NEET-PG 2019 - Surgery PYQs Practice Questions

Q: Most common type of gallstone is?

Mixed stones. ***Mixed stones*** - Mixed gallstones, typically composed of **cholesterol** and **pigment**, are the most prevalent type, accounting for about 70-80% of cases [1]. - They are often associated with **biliary stasis** and **inflammation**, contributing to their formation. *Pigment stones* - Pigment stones are less common, usually representing about 10-20% of gallstones [1]. They are primarily formed from **bilirubin** and are associated with conditions causing **hemolysis**. - They may lead to **complications**, but their overall incidence is lower compared to mixed stones. *Calcium bilirubinate* - These stones are a type of **pigment stone**, formed in conditions like chronic hemolytic anemia, but they are relatively rare overall [1]. - They specifically result from **excess bilirubin**, unlike the mixed stones' composition which includes **cholesterol**. *Pure cholesterol stones* - Pure cholesterol stones occur in about 10-15% of cases, developing primarily due to **supersaturation of cholesterol** in bile. - They are less common than mixed stones and typically present as **large, yellowish stones** in the gallbladder. [Practice more Surgery PYQs on OnCourse]

Q: The most common site of the branchial cyst is:

Anterior border of sternocleidomastoid. ***Anterior border of sternocleidomastoid*** - Branchial cysts most commonly present as a mass along the **anterior border of the sternocleidomastoid muscle**, typically in the upper to middle third of the neck [3]. - This location corresponds to the embryological remnants of the **second branchial cleft**. *Posterior border of sternocleidomastoid* - Cysts or masses in this region are less likely to be branchial cysts and might indicate other conditions like **lymphadenopathy** or a **cystic hygroma** [1]. - The posterior border is not the typical embryological location for branchial cleft remnants to form cysts. *Digastric muscle* - While the digastric muscle is located in the neck, cysts directly associated with this muscle are rare and usually of **different embryological origin** (e.g., salivary gland cysts or submandibular space infections). - Branchial cysts are specifically tied to the branchial apparatus remnants. *Omohyoid muscle* - The omohyoid muscle crosses the lower neck, and masses in its vicinity are typically not branchial cysts but could involve **thyroid pathology**, **lymph nodes**, or **vascular anomalies** [2]. - This location is anatomically distinct from the typical presentation of a branchial cleft cyst. [Practice more Surgery PYQs on OnCourse]

Q: Parathyroid autoimplantation takes place in which muscle?

Brachioradialis. ***Brachioradialis*** - The **brachioradialis muscle** in the forearm is the preferred site for parathyroid autoimplantation due to its accessibility and favorable blood supply. - This muscle allows for easy **monitoring of parathyroid graft function** and re-exploration if necessary. *Sternocleidomastoid* - While located in the neck, the **sternocleidomastoid muscle** is generally not used for parathyroid autoimplantation due to potential cosmetic concerns and the risk of damage to vital neck structures. - Its proximity to the original parathyroid glands could make it difficult to differentiate native tissue from implanted grafts if future surgery is required. *Triceps* - The **triceps muscle** in the upper arm is a large muscle, but it is not typically chosen for parathyroid autoimplantation. - It is less accessible for routine examination and potential re-exploration compared to the brachial region. *Sartorius* - The **sartorius muscle** is located in the thigh and is not used for parathyroid autoimplantation. - Its distant location from the head and neck region would make monitoring and re-exploration of the graft impractical. [Practice more Surgery PYQs on OnCourse]

Q: What type of knot is depicted in the image?

Granny knot. ***Granny knot*** - The image shows a knot where the two half-knots are tied in the **same direction** (left over right, then left over right again, or vice versa), causing it to be unstable and slip. - This instability makes it less secure than a reef knot, as the two end pieces emerge parallel but on opposite sides of the loop. - The granny knot is an **insecure knot** that should be avoided in surgery as it can spontaneously untie. *Surgeon's knot* - A surgeon's knot involves an **extra throw** (double wrap) around the first loop to increase friction and make it more secure, which is not depicted here. - It is typically used to ensure that the first throw holds tension while the second throw is being tied. *Reef knot* - A reef knot (or square knot) is formed by tying two half-knots in **opposite directions** (left over right, then right over left), which creates a flat, stable, and secure knot. - In a reef knot, the two end pieces emerge parallel and on the same side of the loop, unlike the granny knot. *Half hitch* - A half hitch is a simple overhand knot around a standing part of the rope, used as a single throw or in combination with other knots. - It is not the same as the double-throw configuration shown in the image. [Practice more Surgery PYQs on OnCourse]

Q: CEAP score indicates-

Venous disorder. ***Venous disorder*** - The **CEAP classification** is a widely recognized system used to categorize and describe chronic venous disorders. The acronym stands for **Clinical, Etiological, Anatomical, and Pathophysiological** factors. - It provides a standardized framework for clinicians to classify the severity and characteristics of **venous disease**, ranging from spider veins to active ulcers. *Atrial disorders* - **Atrial disorders** refer to conditions affecting the atria of the heart, such as **atrial fibrillation** or **atrial flutter**. - These are cardiovascular conditions distinct from venous disorders, which involve the veins (blood vessels returning blood to the heart). *Neurological disorder* - A **neurological disorder** is a condition affecting the **nervous system**, including the brain, spinal cord, and nerves. - The CEAP classification is specifically designed for vascular conditions and has no direct relevance to neurological diseases. *Trauma disorder* - A **trauma disorder** is a condition resulting from a **physically or psychologically traumatic event**. - While trauma can sometimes lead to venous issues (e.g., deep vein thrombosis from immobilization), the CEAP score itself is a classification system for chronic venous disease, not for traumatic conditions in general. [Practice more Surgery PYQs on OnCourse]

Question 1

Most common type of gallstone is?

Accepted Answer

Mixed stones

Answer

Pure cholesterol stones

Answer

Pigment stones

Answer

Calcium bilirubinate

Question 2

The most common site of the branchial cyst is:

Accepted Answer

Anterior border of sternocleidomastoid

Answer

Posterior border of sternocleidomastoid

Answer

Digastric muscle

Answer

Omohyoid muscle

Question 3

Parathyroid autoimplantation takes place in which muscle?

Accepted Answer

Brachioradialis

Answer

Triceps

Answer

Sartorius

Answer

Sternocleidomastoid

Question 4

What type of knot is depicted in the image?

Accepted Answer

Granny knot

Answer

Half hitch

Answer

Surgeon’s knot

Answer

Reef knot

Question 5

CEAP score indicates-

Accepted Answer

Venous disorder

Answer

Atrial disorders

Answer

Trauma disorder

Answer

Neurological disorder

Question 6

What is the most likely diagnosis for the parotid mass with mixed consistency shown in the image?

Accepted Answer

Pleomorphic adenoma

Answer

Sebaceous cyst

Answer

Dermoid cyst

Answer

None of the options

Question 7

Identify the surgical instrument based on its characteristics: a small, triangular blade used for precise incisions.

Accepted Answer

Blade no. 11

Answer

Blade no. 15

Answer

Blade no. 10

Answer

Blade no. 12

Question 8

Identify the triangle in the image below.

Accepted Answer

Gastrinoma triangle

Answer

Hesselbach’s triangle

Answer

Koch’s triangle

Answer

Sherren’s triangle

Question 9

Degloving injury involves separation of:-

Accepted Answer

Skin + Fascia + Subcutaneous tissue

Answer

Skin

Answer

Everything above from bone

Answer

Skin + Subcutaneous tissue

Question 10

All of the following statements are true about Frey's Syndrome except

Accepted Answer

Sympathetic nerve involvement is the primary cause

Answer

Less chances with enucleation than parotidectomy

Answer

Gustatory sweating

Answer

Aberrant misdirection of parasympathetic fibers of auriculotemporal nerve

NEET-PG 2019 — Surgery