Surgery - NEET PG Important Topics

Surgery carries ~18-23 questions (9% weightage) in NEET PG. Questions are increasingly clinical, image-based, and anatomy-integrated.

1. Trauma & Emergency Surgery ⭐⭐⭐ (Highest Yield)

• Head trauma: Diffuse axonal injury, extradural vs. subdural hematoma (CT features), Glasgow Coma Scale
• ATLS protocol: Primary survey, ABCDEs, fluid resuscitation
• Abdominal trauma: FAST exam, splenic/liver injuries, damage control surgery
• Thoracic trauma: Pneumothorax, hemothorax, flail chest, cardiac tamponade (Beck's triad)
• Vascular trauma: Compartment syndrome, fasciotomy indications
• Fractures with vascular injury

2. Shock ⭐⭐⭐

• Classification (hypovolemic, septic, cardiogenic, neurogenic, obstructive)
• Stages of hypovolemic shock (Grades I-IV)
• Management: fluid resuscitation, vasopressors
• SIRS/Sepsis/Septic shock criteria

3. GI Surgery ⭐⭐⭐

Upper GI

• Achalasia cardia - manometry (high-pressure LES with failed relaxation), Heller's myotomy
• Peptic ulcer disease - Helicobacter pylori, complications (perforation, bleeding), Billroth I & II
• Zollinger-Ellison syndrome - gastrinoma, MEN-1 association
• Esophageal carcinoma - squamous vs. adenocarcinoma, staging, McKeown esophagectomy
• Corrosive ingestion - management

Lower GI

• Colorectal carcinoma - Dukes/TNM staging, CEA, right vs. left-sided presentation
• Intestinal obstruction - adhesions (commonest), sigmoid volvulus (coffee-bean sign), intussusception
• Appendicitis - Alvarado score, perforated appendicitis, carcinoid of appendix
• Inflammatory bowel disease - Crohn's vs. ulcerative colitis (surgical indications)
• Anal fistula - Parks classification (directly asked in NEET PG 2025)
• Hemorrhoids - classification, treatment (Barron's band ligation, MIPH)
• Hirschsprung disease
• Meckel's diverticulum - rule of 2s

4. Hepatobiliary & Pancreatic Surgery ⭐⭐⭐

• Courvoisier's law - carcinoma head of pancreas (asked in NEET PG 2025)
• Obstructive jaundice - causes, investigations, ERCP vs. surgery
• Gallstones - types, complications, Mirizzi syndrome
• Cholecystitis - acute vs. chronic, laparoscopic cholecystectomy, bile duct injury
• Pancreatic carcinoma - Whipple's procedure, CA 19-9
• Acute pancreatitis - Ranson's criteria, CT severity index, complications (pseudocyst, abscess)
• Hepatocellular carcinoma - AFP, Child-Pugh score
• Portal hypertension - varices management, TIPS

5. Breast Surgery ⭐⭐⭐

• Breast carcinoma: BIRADS classification, TNM staging, ER/PR/HER2 status
• Surgical options: Lumpectomy vs. mastectomy, sentinel lymph node biopsy, axillary dissection
• Fibrocystic disease, fibroadenoma, phyllodes tumor - distinguishing features
• Paget's disease of nipple
• Male breast cancer
• BRCA1/BRCA2 mutations and prophylactic surgery

6. Thyroid & Endocrine Surgery ⭐⭐⭐

• Thyroid carcinoma - papillary (most common, psammoma bodies), follicular, medullary (calcitonin, MEN-2), anaplastic (worst prognosis)
• Thyroidectomy complications - recurrent laryngeal nerve injury, hypocalcemia
• Goiter - retrosternal, toxic, non-toxic; Pemberton's sign
• Hyperparathyroidism - primary vs. secondary vs. tertiary; surgical indications
• Adrenal tumors - pheochromocytoma (preoperative alpha-blockade), Conn's syndrome
• MEN syndromes - MEN-1, MEN-2A, MEN-2B

7. Hernias ⭐⭐⭐

• Inguinal hernia - direct vs. indirect (Hesselbach's triangle), Lichtenstein repair, TEP/TAPP laparoscopic
• Femoral hernia - anatomy, Lottheissen/McEvedy/Lockwood approach
• Strangulated hernia - surgical emergency
• Richter's hernia, Maydl's hernia, Littre's hernia - special types
• Congenital diaphragmatic hernia (Bochdalek vs. Morgagni) - asked in NEET PG 2025

8. Vascular Surgery ⭐⭐

• Varicose veins - CEAP classification, Trendelenburg test, treatment (EVLA, SEPS)
• DVT - Virchow's triad, prophylaxis, Wells score
• Peripheral arterial disease - ABPI, Fontaine classification
• Aortic aneurysm - management thresholds, EVAR vs. open repair
• Buerger's disease (Thromboangiitis obliterans)

9. Burns & Plastic Surgery ⭐⭐

• Rule of nines (Wallace's rule), Lund & Browder chart (more accurate for children)
• Burn depth - superficial, partial thickness, full thickness
• Fluid resuscitation - Parkland formula (4 ml/kg/% BSA in 24 hours)
• Inhalation injury - early airway management
• Skin grafting - split thickness vs. full thickness, donor sites
• Flaps - random vs. axial, TRAM flap, DIEP flap
• Wound healing - primary vs. secondary vs. tertiary intention, keloid vs. hypertrophic scar
• Marjolin's ulcer (malignant transformation in chronic wound)

10. Urology ⭐⭐

• Renal cell carcinoma - clear cell type, von Hippel-Lindau, "cannon-ball" metastases
• Transitional cell carcinoma of bladder - smoking association, cystoscopy
• BPH vs. prostate carcinoma - PSA, TURP
• Urinary calculi - types, KUB vs. IVP vs. CT, ESWL/PCNL/ureteroscopy
• Renal trauma

11. Head & Neck Surgery ⭐⭐

• Salivary gland tumors - pleomorphic adenoma (most common), Warthin's tumor, mucoepidermoid carcinoma
• Oral cancer - squamous cell carcinoma, TNM staging, commando operation
• Thyroglossal cyst - Sistrunk's operation
• Branchial cyst/fistula
• Neck dissection types - radical vs. modified radical vs. selective

12. Surgical Infections & Miscellaneous ⭐⭐

• Necrotizing fasciitis - Fournier's gangrene, management
• Tetanus - prophylaxis, treatment
• Surgical site infections - classification, prophylaxis
• Wound dehiscence vs. evisceration
• Surgical nutrition - TPN, enteral vs. parenteral, refeeding syndrome

Key Topics Asked Directly in NEET PG 2025

Preparation Tips

1. Anatomy integration is key - know surgical anatomy for each procedure (nerve relations, blood supply, lymph drainage)
2. Image-based prep - X-rays (obstruction, free air), CT abdomen, laparoscopic images
3. TNM staging - must know for breast, colon, thyroid, oral cancers
4. Operative steps are now being tested - know key steps of common surgeries
5. Standard references: Bailey & Love's Surgery + S. Das Manual (for India-specific content) + Manipal Review Surgery for MCQs