virchow's triad describing the pathophysiology of venous thrombosis?

   Endothelial injury, venous stasis, and hypercoagulability — the three factors predisposing to DVT/thrombus formation.

3. What are the '6 Ps' of acute arterial occlusion (limb ischemia)?

   Pain, Pallor, Pulselessness, Paresthesia, Paralysis, and Poikilothermia (perishing cold). Paralysis and paresthesia indicate advanced ischemia requiring urgent revascularization.

4. What is the gold-standard long-term vascular access for chronic hemodialysis, and why is it preferred over catheters/grafts?

   An autogenous arteriovenous fistula (e.g., radiocephalic/Brescia-Cimino); preferred for lowest infection and thrombosis rates and best long-term patency compared with AV grafts or central venous catheters.

5. In ATLS, what does the primary survey 'ABCDE' stand for, and what is assessed first?

   Airway (with C-spine protection), Breathing, Circulation (with hemorrhage control), Disability (neuro/GCS), Exposure/Environment. Airway is addressed first.

6. State the Glasgow Coma Scale components and the score range, and what GCS indicates severe TBI requiring intubation.

   Eye (1-4), Verbal (1-5), Motor (1-6); total 3-15. A GCS of 8 or less indicates severe traumatic brain injury and the need to secure the airway ('GCS 8, intubate').

7. Differentiate epidural from subdural hematoma on CT and typical vessel/clinical course.

   Epidural: biconvex/lens-shaped, doesn't cross sutures, middle meningeal artery tear, classic lucid interval. Subdural: crescent-shaped, crosses sutures, bridging vein tear, common in elderly/alcoholics.

8. In blunt abdominal trauma, which two solid organs are most commonly injured, and what is the FAST exam used for?

   The spleen (most common in blunt trauma) and liver. FAST (Focused Assessment with Sonography for Trauma) detects free intraperitoneal/pericardial fluid (blood) in the hemodynamically evaluable patient.

9. What is the indication for immediate laparotomy after abdominal trauma regardless of imaging?

   Hemodynamic instability with a positive FAST, peritonitis, evisceration, gunshot wounds traversing the peritoneum, or free air/diaphragmatic rupture — these mandate exploratory laparotomy.

10. What is the Salter-Harris classification used for, and which type is most common?

    It classifies pediatric physeal (growth plate) fractures (Types I-V; mnemonic SALTR). Type II (fracture through physis + metaphysis) is the most common.

11. What is the most feared early complication of a femoral neck fracture and the most common late complication?

    Early/late: avascular necrosis of the femoral head (due to disruption of the retinacular vessels/medial femoral circumflex artery) and nonunion, owing to the precarious intracapsular blood supply.

12. What is the difference between total joint arthroplasty (replacement) for osteoarthritis, and the most common cause of late revision in total hip replacement?

    Arthroplasty replaces damaged articular surfaces with prosthetic components to relieve pain and restore function; aseptic loosening (often from polyethylene wear/osteolysis) is the most common cause of late revision.

13. What is the most common indication for lumbar spine surgery (discectomy), and the classic clinical sign of L5-S1 disc herniation?

    A herniated/prolapsed intervertebral disc causing nerve root compression (sciatica) refractory to conservative care; L5-S1 herniation compresses the S1 root (positive straight-leg-raise, loss of ankle jerk).

14. What is the most common type of kidney (renal) stone, and which type is radiolucent on plain X-ray?

    Calcium oxalate stones are most common (~75%); uric acid stones are radiolucent and require management with urine alkalinization.

15. What stone size threshold typically passes spontaneously versus requires intervention, and what is the first-line treatment for a 5 mm distal ureteric stone?

    Stones less than 5 mm usually pass spontaneously; those over 7 mm often need intervention. A 5 mm distal ureteric stone is managed with medical expulsive therapy (alpha-blocker like tamsulosin) plus hydration/analgesia.

16. What is the most common malignant renal tumor in adults, and its classic triad?

    Renal cell carcinoma (clear cell type, arising from proximal tubule). Classic but late triad: flank pain, hematuria, and a palpable abdominal mass (present in <10%).

17. Which paraneoplastic syndromes are associated with renal cell carcinoma?

    Polycythemia (EPO), hypercalcemia (PTHrP), hypertension (renin), Stauffer syndrome (nonmetastatic hepatic dysfunction), and Cushing's (ACTH).

18. What is the most common cause of congenital ureteropelvic junction (UPJ) obstruction and the imaging study of choice to confirm functional obstruction?

    Intrinsic stenosis/aperistaltic segment at the UPJ (or a crossing lower-pole vessel) causing hydronephrosis; a diuretic (Lasix) renogram (MAG3/DTPA) confirms functional obstruction; pyeloplasty (Anderson-Hynes) is the standard repair.

19. What is the most common cause of acquired ureteral strictures, and the typical first-line endourologic management?

    Iatrogenic injury (e.g., ureteroscopy, pelvic/gynecologic surgery) and impacted stones/radiation; first-line management includes balloon dilation or endoureterotomy with stenting, reserving open/robotic reconstruction for refractory cases.

20. In neonatal surgery, what is the difference between gastroschisis and omphalocele?

    Gastroschisis: full-thickness abdominal wall defect (usually right of umbilicus) with NO covering membrane and few associated anomalies. Omphalocele: central defect at the umbilicus with herniation INTO a membrane-covered sac and frequent associated anomalies (cardiac, chromosomal).

21. What is the classic presentation and diagnostic finding of duodenal atresia in a neonate?

    Bilious vomiting within hours of birth (in ~75% the obstruction is distal to the ampulla) and a 'double bubble' sign (air in stomach and proximal duodenum) on X-ray; strongly associated with Down syndrome.

22. What is the most common surgical cause of vomiting in infants at 3-6 weeks, and its classic findings?

    Hypertrophic pyloric stenosis: non-bilious projectile vomiting, a palpable 'olive' in the epigastrium, visible gastric peristalsis, and a hypochloremic hypokalemic metabolic alkalosis; treated by pyloromyotomy (Ramstedt).

23. What is the most common cause of bowel obstruction in infants (3 months-3 years) presenting with 'red-currant jelly' stools?

    Intussusception (most commonly ileocolic); presents with colicky pain, a sausage-shaped abdominal mass, and red-currant jelly stool; reduced by air/contrast enema, surgery if that fails or peritonitis is present.

24. What is Hirschsprung disease, its pathology, and the diagnostic gold standard?

    Congenital aganglionosis (absent ganglion cells in the distal colon, usually rectosigmoid) causing functional obstruction and failure to pass meconium within 48 hours; rectal suction biopsy showing absent ganglia (with increased acetylcholinesterase) is the gold standard.

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