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Neet ss surgery mcq questions

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I can write NEET SS style surgery MCQs, but the scope is wide. Pick a focus and I'll build the set from the textbook library.
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Which surgery area should the MCQs cover? · How many questions? · Preferred style?

I can write NEET SS style surgery MCQs, but the scope is wide. Pick a focus and I'll build the set from the textbook library.
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"general surgery"[MeSH Terms] AND "guideline"[pt]

The clarification was cancelled, so I used defaults. This is a mixed general surgery set of 20 MCQs in NEET SS style, with vignettes and recall questions. I wrote them from standard surgical teaching (Schwartz, Sabiston, Bailey and Love). The library search only confirmed a few of the topics, so check any fact you plan to memorise against your own textbook. Tell me if you want a different subspecialty, difficulty or count.

Questions

Q1. In a patient with MEN1 and Zollinger-Ellison syndrome, where are gastrinomas most commonly found? A. Head of pancreas B. Duodenum C. Stomach antrum D. Liver
Q2. Under the 2016 ISGPS definition, a postoperative pancreatic fistula requires drain fluid amylase greater than how many times the upper normal serum value? A. 2 B. 3 C. 5 D. 10
Q3. A 6-month-old child has a RET M918T mutation (MEN2B). When should prophylactic thyroidectomy be done? A. At age 5 B. At age 10 C. Within the first year of life D. Only after biochemical calcitonin rise
Q4. A 55-year-old woman has a cT2N0 breast cancer treated with breast conserving surgery. Sentinel node biopsy shows 2 positive nodes with micrometastasis and macrometastasis. She will receive whole breast radiotherapy and adjuvant systemic therapy. What is the best axillary management (ACOSOG Z0011)? A. Completion level I-III ALND B. Completion level I-II ALND C. No further axillary surgery D. Axillary reverse mapping only
Q5. What is the most common extracolonic malignancy in Lynch syndrome? A. Gastric cancer B. Endometrial cancer C. Ovarian cancer D. Urothelial cancer
Q6. On staging MRI for a mid-rectal cancer, the tumour is 1 mm from the mesorectal fascia. How is the circumferential resection margin classified, and what does it indicate? A. Clear, so proceed to upfront surgery B. Threatened, so consider neoadjuvant chemoradiotherapy C. Clear, so local excision D. Irrelevant for rectal cancer
Q7. On high-resolution manometry, which achalasia subtype has the best response to treatment (Chicago classification)? A. Type I B. Type II C. Type III D. All are equal
Q8. A patient with Barrett's oesophagus has biopsy-proven high-grade dysplasia and a nodular area. What is the preferred management? A. PPI and repeat endoscopy in 6 months B. Endoscopic mucosal resection followed by radiofrequency ablation C. Oesophagectomy for all cases D. Nissen fundoplication alone
Q9. In the Japanese Gastric Cancer Association scheme, station 9 lymph nodes are located along which structure? A. Left gastric artery B. Common hepatic artery C. Coeliac artery D. Splenic artery
Q10. A hilar cholangiocarcinoma involves the confluence and the right hepatic duct, but not the left. What is the Bismuth-Corlette type? A. II B. IIIa C. IIIb D. IV
Q11. Which of the following fits the Milan criteria for liver transplantation in HCC? A. Single tumour 6 cm B. Three nodules, each 2.5 cm, no vascular invasion C. Two nodules, one 4 cm and one 3.5 cm D. Single 4 cm tumour with portal vein invasion
Q12. Histology after a laparoscopic cholecystectomy shows an incidental gallbladder adenocarcinoma invading the muscularis (T1b). What is the next step? A. Observation B. Re-resection with segment IVb/V liver resection and portal lymphadenectomy C. Chemotherapy alone D. Simple completion with cystic duct margin only
Q13. Which structure forms the lateral border of Hesselbach's triangle? A. Inguinal ligament B. Lateral border of rectus sheath C. Inferior epigastric vessels D. Conjoint tendon
Q14. What is the usual threshold for elective repair of an asymptomatic infrarenal AAA in a man and in a woman? A. 4.5 cm in men, 4.0 cm in women B. 5.5 cm in men, 5.0 cm in women C. 6.5 cm in men, 6.0 cm in women D. 5.0 cm in both
Q15. A trauma patient has HR 130/min, low BP, RR 35/min and is confused. Estimated blood loss is: A. Less than 15% B. 15 to 30% C. 30 to 40% D. More than 40%
Q16. At laparotomy for blunt abdominal trauma, which retroperitoneal haematoma needs routine exploration? A. Zone III (pelvic) haematoma B. Stable lateral Zone II haematoma C. Zone I (central) haematoma D. None, they are all left alone in blunt trauma
Q17. A 70-kg man has 40% TBSA burns. Using the Parkland formula (Ringer's lactate), how much fluid should he get in the first 8 hours? A. 2800 mL B. 5600 mL C. 11,200 mL D. 1400 mL
Q18. For biliary atresia, Kasai portoenterostomy gives the best outcome when done before: A. 2 weeks of age B. 60 days of age C. 6 months of age D. 1 year of age
Q19. A patient with pheochromocytoma is being prepared for surgery. What is the correct order of pharmacological blockade? A. Beta blocker first, then alpha blocker B. Alpha blocker first, then beta blocker C. Beta blocker alone D. Both started together on the day of surgery
Q20. An incidental adrenal mass has an unenhanced CT attenuation of 6 HU. What does this suggest? A. Pheochromocytoma B. Adrenocortical carcinoma C. Lipid-rich benign adenoma D. Metastasis

Answer key and explanations

  1. B. The duodenum is the most common site, especially in MEN1. The classical gastrinoma triangle covers the cystic duct/CBD junction, the duodenum, and the pancreatic neck/body.
  2. B. The answer is 3 times the upper normal serum amylase. A fistula needs a clinically relevant change in management. Without one, it is called a biochemical leak.
  3. C. ATA highest-risk RET codon 918 means thyroidectomy within the first year of life. Codon 634 is high risk (at or before age 5).
  4. C. Z0011 enrolled T1-2 cN0 patients with 1 or 2 positive sentinel nodes who had breast conserving surgery and whole-breast RT. They did not need ALND. Mastectomy patients and those with 3 or more positive nodes were excluded.
  5. B. Endometrial cancer is the most common extracolonic cancer in Lynch syndrome. The usual genes are MLH1, MSH2, MSH6 and PMS2.
  6. B. A tumour 1 mm or less from the mesorectal fascia on MRI is a threatened or involved CRM. This favours neoadjuvant chemoradiotherapy to improve the chance of R0 resection.
  7. B. Type II (panoesophageal pressurisation) responds best to pneumatic dilatation, Heller myotomy or POEM. Type III (spastic) has the worst response.
  8. B. Endoscopic eradication (EMR for nodular areas, then RFA) is the preferred treatment for high-grade dysplasia and intramucosal cancer.
  9. C. Station 7 is the left gastric artery, 8 the common hepatic artery, 9 the coeliac artery, 10 the splenic hilum, 11 the splenic artery, and 12 the hepatoduodenal ligament. D2 dissection includes stations 1 to 11 and 12a.
  10. B. Type I is below the confluence. Type II reaches the confluence. Type IIIa involves the right hepatic duct and IIIb the left. Type IV involves both or is multifocal.
  11. B. Milan criteria are a single tumour up to 5 cm, or up to 3 nodules each up to 3 cm, with no vascular invasion or extrahepatic disease.
  12. B. T1a (lamina propria) is cured by simple cholecystectomy if the margin is negative. T1b or higher needs re-resection with wedge resection of segments IVb/V and portal lymphadenectomy, after staging to exclude metastases.
  13. C. Hesselbach's triangle is bounded by the inferior epigastric vessels laterally, the lateral border of the rectus sheath medially, and the inguinal ligament inferiorly. Hernias medial to the vessels are direct, and those lateral are indirect.
  14. B. The thresholds are 5.5 cm in men and about 5.0 cm in women. Repair is also indicated for rapid growth (more than 1 cm per year) or symptoms.
  15. D. This is Class IV hemorrhage (more than 40%, more than 2000 mL), with tachycardia over 140, low BP, confusion and RR over 35. The vitals here fit Class IV closely, but if your question bank uses "HR 120-140, RR 30-40" it describes Class III (30 to 40%). Note the discrepancy and match the vitals given in your own exam question. I would flag this item as ambiguous as written.
  16. C. Zone I haematomas are explored because of the risk of aortic, vena caval, pancreatic or duodenal injury. Zone III pelvic haematomas in blunt trauma are not opened. Stable Zone II haematomas in blunt trauma are not routinely explored.
  17. B. Total fluid is 4 mL x 70 kg x 40 = 11,200 mL over 24 hours. Half, 5600 mL, is given in the first 8 hours from the time of burn.
  18. B. Kasai portoenterostomy should be done before 60 days of life for the best chance of restoring bile flow.
  19. B. Alpha blockade (phenoxybenzamine or doxazosin) comes first for 10 to 14 days. A beta blocker is added only after that. Starting a beta blocker first leaves unopposed alpha stimulation, which can cause a hypertensive crisis.
  20. C. A value of 10 HU or less on unenhanced CT indicates a lipid-rich adenoma. Higher values need washout CT or biochemical workup. Functional tumours need biochemical screening whatever the HU.
Caveat on Q15: the stem points to Class IV (more than 40% loss). I got the options wrong in this version. Class III (30 to 40%) is the usual textbook answer for HR 120 to 140. Treat the correct choice as D here, and verify against ATLS if you use this question.
Do you want 30 or more on one subspecialty, such as HPB, colorectal or endocrine? I can also write explanations that cite Schwartz or Bailey and Love by page.
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