NEET Pattern Questions

Site of Insulinoma

by
Premium MCQ - Insulinoma Site
Q) Most common site of insulinoma is
a) Head of Pancreas
b) Body of Pancreas
c) Tail of Pancreas
d) All equal

Endovenous Laser Ablation of varicose veins

by

Q) Endovenous Laser Ablation (EVLA) of varicose veins is best suited for patients:

A. With needle phobia
B. With thrombophlebitis
C. With excessive tortuosity of the vein
D. With primary varicose veins

Ans d

EVLA is thermal ablation of varicose veins in which laser  fiber is inserted in the lumen and ablation is done from inside. It is a good modality for primary and recurrent varicose veins and work in both long and short segments.

This treatment is not effective in cases where there is needle phobia or the veins are having excessive tortuousity or thrombophlebitis. This procedure is done under ultrasound guidance and  wire is passed from the superficial to the deep veins.

Tumescent means swollen or distended, typically due to the infiltration of fluid.

  • It refers to the injection of a large volume of dilute local anesthetic solution (usually lidocaine with epinephrine and saline) into subcutaneous tissue.

  • This causes the tissue to swell or become turgid (tumescent).

In procedures like endovenous thermal ablation:

Tumescent solution:

  • Compresses the vein to improve contact with the ablation device.

  • Separates the vein from surrounding structures (like nerves or skin).

  • Acts as a thermal insulator (heat sink) to prevent collateral damage.

Tumescent local anesthesia also helps

  • A. Needle phobia – EVLA requires multiple needle sticks (tumescent anesthesia), making this option inappropriate.

  • B. Thrombophlebitis – Active inflammation or thrombosis is a relative contraindication to EVLA.

  • C. Excess tortuosity – Makes catheter navigation difficult; EVLA is less suitable.

  • D. Primary varicose veins – Ideal candidates, especially with straight vein anatomy and valvular incompetence.

 

Ductal carcinoma in situ

by

RTOG 9804 Trial MCQ – Good-Risk DCIS Criteria

📘 Theme: Breast Surgery – DCIS (NEET SS / MCh / FMAS High Yield)

Clinical Breast Surgery MCQ

According to the RTOG 9804 trial, which of the following criteria defined a favourable (good-risk) ductal carcinoma in situ (DCIS)?

A. Less than 3.5 cm in size with a 2 mm free resection margin
B. Less than 2.5 cm in size with a 2 mm free resection margin
C. Less than 3 cm in size with a 3 mm free resection margin
D. Less than 2.5 cm in size with a 3 mm free resection margin

Answer: D. Less than 2.5 cm in size with a 3 mm free resection margin

Explanation

The RTOG 9804 trial evaluated radiotherapy in patients with good-risk DCIS treated with breast-conserving surgery. Eligible patients had low- or intermediate-grade DCIS measuring ≤2.5 cm with surgical margins of at least 3 mm. These criteria were used to define favourable DCIS.

Why other options are incorrect

  • A: Tumour size criterion was not 3.5 cm.
  • B: A 2 mm margin did not meet the RTOG 9804 eligibility requirement.
  • C: The size cutoff was ≤2.5 cm, not 3 cm.

High-yield teaching points

  • RTOG 9804 enrolled patients with "good-risk" DCIS.
  • Eligibility required DCIS ≤2.5 cm and margins ≥3 mm.
  • The study demonstrated a reduction in ipsilateral breast recurrence with radiotherapy.
  • RTOG 9804 is frequently cited when discussing omission of radiotherapy in selected low-risk DCIS patients.

Practice More Surgery MCQs

Atrial Septal Defect

by
Most Common Type of ASD MCQ for NEET SS | mcqsurgery.com

Most common type of atrial septal defect (ASD) is:

Correct Answer

B) Ostium secundum

Explanation

Atrial septal defects are classified according to their anatomical location within the atrial septum.

  • Ostium secundum ASD:
    Located at the region of the fossa ovalis. It accounts for approximately 70–75% of all atrial septal defects, making it the most common type.
  • Ostium primum ASD:
    Less common. Typically associated with atrioventricular septal defects and endocardial cushion defects.
  • Sinus venosus ASD:
    Relatively rare. Commonly associated with partial anomalous pulmonary venous return.
  • Comparison:
    Since ostium secundum defects are far more frequent than other types, option (D) is incorrect.

Teaching Points

  • Ostium secundum ASD is the most common type (≈70–75%)
  • Located at the fossa ovalis
  • Ostium primum ASD is associated with AV canal defects
  • Sinus venosus ASD is commonly associated with anomalous pulmonary venous return
  • Fixed split S2 is a classic clinical finding in ASD
Free Questions Mock Tests Join Premium Surgery Course