NEET PG Surgery And Allied Specialties Flashcards

24 sample cards from the Surgery And Allied Specialties deck

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

1. Describe the Mallampati classification used in airway assessment.

   With the patient sitting, mouth open, tongue out: Class I sees soft palate, uvula, fauces, pillars; II soft palate, uvula, fauces; III soft palate and base of uvula only; IV soft palate not visible (hard palate only). Higher classes predict difficult intubation.

2. What are the standard fasting (NPO) guidelines before elective anesthesia?

   2 hours for clear fluids, 4 hours for breast milk, 6 hours for light meal / formula / non-human milk, and 8 hours for a heavy/fatty meal, to reduce aspiration risk (Mendelson's syndrome).

3. What is malignant hyperthermia, its triggers, and its specific antidote?

   A pharmacogenetic hypermetabolic crisis (RYR1 mutation) triggered by volatile anesthetics (halothane, sevoflurane) and succinylcholine, presenting with rising end-tidal CO2, masseter rigidity, hyperthermia and acidosis. Specific treatment is IV dantrolene plus active cooling and supportive care.

4. Differentiate spinal (subarachnoid) from epidural anesthesia in terms of space, onset, and dose.

   Spinal: small dose of LA into subarachnoid (CSF) space below L2, rapid dense onset, single shot. Epidural: larger LA volume into epidural (potential) space, slower onset, catheter allows continuous/top-up dosing. Spinal classically causes hypotension from sympathetic blockade.

5. State the maximum safe dose of lidocaine with and without adrenaline, and the early signs of LA systemic toxicity.

   Plain lidocaine 3 mg/kg (max ~200 mg); with adrenaline 7 mg/kg (max ~500 mg). Early CNS toxicity: perioral/tongue numbness, tinnitus, metallic taste, dizziness; then seizures and cardiovascular collapse. Treat severe toxicity with 20% intralipid emulsion.

6. List the major cardiovascular and hematologic physiological changes of normal pregnancy.

   Cardiac output rises ~30-50%, plasma volume rises more than red cell mass causing physiological (dilutional) anemia, blood pressure falls in the second trimester, and there is a hypercoagulable state with increased clotting factors.

7. What is the recommended antenatal visit schedule and the WHO/standard folic acid supplementation?

   Classic schedule: monthly up to 28 weeks, fortnightly 28-36 weeks, weekly after 36 weeks until delivery. Folic acid 400 mcg/day periconceptionally (5 mg/day if high risk such as prior neural tube defect) reduces neural tube defects.

8. Define the three stages of labor with their durations.

   First stage: onset of true labor to full (10 cm) cervical dilatation - latent (up to ~3-4 cm) and active phases (primigravida up to ~12h). Second stage: full dilatation to delivery of baby (up to ~2h, longer with epidural). Third stage: delivery of baby to expulsion of placenta (within 30 min).

9. What does the partograph plot, and what do the alert and action lines signify?

   The partograph plots cervical dilatation against time during active labor along with fetal heart rate, contractions, and descent. Crossing the alert line indicates slow progress needing closer observation/referral; crossing the action line (4 hours right of alert) mandates intervention.

10. Define the four T's causes of postpartum hemorrhage and the most common cause.

    Tone (uterine atony - most common, ~70%), Trauma (lacerations/rupture), Tissue (retained products), and Thrombin (coagulopathy). PPH is blood loss >500 mL vaginal or >1000 mL cesarean. First-line drug is oxytocin.

11. Differentiate placenta previa from placental abruption clinically.

    Placenta previa: painless, bright-red, recurrent vaginal bleeding, soft non-tender uterus, often malpresentation; diagnosed by ultrasound (avoid PV exam). Abruption: painful, dark bleeding (may be concealed), tense tender 'woody' uterus, fetal distress, associated with hypertension/trauma.

12. What are the diagnostic criteria for preeclampsia and the drug of choice for eclampsia seizure prophylaxis?

    New-onset BP >=140/90 after 20 weeks plus proteinuria (or end-organ dysfunction). Severe features include BP >=160/110. Magnesium sulfate is the drug of choice to prevent/treat eclamptic seizures; antidote for toxicity is IV calcium gluconate.

13. Compare the mechanism of action of combined oral contraceptive pills versus copper IUD versus levonorgestrel.

    COCs: mainly suppress ovulation (inhibit LH/FSH surge) plus thicken cervical mucus. Copper IUD: spermicidal/inflammatory endometrium preventing fertilization (also emergency contraception up to 5 days). Levonorgestrel (POP/emergency pill): thickens mucus, delays/inhibits ovulation.

14. Define infertility and list the most common causes of female and male factor infertility.

    Infertility is failure to conceive after 12 months of regular unprotected intercourse (6 months if age >35). Commonest female cause is ovulatory dysfunction (e.g., PCOS); tubal factor and endometriosis also common. Commonest male cause is abnormal semen parameters (oligo/astheno/teratozoospermia).

15. What HPV types cause most cervical cancer, and what is the recommended screening (Pap) interval?

    HPV types 16 and 18 cause about 70% of cervical cancers. Cytology (Pap) screening every 3 years from age 21, or HPV co-testing every 5 years from age 30. Cervical cancer is most often squamous cell carcinoma; HPV vaccination is preventive.

16. Which gynecological malignancy is the most lethal, which is the most common, and a key tumor marker for ovarian epithelial cancer?

    Ovarian cancer is the most lethal gynecological malignancy (presents late). Endometrial cancer is the most common in developed countries (postmenopausal bleeding is the cardinal symptom). CA-125 is the marker for epithelial ovarian cancer.

17. Differentiate conductive from sensorineural hearing loss using Rinne and Weber tests.

    Conductive loss: Rinne negative (bone > air conduction in affected ear), Weber lateralizes to the affected (worse) ear. Sensorineural loss: Rinne positive (air > bone), Weber lateralizes to the better (normal) ear.

18. Differentiate peripheral (BPPV) from central vertigo, and name the BPPV diagnostic and treatment maneuvers.

    Peripheral (BPPV): brief, severe, positional vertigo with fatigable horizontal-rotatory nystagmus, no neuro deficits; due to otoconia in posterior semicircular canal. Diagnosed by Dix-Hallpike, treated by Epley maneuver. Central vertigo: continuous, vertical/non-fatigable nystagmus, with neurological signs.

19. What are the most common organisms in acute bacterial rhinosinusitis and the danger of a midface infection?

    Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The 'dangerous area of the face' (nasolabial/midface) drains via the facial and ophthalmic veins to the cavernous sinus, risking cavernous sinus thrombosis from spreading infection.

20. Differentiate the three common refractive errors and their correcting lenses.

    Myopia (near-sighted): image focuses in front of retina, corrected with concave (minus) lens. Hyperopia (far-sighted): image focuses behind retina, corrected with convex (plus) lens. Astigmatism: unequal corneal curvature, corrected with cylindrical lens. Presbyopia (age-related loss of accommodation) needs reading (plus) lenses.

21. Differentiate the typical visual field loss in open-angle glaucoma from the presentation of acute angle-closure glaucoma.

    Primary open-angle glaucoma: painless, gradual loss of peripheral vision (arcuate scotoma) with raised IOP and increased optic cup-to-disc ratio. Acute angle-closure: sudden painful red eye, mid-dilated fixed pupil, halos around lights, nausea/vomiting - an ophthalmic emergency requiring IOP-lowering treatment.

22. What is the most common cause of treatable blindness worldwide, and the definitive treatment?

    Cataract (opacification of the lens) is the leading cause of reversible/treatable blindness worldwide. Definitive treatment is surgical extraction with intraocular lens implantation, most commonly phacoemulsification.

23. Differentiate central retinal artery occlusion from central retinal vein occlusion on fundus examination.

    CRAO: sudden painless complete vision loss, pale retina with a cherry-red spot at the fovea, attenuated arteries - an emergency. CRVO: variable painless vision loss with a 'blood and thunder' fundus (widespread retinal hemorrhages, dilated tortuous veins, disc edema).

24. Name the classic ocular emergencies presenting with sudden vision loss and a key feature of retinal detachment.

    Ocular emergencies: CRAO, acute angle-closure glaucoma, retinal detachment, endophthalmitis, and chemical burns (alkali worse than acid - irrigate immediately). Retinal detachment presents with sudden flashes (photopsia), floaters, and a curtain/shadow descending over the visual field.

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