INI-CET November 2025 Recall: Surgery Questions Explained by Dr. Amrit Nasta

Dr. Amrit Nasta discussed around 18–19 recall questions of surgery from the INI-CET November 2025 paper. He emphasised that the recalls were quite accurate and guided students through the reasoning behind each answer.

1. Recurrent Gastric Ulcers and Duodenal Nodule

A patient had recurrent gastric ulcers with a nodule in the 2nd or 3rd part of the duodenum.
👉 Diagnosis: Gastrinoma (endocrine tumor in Passaro’s triangle)
👉 Next step: Serum gastrin levels

Other options like PTH and catecholamines were irrelevant — PTH is for hyperparathyroidism and catecholamines for pheochromocytoma.

Note: Gastrinomas can occur independently of MEN syndrome.

Video Link: INI CET Nov 2025 Surgery Recall Discussion | Questions Explained by Dr. Amrit Nasta #inicet2025

2. Inflammatory Breast Cancer

A classic question with an image provided.

• Diagnosis given: Inflammatory breast cancer → T4 → Locally Advanced Breast Cancer (LABC)
  
• Treatment:Neoadjuvant chemotherapy followed by Modified Radical Mastectomy (MRM)
  
  • BCT (Breast Conservative Therapy) avoided
    
  • Palliative only for metastatic (M1) cases

3. Acute Appendicitis – Correct Statements

Multiple combination-based options were given.

• McBurney’s point tenderness – Classical but not diagnostic.
  
• Oschner Sherren for appendicular lump – True.
  
• Interval appendectomy in all cases – False.
  
• USG is IOC in children/pregnancy – True.

Final correct combination: 2 and 4.

4. Suture Material – Maximum Reaction

Basic question repeated from NEET:

• Correct answer: Catgut – causes maximum reaction and is absorbed fastest.
  Polypropylene is non-absorbable, and PDS lasts long.

5. Bariatric Surgery Image-Based Question

An image showed two anastomoses. 

• Not a mini bypass (mini has a single anastomosis).
  
• It could be Roux-en-Y or BPD (Biliopancreatic Diversion), depending on the common channel length.
  
  • Short common channel (~0.5 m) → BPD.
    
  • GJ (gastrojejunal) anastomosis → Not duodenal switch.

BPD is outdated, but was included as a repeat-type question.

6. Burns Question

Child spilt hot milk/water → image of hand with redness.

• Diagnosis: Superficial partial thickness burns
  Domestic burns don’t cause full-thickness injury. Blisters may or may not be seen.

Full-thickness burns → black/charred, not from domestic causes.

7. TIGARO Classification

Asked for etiology of chronic pancreatitis.
TIGARO stands for:

• T: Toxin
  
• I: Idiopathic/Immune
  
• G: Genetic
  
• A: Autoimmune
  
• R: Recurrent

Commonest cause: Toxic/Idiopathic.

8. Inguinal Hernia – Appendix as Content

Open hernia repair image shown; sac content resembled appendix (tinea coli visible).

• Diagnosis: Amyand’s hernia
  If small bowel/Meckel’s diverticulum → Littre’s hernia.

9. Arrange Steps – Laparoscopic Cholecystectomy

Straightforward sequence:

1. Create pneumoperitoneum
   
2. Identify Calot’s triangle
   
3. Dissect and achieve critical view of safety
   
4. Clip cystic artery and duct
   
5. Remove gallbladder

10. Arrange Steps – Hernioplasty

Correct order:

1. Skin incision
   
2. Identify sac
   
3. Reduce contents
   
4. Place mesh
   
5. Wound closure

11. Manipulation Angle Question

Asked angle between left and right working ports – that’s Manipulation angle.

Previous INI-CET asked about Azimuth angle (between telescope and instrument).

12. Head Injury – EDH

Patient post-RTA, vomiting, raised ICT, CT showing EDH (Epidural Hematoma).
👉 Management: Decompression – Burr hole and evacuation.

13. Match the Following

• Manometry → Achalasia
  
• 24-hr pH → GERD
  
• Sestamibi scan → Parathyroid
  
• CA Esophagus → UGI Endoscopy / PET / EUS

14. Post-Cholecystectomy Bile Leak

Confusion among students about whether a cholecystectomy or a cholecystostomy was done.

• If MRCP showed stump leak → Strasberg Type A → ERCP with stenting.

Percutaneous drainage is only for acute bile leak, not later.

15. Recurrent Pancreatitis

Raised amylase/lipase and MRCP showed a Choledochal cyst.

A common cause of recurrent pancreatitis in such a setting

16. Intestinal Stoma

Statements:

• Ileostomy is pouting ✅
  
• Loop ileostomy is temporary ✅
  
• Colostomy has flat mucosa ✅
  
• Colostomy has maximum fluid loss ❌ (seen in ileostomy/jejunostomy)

Incorrect statement: Colostomy has maximum fluid loss.

17. Late Dumping Syndrome

• Occurs after 2 hours ✅
  
• Aggravated by exercise ✅
  
• Relieved by lying down ❌ (seen in early dumping)

Late dumping = Hypoglycemia → Relieved by eating.

18. Triage Priority

Highest priority to patient with noisy breathing/unconsciousness → Airway obstruction.

19. Miscellaneous Topics

• Hypercalcemia, hypophosphatemia, osteoporosis: Primary hyperparathyroidism → Sestamibi scan
  
• Pancreatic cyst with raised CEA, low amylase, mucin: Mucinous cystic neoplasm

Conclusion

Dr. Amrit Nasta highlighted that the INI-CET November 2025 Surgery paper had around 18–19 well-balanced, concept-based questions — many of them repeated or pattern-based.
Except for minor ambiguities (like the laparoscopic cholecystectomy leak question), the recall seemed accurate and reflected conceptual understanding rather than rote memorisation.

Click Here to watch INI CET November 2025 Recall: Cerebellum Academy Youtube Channel

Download Cerebellum NEET PG Preparation Android app
Download Cerebellum NEET PG Preparation iOS app
Download Cerebellum NEET PG Preparation iphone app