NEET-PG 2025 - Surgery PYQs Practice Questions

Q: What is correct regarding this suture?

Monofilament. ***Monofilament*** - **Monofilament** sutures consist of a single strand, which minimizes tissue drag and reduces the risk of harboring **bacteria** and subsequent wound infection. - This structure is typical for materials like **Prolene** (Polypropylene) and **Nylon**, prized for their low friction and use in delicate or contaminated fields. *Non absorbable* - This describes the **fate** of the suture (remaining permanently in the body) but not its structure; non-absorbable sutures can be either **monofilament** (e.g., Nylon) or multifilament (e.g., Silk). - While many important sutures are non-absorbable, it is a property independent of whether the suture is single-stranded. *Braided multifilament* - This refers to sutures made of multiple intertwined strands, which is the structural opposite of a **monofilament**. - Multifilament sutures typically offer better knot security but have increased tissue drag and potential for **capillarity** (wicking action). *Collagen derived* - This refers to the material source, specifically **catgut** (made from sheep or cow intestine), which is an absorbable natural material. - Catgut is absorbable and rapidly loses its tensile strength; 'monofilament' describes the physical form and is not exclusive to this biologic material. [Practice more Surgery PYQs on OnCourse]

Q: A 56-year-old man presents with the following pathology shown in the image, which of the following is correct?

Lipodermatosclerosis/eczema can occur. ***Lipodermatosclerosis/eczema can occurs*** - The image suggests features of **chronic venous insufficiency (CVI)**, including skin discoloration (hyperpigmentation/hemosiderin deposition) and induration, which are classic features leading to **lipodermatosclerosis** and **venous eczema** (C4 changes in CEAP classification). - Lipodermatosclerosis involves inflammation and fibrosis of the skin and subcutaneous fat in the gaiter area due to prolonged **venous hypertension**. *Sclerotherapy is the best treatment* - Sclerotherapy is typically indicated for **small varicose veins** or **telangiectasias**. - For CVI causing advanced skin changes (like lipodermatosclerosis), the best initial treatment is usually **compression therapy** and addressing the source of reflux (e.g., endovenous ablation). *Telangiectasia is rare* - **Telangiectasias** (spider veins) are very common in patients with CVI and often represent the earliest visible sign of **venous disease** (C1 in CEAP classification). - The presence of more advanced skin changes (like those shown) indicates significant venous hypertension, often accompanied by microcirculatory changes including telangiectasia. *No possibility of venous ulcer* - The changes seen (hyperpigmentation and probable underlying induration/atrophy) are stages C4/C5 of the CEAP classification, which are **immediate precursors** to or associated with **venous leg ulcers** (C6). - Venous hypertension is the underlying cause for both the skin changes and the development of **venous ulcers**, making the possibility very real in this patient. [Practice more Surgery PYQs on OnCourse]

Q: A 3-year-old child was brought to OPD with complaint of dysuria and ballooning on micturition and examination as given below, what is the diagnosis?

True phimosis. ***True phimosis*** - The image shows a severely narrowed, pinhole-like preputial opening, coupled with **dysuria** and **ballooning on micturition**, which are hallmark symptoms of symptomatic or **pathological phimosis**. - **Ballooning** occurs because the tight foreskin traps urine before it can exit, confirming significant distal urinary outflow obstruction. *Balanitis xerotica obliterans* - Although BXO is a leading cause of pathological phimosis, this diagnosis is reserved for cases showing characteristic **sclerotic, white, atrophic skin changes** around the meatus, which are absent in the image. - BXO typically develops secondary to a chronic inflammatory process and is often considered when the phimosis is **acquired** rather than purely developmental. *Recurrent balanoposthitis* - Balanoposthitis is an inflammation of the glans and prepuce, typically presenting with **erythema, swelling, and discharge**. - While repeated episodes can lead to **scarring and acquired phimosis**, the primary and most concerning diagnosis here is the resulting anatomical obstruction (phimosis) that is causing symptoms. *Recurrent urinary tract infections* - **Recurrent UTIs** are a potential complication of significant true phimosis, resulting from urine stasis and poor hygiene. - However, the symptoms described, especially **ballooning on micturition**, directly indicate the presence of urethral **outflow obstruction**, which is the diagnosis. [Practice more Surgery PYQs on OnCourse]

Q: A 30-year-old female was brought to the emergency room after a fire. On examination, full-thickness burns and deep partial-thickness burns were present involving the lower limb circumferentially. A procedure was performed to relieve vascular compromise. Identify the procedure?

Escharotomy. ***Escharotomy*** - Performed for **full-thickness (circumferential)** burns to relieve pressure caused by the rigid, constricting **eschar** (necrotic tissue). - Indicated when there are signs of **compartment syndrome** or impaired distal circulation (e.g., absent pulses, cyanosis) in the affected limb. *Debridement* - Involves removing dead, contaminated, or foreign material from a wound to promote healing. - While necessary for complex burns, simply debridement does not address the acute vascular compromise caused by circumferential full-thickness burns. *Excised to healthy tissue* - Refers to **tangential** or **fascial excision** of the burn wound, an operative procedure typically done under general anesthesia for definitive wound management. - This is performed later for wound bed preparation, not an immediate, bedside procedure to restore circulation and prevent limb loss like **escharotomy**. *Early skin grafting* - The definitive procedure used to close the wound after it is excised and prepared. - Cannot be performed until severe vascular constriction is relieved and the wound bed is adequately prepared, making it a later step in management. [Practice more Surgery PYQs on OnCourse]

Q: Identify the fistula according to Park's classification?

Intersphincteric. ***Intersphincteric*** - This type of fistula tract is confined entirely to the space **between the internal and external anal sphincters**, as clearly depicted in the image. - It represents the **most common** variety of anal fistula, accounting for about 70% of cases in Park's classification. *Supra-sphincteric* - A supra-sphincteric fistula passes through the intersphincteric space, hooks **above the puborectalis muscle**, and then descends through the ischiorectal fossa. - The illustrated tract does not traverse cephalad to the **external anal sphincter** or the puborectalis muscle. *Extra-sphincteric* - This rare type runs **outside both the internal and external anal sphincters** and often penetrates the levator ani muscle to connect the rectum to the perianal skin. - The tract shown is contained **within the muscle planes** of the anal canal, ruling out an extra-sphincteric course. *Trans-sphincteric high* - Trans-sphincteric fistulas pass **through the external anal sphincter** (usually involving the lower or middle third) to reach the ischiorectal fossa. - The depicted track runs strictly **between** the internal and external layers without crossing the external sphincter. [Practice more Surgery PYQs on OnCourse]

Question 1

What is correct regarding this suture?

Accepted Answer

Monofilament

Answer

Collagen derived

Answer

Non absorbable

Answer

Braided multifilament

Question 2

A 56-year-old man presents with the following pathology shown in the image, which of the following is correct?

Accepted Answer

Lipodermatosclerosis/eczema can occur

Answer

Sclerotherapy is the best treatment

Answer

Telangiectasia is rare

Answer

No possibility of venous ulcer

Question 3

A 3-year-old child was brought to OPD with complaint of dysuria and ballooning on micturition and examination as given below, what is the diagnosis?

Accepted Answer

True phimosis

Answer

Recurrent balanoposthitis

Answer

Balanitis xerotica obliterans

Answer

Recurrent urinary tract infections

Question 4

A 30-year-old female was brought to the emergency room after a fire. On examination, full-thickness burns and deep partial-thickness burns were present involving the lower limb circumferentially. A procedure was performed to relieve vascular compromise. Identify the procedure?

Accepted Answer

Escharotomy

Answer

Debridement

Answer

Early skin grafting

Answer

Excised to healthy tissue

Question 5

Identify the fistula according to Park's classification?

Accepted Answer

Intersphincteric

Answer

Extra-sphincteric

Answer

Trans-sphincteric high

Answer

Supra-sphincteric

Question 6

After a building collapse, a patient presents with airway obstruction and mouth filled with concrete debris. BP is 90/60 mmHg, HR 105/min. A cricothyrotomy is performed. Which of the following statements regarding this procedure is true?

Accepted Answer

It must be followed by a formal tracheostomy

Answer

It provides adequate ventilation for up to 6 hours

Answer

It can be safely used for prolonged airway management without further intervention

Answer

It allows for removal of large foreign bodies from the airway

Question 7

Identify the knot?

Accepted Answer

Surgeon's knot

Answer

Double Knot

Answer

Reef knot

Answer

Granny's knot

Question 8

A 43-year-old female presents to OPD due to changes in breast and a lump in breast as given below. What is the diagnosis?

Accepted Answer

T4d

Answer

T3

Answer

T1c

Answer

T4a

NEET-PG 2025 — Surgery