NEET-PG 2018 - Surgery PYQs Practice Questions

Q: Which is the most common site of peripheral aneurysm?

B. ***Option B*** - This image points to the **popliteal artery**, which is the most common site for **peripheral aneurysms**. - **Popliteal artery aneurysms** account for approximately 70% of all peripheral aneurysms and are more common in men. *Option A* - This image points to the **brachial artery** in the upper arm, which is a less common site for aneurysms. - While aneurysms can occur here, they are not as frequent as in the popliteal artery. *Option C* - This image points to the **femoral artery** in the groin region. - Although the femoral artery can be affected by aneurysms, they are less common than popliteal artery aneurysms. *Option D* - This image points to the **tibial arteries** in the lower leg. - Aneurysms in the tibial arteries are rare and typically much less common than those in the popliteal artery. *Option E* - This image points to the **radial artery** in the forearm. - Radial artery aneurysms are very rare and usually occur secondary to trauma or iatrogenic injury, not spontaneously like popliteal aneurysms. [Practice more Surgery PYQs on OnCourse]

Q: In the MRI breast shown below, 4 cm mass is present with no nodal metastasis. Which is the stage of breast cancer?

Stage II. ***Stage II*** - A tumor of **4 cm** with no nodal metastasis is classified as pT2, N0, M0. This falls under **Stage IIA** breast cancer according to the TNM staging system. - Stage II breast cancer typically includes tumors that are larger than 2 cm but not larger than 5 cm (T2N0), or smaller tumors with lymph node involvement. - The **4 cm size with N0 status** specifically defines Stage IIA. *Stage 0* - Stage 0 represents **ductal carcinoma in situ (DCIS)** or **lobular carcinoma in situ (LCIS)**, which are non-invasive breast cancers. - This case describes a **4 cm mass**, indicating an invasive tumor, not in-situ disease, ruling out Stage 0. *Stage I* - Stage I breast cancer includes tumors that are **2 cm or smaller** (T1) and have no lymph node involvement (N0). - Since the mass is **4 cm**, it exceeds the size criteria for Stage I. *Stage III* - Stage III breast cancer involves **larger tumors** (greater than 5 cm) or any tumor size with extensive lymph node involvement, or tumors invading the chest wall/skin. - While this mass is 4 cm, there is **no nodal metastasis**, which rules out Stage III. *Stage IV* - Stage IV breast cancer indicates the presence of **distant metastases** (M1), meaning the cancer has spread to other parts of the body. - The information provided clearly states **no nodal metastasis**, and no information about distant spread, therefore Stage IV is incorrect. [Practice more Surgery PYQs on OnCourse]

Q: Which of the following is not an indication for surgery in the condition shown below?

Patient's decision. ***Patient's decision*** - While patient preferences are crucial in medical decision-making, simply the **patient's decision alone is not a primary medical indication for surgery** in the absence of other objective criteria for a fibroadenoma. - Surgery for **fibroadenoma** is typically guided by clinical and radiological findings, not solely by patient request. *Size more than 5 cm* - A **fibroadenoma** with a size of **more than 5 cm** is generally considered a strong indication for surgical excision. - Large fibroadenomas can cause **cosmetic distortion**, discomfort, and may be harder to distinguish from malignant lesions, especially if they show rapid growth. *Complex type* - **Complex fibroadenomas** have features such as **cysts larger than 3 mm**, sclerosing adenosis, epithelial calcifications, or papillary apocrine metaplasia. - These features are associated with a slightly **increased risk of future breast cancer** and are often considered an indication for excision to rule out malignancy and for risk reduction. *Recurrence* - If a **fibroadenoma recurs** after previous excision, particularly if it grows rapidly or shows atypical features, surgical removal is indicated. - **Recurrence** suggests a persistent or potentially more aggressive benign process that warrants further investigation and management. *Rapid increase in size* - A **rapid increase in size** of a fibroadenoma is a clear indication for surgical excision. - Rapid growth raises concern for **phyllodes tumor** or other potentially aggressive lesions and warrants histopathological examination. - Serial measurements showing significant growth over a short period (typically doubling in size over 3-6 months) indicate the need for surgical intervention. [Practice more Surgery PYQs on OnCourse]

Q: Which subtype of gastric ulcer is shown in the image?

Lesser curvature at incisura. ***Lesser curvature at incisura*** - The image clearly labels the **incisura angularis (Incision)**, which is a notch on the lesser curvature of the stomach. Gastric ulcers frequently occur at this location. - Ulcers at the incisura are often associated with **Type I gastric ulcers**, which are typically found on the lesser curvature. *High on lesser curvature* - While ulcers can occur high on the lesser curvature (Type II or III, depending on whether there's an associated duodenal ulcer), the label in the image specifically points to the **incisura**. - High lesser curvature ulcers are distinct from those precisely at the incisura, which is a more distal point on the lesser curvature. *Greater curvature* - Ulcers on the **greater curvature** are relatively rare and often raise suspicion for malignancy. - The image explicitly shows a potential ulcer location along the lesser curvature, not the greater curvature. *Pre-pyloric* - **Pre-pyloric ulcers** are located in the region immediately before the pylorus, in the antrum. - The label in the image is proximal to the pylorus, but specifically points to the incisura, which is generally considered part of the gastric body/antrum junction rather than solely pre-pyloric. *Cardia* - **Type IV gastric ulcers** occur at the cardia, near the gastroesophageal junction. - The image shows the incisura angularis on the lesser curvature, which is significantly distal to the cardia. [Practice more Surgery PYQs on OnCourse]

Question 1

Which is the most common site of peripheral aneurysm?

Accepted Answer

B

Answer

A

Answer

C

Answer

D

Answer

E

Question 2

In the MRI breast shown below, 4 cm mass is present with no nodal metastasis. Which is the stage of breast cancer?

Accepted Answer

Stage II

Answer

Stage I

Answer

Stage III

Answer

Stage IV

Answer

Stage 0

Question 3

A 9-month-old child presents with excessive cry and presentation shown below. On examination right iliac fossa sausage shaped lump is felt. What is the best treatment?

Accepted Answer

IVF- Antibiotic-Air enema

Answer

IVF- Antibiotic- NG tube

Answer

IVF-Antibiotics- Barium enema

Answer

IVF- Antibiotics-Warm saline enema

Answer

IVF- Antibiotics- Laparotomy

Question 4

Which of the following is not an indication for surgery in the condition shown below?

Accepted Answer

Patient's decision

Answer

Size more than 5 cm

Answer

Complex type

Answer

Recurrence

Answer

Rapid increase in size

Question 5

Which subtype of gastric ulcer is shown in the image?

Accepted Answer

Lesser curvature at incisura

Answer

High on lesser curvature

Answer

Greater curvature

Answer

Pre-pyloric

Answer

Cardia

Question 6

Which is correct about tumor found in the triangle location shown below?

Accepted Answer

Associated with MEN1

Answer

Most common site is stomach

Answer

Best test for diagnosis is pentagastrin test

Answer

Metastasis to adjacent gut

Answer

Primary treatment is medical with proton pump inhibitors

Question 7

This 1-day-old neonate presents with bilious vomiting and progressive abdominal distension. Antenatal ultrasound reveals echogenic bowel in fetus. Barium enema findings are shown. What is likely diagnosis?

Accepted Answer

Cystic fibrosis

Answer

Duodenal atresia

Answer

Hirschsprung disease

Answer

Gastroenteritis

Answer

Meconium plug syndrome

Question 8

Based on the image shown, a patient has been diagnosed with a gastric ulcer. According to the Modified Johnson classification, what type of gastric ulcer is present?

Accepted Answer

Type 1

Answer

Type 2

Answer

Type 3

Answer

Type 4

Answer

Type 5

NEET-PG 2018 — Surgery