Mastering Surgery for NEET-PG and INI-CET in Just 6 Days

Mastering Surgery for NEET-PG and INI-CET in Just 6 Days

Daily Targets

  • Read/Revise 7.5–8.5 h/day (60–75 min blocks + 10–15 min breaks).
  • Solve 150–180 MCQs/day; keep an error log; write one rule learned per error.
  • Build mini‑cards (algorithms, staging/score grids, first steps, complications).
  • End with a 20‑min Rapid Recap (bleed/perf/obstruction algorithms; staging/score gists; trauma priorities).

Day 1 — Esophagus • Stomach • Duodenum • UGIB • Bariatric (Snapshot)

Esophagus — Topics & Subtopics

  • Anatomy/physiology: UES/LES, peristalsis; blood supply; lymphatics; physiologic narrowings.
  • Diagnostics: OGD; barium swallow (achalasia, webs/rings); HRM (Chicago); 24‑h pH‑impedance; CT/PET‑CT; EUS for T stage.
  • Motility disorders: Achalasia (types I–III; PBD vs Heller vs POEM; post‑op reflux); DES; jackhammer; scleroderma esophagus.
  • GERD & Barrett: typical vs alarm features; PPI trial; indications for anti‑reflux surgery; Barrett surveillance; dysplasia/early neoplasia overview.
  • Inflammation/injury: reflux esophagitis grades; caustic ingestion (Zargar; timing for scope; stricture prevention); pill esophagitis; eosinophilic esophagitis snapshot.
  • Structural lesions: webs/rings (Plummer–Vinson, Schatzki); benign strictures (peptic/caustic); diverticula (Zenker, mid‑esophageal, epiphrenic)—myotomy/diverticulectomy concepts.
  • Perforation/trauma: Boerhaave vs Mallory–Weiss; iatrogenic; mediastinitis; stent/repair/drain principles.
  • Malignancy: SCC vs adenocarcinoma (risk/location); TNM gist; neoadjuvant chemoradiation; esophagectomy conduits (stomach/colon) & anastomosis.

Stomach & Duodenum — Topics & Subtopics

  • Anatomy/physiology: blood supply; lymphatic basins (D1/D2); acid/pepsin physiology; gastric emptying.
  • Peptic ulcer disease: H. pylori concept; NSAIDs; complications—UGIB (Forrest with endotherapy options), perforation (free air; Graham patch), gastric outlet obstruction (balloon vs surgery).
  • Benign: polyps (fundic gland vs adenomatous), bezoars, GAVE.
  • Gastric cancer: Lauren (intestinal vs diffuse), linitis; early gastric ca endoscopic vs surgical options; staging (EUS/CT); margins; D‑station idea; peri‑op chemo.
  • GIST: KIT/PDGFRA idea; indications for wedge; avoid rupture; TKI concept.
  • Duodenum: posterior DU bleed vs anterior perforation; periampullary region awareness; congenital anomalies (annular pancreas, atresia—snapshot).

Upper GI Bleed (non‑variceal focus)

  • Resuscitation: ABCs; restrictive transfusion; correct coagulopathy.
  • Risk tools: Blatchford, Rockall (gist); endotherapy (clip/thermal/injection); when to surgery/IR.
  • Variceal vs non‑variceal—first steps (awareness only; details in HPB/portal HTN on Day 3).

Bariatric (Snapshot)

  • Indications; procedures (SG/RYGB); early/late complications (leak/bleed/stricture; nutritional issues).

Day‑1 MCQs: Achalasia best test/therapy; Boerhaave imaging; Forrest next‑step; PUD perf bundle; Lauren vs GIST rules; UGIB escalation threshold.

Day 2 — Small Bowel • Colon • Rectum/Anus • Hernia • Acute Abdomen

Small Bowel — Topics & Subtopics

  • Anatomy: mesentery, arcades, lymphatics; Peyer patches.
  • SBO/ileus: adhesions/hernia; closed‑loop/strangulation signs; CT transition point; conservative vs OR triggers.
  • Meckel: rule of 2s; ectopic mucosa; bleeding; Meckel scan; indications for resection.
  • Inflammatory/Infective: Crohn (stricture/fistula/abscess; limited resections; short‑gut risk); ileocecal TB mimic; radiation enteritis; typhoid perforation.
  • Ischemia: acute (embolic/thrombotic/NOMI) & chronic; CTA; revascularisation/debridement.
  • Neoplasms: adenocarcinoma; NETs (carcinoid); lymphoma—resection/nodes basics.
  • Fistulas: ECF care—sepsis, skin, source, nutrition; timing of closure.

Colon — Topics & Subtopics

  • Anatomy/physiology: taeniae/haustra; water/Na handling.
  • Diverticular disease: uncomplicated vs complicated; Hinchey; abscess drainage vs surgery; fistulas.
  • Colitis: C. difficile; ischemic; IBD—UC (surgical indications; toxic megacolon), Crohn colonic.
  • CRC: risk & pathways (adenoma–carcinoma; serrated); screening; site‑specific presentation; TNM gist; oncologic resection (margins; ≥12 nodes); obstruction/perforation (stent vs emergency resection concept).
  • Polyposis/syndromes: FAP/AFAP, MAP; Lynch (Amsterdam/Bethesda); prophylactic surgery indications; surveillance.
  • Volvulus: sigmoid vs cecal; endoscopic decompression vs surgery.

Rectum & Anal Canal — Topics & Subtopics

  • Anatomy: mesorectum; sphincters; CRM; pelvic floor.
  • Rectal cancer: MRI staging; TME; neoadjuvant chemoradiation indications; local excision criteria for early lesions; stomas.
  • Benign anorectal: hemorrhoids (grading; RBL/sclerotherapy vs hemorrhoidectomy/stapled); fissure (acute vs chronic; LIS indications/continence risk); fistula‑in‑ano (Parks; Goodsall; seton/ligation/advancement flap; Crohn considerations); pilonidal.
  • Anal cancer: SCC (Nigro protocol overview).
  • Functional: fecal incontinence basics; rectal prolapse.

Hernias — Topics & Subtopics

  • Groin anatomy; indirect vs direct (Hesselbach); femoral canal.
  • Inguinal repairs: open Lichtenstein vs lap (TEP/TAPP)—indications, pros/cons; chronic pain avoidance tips.
  • Femoral hernia: strangulation risk; urgent repair.
  • Incisional/ventral: loss of domain; mesh choices; component separation; contaminated fields.
  • Hiatus/paraesophageal (link to Day 1 GERD): indications for repair.

Acute Abdomen Algorithms

  • Differentiate obstruction vs perforation vs ischemia vs inflammatory; CT role; peritonitis bundle; source control.

Day‑2 MCQs: SBO strangulation; Meckel bleed; CRC margins/nodes; rectal TME/neoCRT; Hinchey stage; Alvarado/AIR (appendix); TEP vs TAPP.

Day 3 — Hepato‑Biliary • Pancreas • Spleen • HPB/Trauma Pearls • Imaging & Peri‑op

Jaundice/Cholestasis (Approach)

  • Pattern recognition: pre‑hepatic vs hepatic vs post‑hepatic; LFT patterns; USG first; when MRCP/EUS/ERCP/PTC.

Gallbladder & Bile Ducts — Topics & Subtopics

  • Cholelithiasis spectrum: biliary colic vs acute cholecystitis (Tokyo); USG signs; early LC vs delayed; subtotal LC.
  • Choledocholithiasis: probability tiers; ERCP vs laparoscopic CBD exploration; post‑ERCP pancreatitis awareness.
  • Cholangitis: Charcot triad/Reynolds pentad; resuscitation + antibiotics; urgent biliary drainage.
  • Mirizzi: types & management overview; gallstone ileus (Rigler triad) — enterolithotomy snapshot.
  • Bile duct injury: Strasberg types; recognition intra/post‑op; drainage; delayed reconstruction.

Liver — Topics & Subtopics

  • Anatomy/segments (Couinaud); future liver remnant (FLR); regeneration.
  • HCC: risk/cirrhosis; triphasic imaging (arterial enhancement + washout); BCLC options (resection, ablation, transplant); AFP note.
  • CRLM: resectability logic (FLR/margins/bilobar strategies); PVE snapshot; ablation/HAI overview.
  • Abscesses: amoebic vs pyogenic—diagnosis & drainage; antibiotics.
  • Hydatid: daughter cysts; PAIR vs surgery; avoid spillage.
  • Portal HTN (surgical lens): variceal bleed bundle; TIPS/shunts awareness.

Pancreas — Topics & Subtopics

  • Acute pancreatitis: causes (gallstones/alcohol); Atlanta definitions; BISAP/Ranson idea; fluids; nutrition; collections (APFC→pseudocyst; ANP→WON) with timing; step‑up approach (endo/percutaneous → minimally invasive necrosectomy).
  • Chronic pancreatitis: pain mechanisms; calcifications; exocrine/endocrine failure; decompression vs resection (Puestow/Frey) — indications.
  • Neoplasms: PDAC (resectable/borderline; Whipple outline; adjuvant concept); cystic neoplasms (serous vs mucinous vs IPMN — risk cues; resect vs surveil); NETs (insulinoma/gastrinoma snapshot).
  • Post‑op issues: POPF concept; DGE; enzyme replacement.

Spleen & Trauma — Topics & Subtopics

  • Splenic trauma: AAST grading; hemodynamic algorithm; NOM with AE; splenectomy indications; post‑splenectomy vaccines.
  • Abdominal trauma: ATLS; eFAST; CT vs OR; retroperitoneal hematoma zones (I/II/III) — explore vs observe.

Imaging & Peri‑operative Safety

  • Pick‑the‑test: CT vs MRCP vs ERCP vs EUS; CTA in ischemia; Meckel scan.
  • Peri‑op: antibiotic prophylaxis; ERAS; DVT prophylaxis; pain; glycemic control; nutrition (enteral vs TPN; refeeding risk).

Day‑3 MCQs: AC vs biliary colic; CBDS probability tier; cholangitis first step; Mirizzi clue; Strasberg type; HCC resection vs transplant; Atlanta & collections; PDAC resectability; splenic NOM vs OR.

Day 4 — General Surgery‑I (Principles)

Wound Healing & SSI

  • Phases; local/systemic factors; primary vs secondary vs tertiary intention; staples vs sutures; drains; SSI prevention bundles; dehiscence vs evisceration.

Surgical Infections & Sepsis

  • Source control; empiric choices (concept); SIRS/Sepsis‑3 snapshot; catheter/line bundles; antibiotic stewardship.

Shock & Resuscitation

  • Types (hypovolemic/distributive/cardiogenic/obstructive); endpoints; lactate; vasopressors overview.

Fluids/Electrolytes/Acid‑Base

  • Maintenance & replacement; crystalloids vs colloids; Na/K disorders; ABG patterns (metabolic acidosis/alkalosis; respiratory derangements) with common causes.

Day‑4 MCQs: SSI bundle steps; fluid calculations; sepsis recognition; shock differentiators; ABG interpretation.

Day 5 — Breast & Endocrine

Breast — Topics & Subtopics

  • Benign: fibroadenoma; fibrocystic change; mastitis/abscess.
  • Work‑up: triple assessment; BIRADS snapshot; imaging by age; core‑needle.
  • Cancer: risk; receptor status; staging; BCS vs MRM; margins; SLNB vs ALND; neoadjuvant indications; reconstruction basics; radiation/chemo concept.

Thyroid — Topics & Subtopics

  • Goiter; thyroiditis snapshot; hyper/hypothyroidism (surgical lens).
  • Nodule algorithm: TSH → USG features → FNAC (Bethesda gist); when to operate; nerve/parathyroid preservation pearls; RAI concept.

Parathyroid & Adrenal (Snapshot)

  • Primary hyperparathyroidism; intra‑op PTH idea.
  • Adrenal incidentaloma; functional lesions; pheochromocytoma pre‑op alpha‑block.

Day‑5 MCQs: triple assessment; BCS/SLNB selection; Bethesda actions; RLN/hypocalcemia risks; pheo prep.

Day 6 — Vascular & Thoracic

Peripheral Arterial Disease

  • Claudication vs critical limb; ABI thresholds; imaging choices; revascularization options.

Aneurysms

  • AAA surveillance vs repair indications; EVAR snapshot; rupture management.

Venous Disease

  • Varicose veins (CEAP gist; ablation vs stripping); DVT prophylaxis & treatment.

Thoracic Surgery Basics

  • Pneumothorax (needle vs ICD); hemothorax; empyema stages & decortication concept.

Day‑6 MCQs: ABI cut‑offs; AAA repair triggers; varicose procedure choice; chest drain steps/site; PE prevention.

Day 7 — Trauma, Burns & Transplant (Essentials)

Trauma (ATLS Framework)

  • Primary/secondary survey; airway adjuncts; shock in trauma; eFAST; when to CT vs straight to OR; pelvic binder & angio‑embolization.

Organ‑Specific Trauma

  • Liver, spleen, pancreas injury grading (AAST) & algorithms; hollow viscus injury cues; retroperitoneal hematoma zones (I/II/III) — explore vs observe.

Burns

  • Depth; TBSA; Parkland formula; airway burns; escharotomy/fasciotomy indications; infection control basics; nutrition.

Transplant Basics

  • Immunosuppression snapshot; rejection types; living vs deceased donation.

Day‑7 MCQs: airway firsts; AAST → NOM vs OR; Parkland numbers; pelvic bleed control; rejection cues.

Day 8 — Mixed High‑Yield + Imaging/Peri‑op + Stomas/Fistulas + Nutrition

Imaging Choices

  • When to use CT/MRCP/ERCP/EUS; CTA for mesenteric ischemia; Meckel scan; CT colonography vs colonoscopy.

Peri‑op/ICU & ERAS

  • ERAS elements; DVT/antibiotic prophylaxis; pain; glycemic control; early feeding; catheter/line bundles.

Stomas & Fistulas

  • Types/indications; early/late complications; ECF management (sepsis, skin, source, nutrition); timing of closure.

Nutrition in GI Surgery

  • Enteral vs TPN; indications; refeeding risk; micronutrient highlights.

Recent Concepts (Awareness)

  • MIS/robotics/IR‑assisted strategies at a high level.

Day‑8 MCQs: pick‑the‑test; ERAS benefits; stoma complications; ECF priorities; nutrition selector.

3‑Day Revision Plan (after Day 8)

  • Rev‑1 — Algorithms & Scores: UGIB/LGIB; obstructive jaundice; SBO/strangulation; perforation; cholangitis; pancreatitis step‑up; trauma priorities; Forrest, Blatchford/Rockall, Hinchey, Alvarado/AIR, AAST, Atlanta/BISAP, Strasberg, Tokyo.

  • Rev‑2 — Oncology & HPB: CRC/Rectal staging; TME/neoCRT; gastric ca margins/lymph basins; HCC (BCLC); PDAC resectability; CRLM resectability.

  • Rev‑3 — Full Mock + Weak Areas: 200‑Q mock; re‑attempt incorrects; mini‑cards update.

Heat‑Map: Very High‑Yield (Exam Probability)

  • Acute abdomen (bleed/perf/obstruction/ischemia/sepsis).

  • HPB triad (acute cholecystitis, choledocholithiasis, cholangitis) + ERCP vs surgery selector.

  • Pancreatitis (Atlanta; collections; intervention timing; step‑up approach).

  • CRC/Rectal (staging gist; TME; neoCRT triggers).

  • Shock + fluids/ABG (principles; first hour).

  • Breast (triple assessment; BCS vs MRM; SLNB; adjuvant indications concept).

  • Thyroid (TSH→USG→FNAC; Bethesda; nerves/RAI overview).

  • Hernia (inguinal anatomy; femoral danger; lap vs open indications).

  • Trauma (ATLS; solid organ injury algorithms; pelvic control; eFAST).

Mini‑Cards (carry‑along)

  • UGIB/LGIB algorithms; obstructive jaundice path.

  • SBO vs ileus; strangulation red flags; perforation bundle.

  • Tokyo (AC/cholangitis); Strasberg (BDI); Blatchford/Rockall; Forrest.

  • Atlanta + BISAP; collection map (APFC/pseudocyst/ANP/WON) + timing.

  • CRC vs Rectal work‑up grid; TME/neoCRT cues; margins/nodes checklist.

  • Inguinal hernia map (direct/indirect; TEP/TAPP selector); femoral red flags.

  • Breast triple assessment; thyroid nodule algorithm; Bethesda quick grid.

  • Burns: TBSA + Parkland; escharotomy indications.

  • ERAS bundle; DVT/antibiotic prophylaxis; nutrition selector (enteral vs TPN).

How to Use

  • Treat each bullet as a check item; tick off coverage; convert weak areas into targeted MCQ sets.

  • Keep algorithms/staging/score grids on 1‑page quick cards for nightly recap.

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