Surgical NEET SS Exam Preparation and Books

Pattern of Surgical NEET SS Exam 

  1. You can choose a maximum of two super speciality courses for which your broad specialty qualification is eligible.
  2. 40% of the questions shall be from General Surgery and the remaining 60% shall be from the super specialty course selected.

Facebook Group for Surgery NEET SS Aspirants

Following is the link for facebook group for Surgery NEET SS Aspirants. In this group we can discuss and share knowledge and facts related to Surgery NEET SS preparation. Best books to study, important topics and discussion of MCQs and much more.

Books for preparation for General Surgery NEET SS (40% Questions)

Surgery Essence 7th Edition 2019 By Pritesh Singh





Dorsal Root Ganglion Anatomy
Dorsal Root Ganglion (Malanowski et al)





Lesion in Dorsal root ganglion of a spinal nerve in the neck is most likely to lead to what type of loss?

A. Sensory
B. Motor
C. Sympathetic
D. Parasympathetic
E. All of the above

Explanation:


The functions of dorsal root ganglia are all associated with the perception of sensations. These include:


  • Nociception
  • Perception of mechanical stimulus upon compression
  • First processing center of the sensory information
  • Role in reflex action


The clinical significance of dorsal root ganglion includes the treatment of chronic pain according to the gate-therapy or via complete resection of the ganglion. The ganglion also serves as a source or reservoir of several viruses such as herpes simplex virus.


References:

https://human-memory.net/dorsal-root-ganglion/

Malinowski M.N., Bremer N.J., Kim C.H. (2019) Dorsal Root Ganglion Stimulation. In: Abd-Elsayed A. (eds) Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-99124-5_189


Cerebral Localization: Definition


1. "Mapping of the cerebral cortex into areas, and the correlation of these areas with cerebral function"

2. "Diagnosis of the location of a brain lesion in the cerebrum, done either by
       Signs and symptoms manifested
                              or
       Using any investigation modality"


History of Cerebral Localization


History of Cerebral Localization

History of Cerebral Localization

There are various informal and online MRCS courses which are being run by various successful candidates which are easy on pocket and promise to provide all the reading material and guidance to the candidates who join. We will be posting useful links and courses which are usually not advertised  so that those preparing for MRCS can benefit. Please choose the courses carefully at your own discretion.

Course 1

Source:
https://m.facebook.com/story.php?story_fbid=509416652979128&id=192474441340019

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• Full online emrcs
• Full online pastest
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• All lectures available permanently via zoom links
• Full Surgery Specialities iFile Lectures made for Paper 2 strengthening
• All Recalls finally and fully answered correctly
• Full guide from 20/12
till January exam day

The Course Fees include

• Online emrcs
• Online pastest
• Organised Daily Plan of Question Posting that force you into our day one to exam day - schedule

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• Full MRCS Part A Materials

• The Crash Courserevisiont that involves

1 - Daily Homework for our theory study from MRCSME Book

2 -iFiles - Strengthening your paper two weakness with our selected questions made in pdf files scenarios from highly yielding MRCS Books

3 - iMocks - the most repeated exam questions

4 - iRecalls - previous real solved exams
will be done Online On Zoom Cloud meetings including :

* January 2019
* September 2019
* April 2019
* January 2019
* September 2018
* April 2018
( surprise - scanned complete real exam)
* January 2018
* September 2017
* April 2017
* January 2017
* September 2016
* April 2016
* January 2016

Our Supreme Revision will raise your pass mark by 15% ;
You can check our January Candidates Scores

Answers to FAQs

You can join from now
You will be added to our Course group
You will have all drive materials
You need just 4 hours daily
Our new Course Features allow you to attend every day session once you are free. We start 5 pm GMT but we have above 250 Surgeons in our Course ; no one can collect five Surgeons in one place for 4 hours...therefore all Course live discussions and sessions are permanently available once you are free from your list, clinic our hospital.

Course starts in 20/12
And booking started from 1/11




Course 2

Source :
 https://www.facebook.com/groups/1171998452846874/permalink/2750847058295331/



JOIN TO PASS THE APRIL'20 PART A EXAM

We have successfully completed the MRCS Part A Jan'20 exam preparation With our exclusive brand new 7. edition study materials Our Most Popular Ensure Pass Course Group - April'2020 Part A Exam is running now.

Doctors joining in this group will be in an structured study plan to complete and revise all study modules by 2020 March, before Revision Tests and Final Mock Exams starts.


Enquiry of Course Groups, Enrolment Procedure, Sample Materials — April'2019 "Ensure Pass" Course Groups

mrcsauk@yahoo.com


Enquiry of Part B OSCE "Ensure Success Group" and Materials for 2020 sessions with the upcoming exam system changes !!!

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MRCS Online Course by Nasa Khan (www.facebook.com/mrcsoc) Please Explore The Group More, By Visiting Our Face Book Page





History Taking in Neurosurgery : Headache

What are the pain sensitive intracranial structures?

Brain itself is pain insensitive. 

The following intracranial structures are pain-sensitive:
  1. Meningeal arteries
  2. Proximal portions of the cerebral arteries
  3. Dura at the base of the brain
  4. Venous sinuses
  5. Cranial nerves 5, 7, 9, and 10, and cervical nerves 1, 2, and 3

What are the mechanisms causing headaches?

  • Distortion or traction of Dura, Venous Sinuses or Blood vessels: 

    • Drainage of CSF in erect posture causes headache, secondary to traction on the venous sinuses when the brain sinks toward the tentorium as it loses CSF flotation
    • Intracranial mass distorts the dura or the arteries at the base of the brain 
    • Distortion due to raised ICP 

  • Distension of a vessel

    • Distension of extracranial and occasionally intracranial arteries is thought to be the cause of pain in migraine (activate the trigeminal nerve terminals in the vessel wall)

  • Inflammation

    • Inflammation in the subarachnoid space can result in headache. Inflammation can be caused by infection, hemorrhage, or chemical irritation
    • Inflammation of vessel wall by autoimmune process. eg Giant cell arteritis

  • Referral of Pain

    • Lesions above the tentorium - referred pain in trigeminal nerve distribution (the forehead or behind the eye) - because the dura in this region is supplied by the trigeminal nerve
    • Lesions in the posterior fossa
      • referred pain in the ear and the back of the head - because this part of the dura is supplied by cranial nerves 9 and 10 and the upper three cervical roots
      • refer pain to orbit -  termination of orbital (ophthalmic division) pain nerve fibers in the lowest part of the spinal nucleus of the trigeminal nerve, which also receive termination of the upper cervical pain afferent nerve fibers 
      • referred pain to ear - Irritation of cranial nerves 7, 9, and 10 - because the ear has cutaneous supply from each of these nerves as well as cranial nerve 5.

What are the types of Headaches?

For the purpose of history taking, headaches can be divided into two types:
  • Primary- no identifiable cause on examination or investigation and diagnosis is based on  recognizing a pattern, e.g.
    • Migraine
    • Cluster headache
    • Tension-type headache
  • Secondary - definite identifiable cause on examination or investigation, e.g. 
    • Brain tumors
    • Meningitis
    • Sub-arachnoid hemorrhage 
  • 90% - primary headaches, less than 10% are secondary headaches (Rasmussen 1991)

What are the headache "Red Flags"?

  • Worst Headache ever
  • New onset Headache
  • Onset after age of 50 yrs
  • Change in pattern of headache
  • Worsening headache
  • Sudden onset during exertion, sneezing, coughing
  • Headache with postural variation
  • Headache in setting of malignancy or HIV
  • Headache associated with Neurological symptoms or signs
  • Associated with systemic symptoms - fever, weight loss and chronic cough

What history to take in a patient presenting with Headache?


Duration
Exact duration as reported by patient
NEW onset headache or something that has been there since before and has worsened now

Onset ( sudden/ gradual )
Acute onset, severe, first and worst headache, the common possibilities are sub-arachnoid hemorrhage, vascular dissection, pituitary apoplexy
Gradual onset – migraine(mins to days), SDH, GCA(days to months)

Severity
verbal rating scale from 0 to 10

Character
Pulsatile or throbbing or hammering (Raised ICP Headaches/ Migraine)
Dull featureless pain (Tension type headache)
Boring sharp- cluster HA

Time of occurrence
Raised ICP headaches - More in morning, May waken the patient at an early hour

Frequency
Increase in frequency - red flag

Distribution
Frontal or Holocranial - Raised ICP
Band like - tension headaache


Aggravating factors
Exertion, coughing, sneezing, stooping, and straining at stool
Changes in posture (increases in supine - ↑ICP , increases in upright – low CSF pressure headache)

Relieving factors
Improvement on lying flat - low pressure headache

Associated features
Blurring of Vision - Papilloedema
Diplopia, the commonest cause of which is abducens nerve paresis
Nausea & vomiting – migraine, ↑ICP
Neck stiffness – meningeal process
Changes in consciousness
Focal neurological symptoms


References


Introducing surgery MCQs in cram sheet format to get the most out of your limited time online. Will be adding more MCQs patterned for MRCS Part A, NEET SS, DNB CET SS exams.



1.In blast injury, which of the following organ is least vulnerable to blast wave?

a) GIT
b) Lungs
c) Ear drum
d) Liver
b: Liver
Primary injuries are caused by blast shockwaves. The ear drums are most often affected by the blast wave, followed by the lungs and the hollow organs of the gastrointestinal tract.
2.On mammogram all of the following are the features of a malignant tumor except:

a) Spiculation
b) Micro-calcification
c) Macro-calcification
d) Irregular mass
c. Macro-Calcification
Micro-calcifications may be associated with cancer.
Macro calcification may be caused by aging or by a benign condition such as fibro-adenoma, a common noncancerous tumor of the breast.
Distorted areas suggest tumors that may have invaded neighbouring tissues
3.A 40 year old patient is suffering from carotid body tumor. Which of the following is the best choice of treatment for him?

a) Excision of tumor
b) Radiotherapy
c) Chemotherapy
d) Carotid artery ligation both proximal and distal to the tumor
a. Excision of tumor
Surgical excision is the treatment of choice. The larger the tumor the higher is the risk of operative complication
4.The diagnosis of congenital mega-colon is confirmed by
a) Clinical features
b) Barium enema
c) Rectal biopsy
d) Recto-sigmoidoscopy
c. Rectal biopsy
In Hirschsprug’s disease, the migration is not complete and part of the colon lacks these nerve bodies that regulate the activity of the colon. The suction rectal biopsy is considered the current international gold standard
5.Which of the following renal calculi are most difficult to treat with lithotripsy?

a) Uric acid stones
b) Cystine stones
c) Calcium oxalate stones
d) Triple phosphate stones
b. Cystine stones
ESWL does not successfully treat Cystine kidney stones
6.Most common site of spinal cord tumour is:

a) Intra-dural extra-medullary
b) Extra-dural
c) Intra-medullary
d) Equally distributed
b. Extra-dural
Spinal tumors are neoplasms located in the spinal cord. Extra-dural tumors are more common than intra-dural neoplasms.
Extra-dural tumors are mostly metastases from primary cancers elsewhere (commonly breast, prostate and lung cancer).
7.Most common cause of liver abscess in chronic granulomatous disease:
a. Klebsiella
b. Staph. aureus
c. Peptostreptococcus
d. E. coli



b. Staph. Aureus
Staphylococcus is most common.
Occurs in the setting of chronic granulomatous diseaseQ, disorder of granulocyte function and hematologic malignancies.

8.Choledochocoele is which type as per Todani classification:
a. Type 2
b. Type 3
c. Type 4
d. Type 5



b. Type 3
Type 1: Solitary Extrahepatic fusiform in shape
Type 2: Extrahepatic supraduodenal diverticulum
Type 3: Choledochocoele
Type 4: Extra and Intrahepatic/ Multiple Extrahepatic
Type 5: Multiple Intrahepatic




9.A patient with obstructive jaundice bilirubin level of 40 mg/dl, the possible explanation is
a) Malignancy of gall bladder
b) Concomitant renal failure
c) Chronic cholecystitis
d) Complete obstruction of common bile duct
b) Concomitant renal failure

In presence of complete biliary obstruction, serum bilirubin levels generally plateau at 25 to 30 mg/dl.
At this level, daily bilirubin load equals that excreted by kidneys,
Situation in which even higher bilirubin levels can be found include renal insufficiency, hemolysis and hepato-biliary disease.



10.TRUE about neurogenic shock
a) Cold and moist extremity
b) Tachycardia
c) Due to parasympathetic cut-off
d) Diagnosis of exclusion



d) Diagnosis of exclusion

Following are features of neurogenic shock which you should remember:
· Due to sudden loss of autonomic tone
· Disruption of descending sympathetic pathway
· Patient has bradycardia
· Extremities are warm