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NEET PG - High-Yield Topics Master Guide

Exam Format (2025-2026 Pattern)

• 200 questions, 3.5 hours
• +4 marks for correct, -1 mark for wrong
• Mix: ~60% clinical/case-based, ~40% direct recall

• 50% questions are image-linked (radiology, histology, clinical photos)

• Difficulty: ~25% easy, ~60% moderate, ~15% difficult

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Subject-Wise Weightage (PYQ Analysis + 2026 Projection)

Top 5 subjects = ~50% of paper: OBG + Medicine + Microbiology + Surgery + Physiology (2025 trend)

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Tier 1 - Maximum ROI Subjects (Study First)

1. Medicine (~21 Q) - Highest concept depth

• Cardiovascular: Heart failure (HFpEF vs HFrEF), Infective endocarditis (Duke criteria), AF management
• Respiratory: ARDS (low tidal volume + high PEEP), COPD vs Asthma management, Pulmonary HTN
• Endocrine: Diabetes complications, Addison's disease, Thyroid disorders, Cushing's
• Rheumatology: RA (pannus, anti-CCP), SLE (criteria, lupus nephritis), Gout vs Pseudogout
• Neurology: Stroke management, Meningitis (CSF findings), Epilepsy drug selection
• HIV: IRIS in HIV-TB, opportunistic infections, ART timing
• Gastro: Cirrhosis complications, IBD (Crohn's vs UC), Upper GI bleeds
• Dermatology (under Medicine): Pemphigus vs Pemphigoid, Psoriasis, Stevens-Johnson Syndrome
• Psychiatry: Delirium vs Dementia, Antidepressant MOA, Substance abuse (withdrawal syndromes)

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2. OBGYN (~19 Q) - Highest repeat rate, most predictable

• Obstetrics (extremely high yield):
  • High-risk pregnancy: Pre-eclampsia/Eclampsia (MgSO4 protocol, HELLP syndrome)
  • Antepartum hemorrhage (Placenta previa vs Abruption - every year)
  • Postpartum hemorrhage: Bakri balloon, Brace suture, uterotonics sequence
  • Labor: Cord prolapse management, McRoberts maneuver (shoulder dystocia)
  • CTG interpretation (fetal monitoring)
  • PROM vs PPROM management
• Gynaecology:
  • Contraception: OCPs (mechanism, contraindications), Cu-T, Implanon
  • Adenomyosis (MRI diagnosis), Endometriosis
  • Ovarian tumors (markers: CA-125, AFP, beta-hCG, LDH)
  • Premature ovarian insufficiency (↑FSH, ↓AMH)
  • Cervical cancer (HPV 16/18, staging, Pap smear)
  • Fibroid uterus (myomectomy vs hysterectomy indications)

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3. Surgery (~23 Q) - Clinical reasoning focus

• Thyroid: Papillary vs Follicular vs Medullary carcinoma, RET proto-oncogene, MEN syndromes
• Breast: Modified Halsted, sentinel node biopsy, BRCA mutations
• Hernias: Indirect vs Direct inguinal, femoral - boundaries, complications
• Acute abdomen: Appendicitis (Alvarado score), acute pancreatitis (Ranson's criteria, management)
• GI cancers: TNM staging, surgical margins, adjuvant therapy
• Shock: Types, management, CVP/PCWP values
• Burns: Rule of 9s, fluid resuscitation (Parkland formula), Curling's ulcer
• Trauma/Head injury: Diffuse axonal injury, extradural vs subdural hematoma (CT findings)
• Vascular: DVT (Wells score), varicose veins
• Post-operative complications: timing and types

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4. Community Medicine/PSM (~15-25 Q) - ~40% repeat rate

• Epidemiology: Incidence, prevalence, RR, OR, NNT calculations
• Screening tests: Sensitivity, specificity, PPV, NPV - must know how to calculate
• National Programs: NTEP (tuberculosis), NPCDCS, NHM, Ayushman Bharat PM-JAY
• Immunization schedule: EPI, cold chain, vaccines - storage temperatures
• Nutrition: PEM (Kwashiorkor vs Marasmus), vitamin deficiencies, ICDS
• Water/Air quality standards: BOD, MPN, chlorination
• Biostatistics: Types of studies, p-value, confidence intervals
• Occupational health: Silicosis, asbestosis, byssinosis, occupational exposures

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Tier 2 - High-Yield Foundation Subjects

5. Pathology (~14 Q)

• Inflammation: Granuloma types (caseating vs non-caseating, causes)
• Neoplasia: Tumor markers, hallmarks of cancer, oncogenes vs TSGs
• Hematology: Anemia classification, CML (Philadelphia chromosome), Hodgkin's vs NHL (RS cells)
• Renal: Nephrotic vs Nephritic syndrome, IgA nephropathy, FSGS
• Amyloidosis: Types (AL, AA, transthyretin), staining (Congo red - apple green birefringence)
• Coagulation disorders: Hemophilia, von Willebrand disease, DIC
• Cell injury: Apoptosis (caspases, Bcl-2), necrosis types

6. Pharmacology (~14 Q) - Drug of Choice is #1 ROI

• Antimicrobials: Spectrum, resistance mechanisms, drug-organism pairs
• Antiepileptics: Seizure-type matching (sodium valproate, levetiracetam in pregnancy)
• Antihypertensives: Comorbidity-based selection (ACEi in diabetic nephropathy, beta-blockers in HF)
• CYP450: Inducers (rifampicin, phenytoin, carbamazepine) vs Inhibitors (ketoconazole, erythromycin)
• Adverse Drug Reactions: Gray baby syndrome (chloramphenicol), SLE-like (hydralazine), ototoxicity (aminoglycosides), tendon rupture (fluoroquinolones)
• MOA: Beta-blockers, diuretics, antipsychotics (D2 blockade), SSRIs
• New drugs: Monoclonal antibodies (-mab suffix), biologics in RA/IBD

7. Microbiology (~12 Q)

• Bacteriology: Gram stain classification, culture media (selective, enriched), toxins
• Virology: Hepatitis (markers - HBsAg, HBeAg, anti-HBc IgM), HIV, TORCH infections
• Parasitology: Malaria (P. falciparum complications), Kala-azar, Amoebiasis, Hydatid cyst
• Immunology: Immunodeficiency syndromes (SCID, DiGeorge, Bruton's), complement pathways
• Mycology: Cryptococcus (India ink), Candida, Aspergillus
• PYQ repeat topics: Vitamin B12 deficiency + bacteria, TORCH infections, STDs (2024 paper)

8. Biochemistry (~13 Q)

• Metabolic pathways: Glycolysis, Krebs cycle, oxidative phosphorylation - key enzymes
• Enzyme deficiencies: G6PD deficiency, PKU, galactosemia, maple syrup urine disease
• Inborn errors of metabolism: Storage diseases (Gaucher's, Niemann-Pick, Tay-Sachs)
• Vitamins: Deficiency syndromes (B1-Beriberi, B3-Pellagra, B12-subacute combined degeneration)
• Molecular biology: PCR types, gel electrophoresis, DNA repair mechanisms
• Porphyria: Acute intermittent porphyria (AIP), lead poisoning

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Tier 3 - Support Subjects (Don't Ignore)

Anatomy (~9 Q)

• Nerve injuries: Radial nerve (wrist drop), Ulnar nerve (claw hand), Common peroneal (foot drop)
• Cranial nerves: Nuclei, course, clinical testing
• Embryology: Branchial arch derivatives, congenital defects
• Radiological anatomy (increasingly tested): Identify structures on X-ray/CT/MRI

Physiology (~7 Q)

• Cardiovascular: Cardiac cycle, JVP waveforms, Frank-Starling law
• Respiratory: Spirometry, V/Q mismatch, hypoxia types
• Acid-base: pH, HCO3, PaCO2 interpretation (ABG analysis)
• Endocrine: Feedback loops, receptor types

Forensic Medicine (~6 Q)

• Post-mortem changes: Rigor mortis, livor mortis - timing
• Wounds: Incised, lacerated, contused wounds - differences
• Poisons: Organophosphate (cholinergic crisis), arsenic, cyanide
• Legal: IPC sections relevant to medical practice, MLC

Ophthalmology (~6 Q)

• Glaucoma: Open vs Closed angle, drugs (timolol, pilocarpine, latanoprost)
• Retina: Diabetic retinopathy (dot-blot hemorrhages, neovascularization), retinal detachment
• Cataracts: Congenital types, age-related
• Image-based questions on fundoscopy are common

ENT (~5 Q)

• Otitis media: Acute vs Chronic (CSOM with cholesteatoma)
• Hearing loss: Conductive vs Sensorineural, Audiogram interpretation
• Rhinitis: Allergic rhinitis, polyps
• Larynx: Vocal cord palsy, laryngeal carcinoma

Orthopedics (~6 Q)

• Fractures: Colles', Pott's, hip fractures (neck of femur - blood supply)
• Spine: Chance fracture, PIVD
• Bone tumors: Osteosarcoma (sunray appearance), Ewing's (onion peel)
• Infections: Acute hematogenous osteomyelitis, septic arthritis

Pediatrics (~6 Q)

• Milestones: Fine motor, gross motor, language
• Nutrition: Breastfeeding, complementary feeding timings
• Neonatal emergencies: Jaundice (exchange transfusion threshold), RDS
• Vaccines (integration with PSM)
• Congenital heart disease (cyanotic vs acyanotic)

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Quick Revision - Absolute Must-Know Lists

Drugs of Choice (compile this list - highest single ROI)

CSF Findings (comes every year)

Classic Syndromes (image + recall)

• Horner's syndrome: Ptosis, miosis, anhidrosis (sympathetic chain lesion)
• Brown-Sequard: Ipsilateral motor + proprioception loss; Contralateral pain/temp loss
• Cauda equina: Saddle anesthesia, bladder/bowel dysfunction, LMN signs
• Marfan's: FBN1 gene, aortic dissection, ectopia lentis
• Cushing's disease vs syndrome distinction

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PYQ Trend Analysis - Repeating Themes (Every Year)

1. Bakri balloon / PPH management (OBG)
2. Ranson's criteria / Pancreatitis (Surgery)
3. Duke criteria / Infective endocarditis (Medicine)
4. CYP450 drug interactions (Pharmacology)
5. Sensitivity/Specificity calculations (PSM)
6. TORCH infections (Microbiology/Pediatrics)
7. Vitamin deficiency syndromes (Biochemistry)
8. Nerve injury identification (Anatomy)
9. Atypical fractures (Orthopedics)
10. National health programs (PSM)

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Preparation Strategy Summary

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Key insight for 2026: The paper is shifting toward integrated clinical reasoning - you need to know not just the diagnosis but also mechanism, investigation of choice, and first-line management together. Pure rote recall is no longer sufficient.