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DNB General Surgery · 4 Papers

DNB General Surgery — Frequently Asked Questions

High-yield topics compiled from DNB General Surgery examinations, organised by paper and system. Frequency badges show how often each topic appears. Original papers are not reproduced — this is the author’s own analysis and compilation.

Practical Examination: 300 marks (OSCE + Clinical Cases + Ward Round + Viva voce). Pass mark: 150/300. Maximum 3 attempts. No grace marks in practical. Aggregate marks rounded to whole number (components not individually rounded).
Note: Topic frequency and lists are the author’s own analysis of DNB General Surgery examination patterns. Original question papers are not reproduced on this site. Not affiliated with or endorsed by the National Board of Examinations (NBE).
400
Theory marks (4×100)
200
Pass mark (aggregate)
300
Practical (pass: 150)
3 hrs
Per paper
10×10
Short notes per paper
8
Grace marks (192–199 only)

Paper I covers: Basic sciences applied to General Surgery · Principles of General Surgery · Perioperative care · Trauma and critical care · Research Methodology. Format: 10 short notes × 10 marks = 100 marks. 3 hours.

Must-Study Topics — Paper I

Varicose veins — CEAP, endovenous, surgical treatment
Asked 8× CEAP classification, venous anatomy, EVLT, venous ulcer
Acute mesenteric ischaemia
Asked 7× Types, etiology, diagnosis, surgical management
GERD — diagnosis & surgical management
Asked 7× Fundoplication, newer techniques (LINX, TIF/EsophyX, Stretta)
Obstructive jaundice — work-up & management
Asked 6× Causes, preoperative prep, Courvoisier law, biliary drainage
Whipple’s operation — steps & complications
Asked 6× PPPD vs classic, reconstruction, pancreatic fistula
Peripheral arterial disease & chronic limb ischaemia
Asked 5× Claudication, CLI, ABI, Buerger’s disease, lumbar sympathectomy
Gallbladder carcinoma — staging & resection
Asked 5× TNM staging, incidental GBC after LC, radical resection
Inguinal hernia — anatomy, open & laparoscopic repairs
Asked 5× TEP, TAPP, sliding hernia, strangulated hernia, post-hernioplasty pain
Acute pancreatitis — revised Atlanta, severity, management
Asked 5× Atlanta classification, necrosectomy, step-up approach
CBD injury & biliary fistula
Asked 5× Strasberg classification, management, Roux-en-Y hepaticojejunostomy
Skin grafts & flaps — types, principles
Asked 5× STSG vs FTSG, local/musculocutaneous flaps, microvascular surgery
Compartment syndrome — limb & abdominal
Asked 4× Escharotomy, fasciotomy, crush syndrome, ACS management
BATCH 1Highest yield
  • Varicose veins
    CEAP classification · venous anatomy · EVLT · surgical treatment · venous ulcer · chronic venous insufficiency
  • Acute mesenteric ischaemia
    Types · etiology · diagnosis · investigations · surgical management
  • GERD
    Etiology · diagnosis · fundoplication · newer techniques (LINX, TIF, Stretta)
  • Obstructive jaundice
    Causes · investigations · preoperative preparation · Courvoisier law · biliary drainage
  • Whipple’s operation (PD & PPPD)
    Indications · operative steps · reconstruction · complications · pancreatic fistula
BATCH 2–5Frequently asked
  • Peripheral arterial disease / CLI — claudication, ABI, Buerger’s, lumbar sympathectomy
  • Gallbladder carcinoma — TNM staging, radical resection, incidental GBC
  • Inguinal hernia — anatomy, open repair, TEP, TAPP, sliding, strangulated, sports hernia
  • Acute pancreatitis — severity scoring, Atlanta classification, step-up approach, necrosectomy
  • CBD injury / biliary fistula — Strasberg classification, early vs late repair
  • Rectal prolapse — types, Delorme, Altemeier, Ripstein operations
  • Lymphoedema — classification, filariasis, conservative & surgical management
  • DVT — Virchow’s triad, diagnosis, complications, treatment, prophylaxis
  • Choledocholithiasis — ERCP, laparoscopic CBD exploration, rendezvous technique
  • Colorectal cancer — staging, TME, laparoscopic vs open, HIPEC
  • Femoral hernia — anatomy, repair options (Lockwood, McEvedy, Lotheisen)
  • Haemorrhoids — pathogenesis, Milligan-Morgan, stapled haemorrhoidopexy
  • Fistula-in-ano — Parks classification, LIFT, mucosal advancement flap, VAAFT
  • Pilonidal sinus — surgical options, rhomboid flap, Bascom, pit-picking
  • Splenectomy — indications, laparoscopic technique, OPSI prophylaxis
  • Hydatid cyst liver — surgery, scolicidal agents, PAIR
  • HCC — BCLC staging, resection vs ablation vs transplant
  • Carcinoma stomach — D2 gastrectomy, lymph node stations, adjuvant therapy
  • GIST — pathology, diagnosis, imatinib management
  • Intussusception — diagnosis, management, transient intussusception
  • Malrotation — double bubble sign, Ladd’s procedure
  • Infected pancreatic necrosis — step-up approach, VARD, endoscopic necrosectomy
  • SMA syndrome — diagnosis, conservative vs surgical
  • Myopectineal orifice / Corona mortis — surgical anatomy
  • ERAS — components, evidence, colorectal application
  • EUS — indications, role in pancreatic and GI disease
  • Carcinoid tumour — clinical features, carcinoid syndrome, management

Paper II covers: Elective Orthopaedics · Skin and Subcutaneous Tissue / Soft Tissue · Head and Neck · Breast and Endocrine. Format: 10 short notes × 10 marks = 100 marks. 3 hours.

Must-Study Topics — Paper II (Head & Neck, Breast, Endocrine, Skin)

Note: Paper II also includes Elective Orthopaedics — this is unique to DNB and not in MS exams. Common orthopaedic short notes: compartment syndrome, bone tumours, infections of bones & joints, amputations, fracture principles.
Renal transplantation — full work-up to complications
Asked 9× Donor selection, recipient surgery, rejection types, triple immunosuppression, DCD
Undescended testis — embryology to management
Asked 8× Embryology, consequences, orchidopexy timing, adult UDT
Hydronephrosis / PUJ obstruction
Asked 7× Causes, bilateral vs unilateral, radioisotope scan, pyeloplasty
Prostate — BPH & carcinoma prostate
Asked 7× BPH: medical/surgical/newer minimally invasive · Ca prostate: PSA, staging, metastatic
Urinary stones — ESWL, RIRS, PCNL
Asked 6× Stone types, ureteric stone, VUJ stone, calculus anuria
Ventral hernia — recent advances
Asked 6× EHS classification, eTEP, component separation, biological mesh, loss of domain
Robotics & AI in surgery
Asked 6× Advantages, disadvantages, indications, AI, ICG, NBI, fluorescence surgery
Breast cancer — early, LABC, axillary management
Asked 5× BCS, oncoplastic, SLNB, N0 axilla, molecular subtypes
Thyroid — solitary nodule & thyroid cancer
Asked 5× Bethesda system, differentiated Ca thyroid, medullary, central node dissection
Hydrocele & acute scrotum
Asked 4× Classification, primary vs secondary, acute scrotum differential
Testicular torsion — diagnosis & management
Asked 4× Etiology, types, acute scrotum, salvage vs orchidectomy
Penile & urethral disorders
Asked 4× Carcinoma penis, TNM, inguinal node management, urethral stricture
BATCH 1Urology & transplant
  • Renal transplantation
    Indications · donor selection (living & deceased) · recipient surgery · warm/cold ischaemia · rejection types · triple immunosuppression · DCD · brain death
  • Undescended testis
    Embryology · classification · consequences (infertility, malignancy) · timing of orchidopexy · adult UDT
  • Hydronephrosis / PUJ obstruction
    Causes · bilateral vs unilateral · radioisotope scan · pyeloplasty · endopyelotomy
  • Prostate (BPH & carcinoma)
    BPH: medical, surgical, newer minimally invasive · Ca prostate: PSA, Gleason, staging, metastatic disease
  • Urinary stones
    Stone types · radiolucent stones · ureteric stone · ESWL · RIRS · PCNL · calculus anuria
BATCH 2–6All other Paper II topics
  • Ventral hernia recent advances — EHS classification, eTEP, component separation, biological mesh, loss of domain
  • Robotics & AI — robotic surgery, AI in surgery, ICG, Narrow Band Imaging
  • Penile & urethral disorders — carcinoma penis, urethral stricture, neurogenic bladder
  • Kidney — horseshoe kidney, ADPKD, renal TB, RCC, radical nephrectomy, recent advances
  • Hydrocele & acute scrotum — classification, primary vs secondary, management
  • Testicular torsion — etiology, acute scrotum differential, management
  • Paediatric surgery — malrotation, intussusception, IHPS, TEF, posterior urethral valves, bladder exstrophy
  • Bariatric & metabolic surgery — classification, selection criteria, procedures, nutritional consequences
  • Breast — benign disease (biopsy, image-guided), carcinoma (TNM, BCS, oncoplastic, MDT, PET scan)
  • Plastic & reconstructive surgery — flap types, local flaps, musculocutaneous flaps, microvascular
  • Thoracic surgery — VATS, pleural infection, empyema, decortication, bronchopleural fistula, chylothorax
  • Thyroid cancer — differentiated, medullary, Bethesda system, central node dissection
  • SLNB — current status in breast cancer and melanoma
  • Pheochromocytoma — preoperative preparation, intraoperative management
  • MEN syndromes — classification, surgical implications
  • Achalasia cardia — Heller’s myotomy, POEM, outcome comparison
  • Colorectal cancer — staging, TME, laparoscopic approach, adjuvant therapy
  • Neck dissection — classification (I–VI), selective dissections, complications
  • Superficial parotidectomy — facial nerve identification, Frey’s syndrome
  • Lymph node levels in head & neck cancers
ELECTIVE ORTHOPAEDICSUnique to DNB Paper II
  • Compartment syndrome — limb, fasciotomy, escharotomy, crush syndrome
  • Bone tumours — osteosarcoma, Ewing’s, classification, limb salvage vs amputation
  • Infections of bones & joints — osteomyelitis (acute/chronic), septic arthritis
  • Principles of fracture management — types, healing, complications (fat embolism, DVT, AVN)
  • Amputations — BKA steps, indications, stump care, rehabilitation
  • Spine — disc prolapse, spinal cord compression, spondylolisthesis
  • Soft tissue sarcomas — classification, wide excision, adjuvant therapy
  • Carpal tunnel syndrome, Dupuytren’s contracture — surgical management

Paper III covers: Vascular Surgery · Abdominal Surgery (GI, hepatobiliary, hernia, colorectal). Format: 10 short notes × 10 marks = 100 marks. 3 hours. Operative steps and surgical decision-making are the dominant format.

Must-Study Topics — Paper III (Vascular & Abdominal)

Total thyroidectomy — steps & complications
Asked 9× RLN identification, parathyroid preservation, hypocalcaemia
Laparoscopic cholecystectomy — CVS, difficult LC, bail-out
Asked 8× Critical view of safety, subtotal cholecystectomy, intraop CBD injury
Whipple’s / PPPD — steps, reconstruction & complications
Asked 7× Vascular resection, reconstruction, POPF management
Radical nephrectomy — steps & IVC thrombus
Asked 7× Open vs laparoscopic, IVC thrombus levels
TME — total mesorectal excision
Asked 7× Planes, nerve preservation, TaTME, ERAS integration
Carcinoma oesophagus — transhiatal oesophagectomy
Asked 6× THE vs Ivor Lewis vs thoracolaparoscopic, steps, complications
Pheochromocytoma — preop prep & operative steps
Asked 6× Alpha blockade → beta blockade, intraop BP, laparoscopic adrenalectomy
MRM & breast conservation surgery
Asked 5× MRM steps, BCS indications, oncoplastic techniques
Neck dissection — radical vs modified, complications
Asked 5× Classification, levels I–VI, selective dissections, complications
Superficial parotidectomy — steps & facial nerve
Asked 5× Facial nerve identification, Frey’s syndrome prevention
Lichtenstein & laparoscopic inguinal hernia repair
Asked 5× Steps of Lichtenstein, TAPP, TEP, eTEP, anatomical landmarks
Radical cholecystectomy — incidental GBC
Asked 4× T-stage-based management, liver resection extent
GI SURGERYOperative steps
  • Perforated peptic ulcer — laparoscopic vs open Graham’s patch, omental plug
  • D2 gastrectomy — lymph node stations, reconstruction options
  • Total gastrectomy — steps, Roux-en-Y reconstruction
  • Low anterior resection — steps, anastomotic leak management
  • Hemicolectomy — right vs left, extended, TB vs malignancy differences
  • Total proctocolectomy + IPAA (J-pouch) — steps & complications
  • APER (abdominoperineal resection) — conventional vs extra-levator
  • Sigmoid volvulus — endoscopic vs surgical management
  • Fistula-in-ano — LIFT, mucosal advancement flap, fibrin glue, VAAFT
  • Milligan-Morgan haemorrhoidectomy & stapled haemorrhoidopexy (PPH)
  • Pilonidal sinus — rhomboid flap, Bascom, pit-picking
HPB SURGERYOperative steps
  • Hydatid cyst liver — operative steps, scolicidal agents, cyst-biliary communication
  • Liver resections — types, Pringle manoeuvre, haemostasis
  • Roux-en-Y hepaticojejunostomy — steps, stricture prevention
  • Choledochal cyst — types, excision and biliary reconstruction
  • Pancreatic pseudocyst — drainage options, cystogastrostomy
  • Distal pancreatectomy — steps, splenic preservation vs splenectomy
  • Splenectomy — elective vs emergency, laparoscopic, vaccinations
VASCULAR & OTHEROperative steps
  • Below-knee amputation — steps, stump care, complications
  • Lumbar sympathectomy — anatomy, technique, indications
  • Varicose veins — Trendelenburg, stripping, EVLT
  • Acute embolic occlusion — embolectomy, Fogarty catheter
  • Radical cystectomy — steps, urinary diversion options
  • Orchidopexy — technique, timing, complications
  • PCNL — indications, technique, results
  • Tracheostomy — surgical vs percutaneous, indications, complications
  • Thyroglossal cyst — Sistrunk procedure
  • Cervical rib excision — anatomy, steps, complications

Paper IV covers: Genitourinary and other subspecialties · Transplantation · Recent Advances. Format: 10 short notes × 10 marks = 100 marks. 3 hours. Recent advances, technology, and evolving surgical techniques are heavily tested.

Must-Study Topics — Paper IV (GU, Transplant & Recent Advances)

Robotic surgery vs laparoscopic surgery
Asked 10× Principles, 3D vision, haptics, cost, learning curve, current indications
ICG fluorescence / Indocyanine Green
Asked 8× Biliary anatomy, perfusion assessment, SLNB, oncological use
HIPEC / PIPAC — peritoneal surface malignancy
Asked 7× Principles, CRS+HIPEC, PIPAC for palliation
Sentinel lymph node biopsy — current status
Asked 7× Breast, melanoma, GI cancers, ICG-guided SLNB
TaTME — transanal total mesorectal excision
Asked 6× Indications, technique, IORT integration, ERAS
Biological & composite meshes in hernia repair
Asked 6× Classification, decellularised matrices, composite mesh properties
eTEP repair — inguinal & ventral hernia
Asked 6× eTEP-RS, eTEP-TAR, advantages vs TEP/TAPP, loss of domain
Targeted therapy & immunotherapy in cancer
Asked 5× Trastuzumab, bevacizumab, checkpoint inhibitors, PDL-1
POEM — peroral endoscopic myotomy
Asked 5× Principle, technique, vs Heller’s, outcomes, GERD after POEM
AI in surgery & computer-aided surgery
Asked 5× Machine learning, augmented reality, surgical navigation
3D printing in surgery
Asked 4× Preoperative planning, custom implants, anatomical models
Liquid biopsy & newer cancer diagnostics
New ctDNA, circulating tumour cells, clinical applications
TECHNOLOGY & MAS
  • Robotic surgery — types, uses across specialties, vs laparoscopy
  • SILS (single-incision laparoscopic surgery) — technique, pros & cons
  • Energy devices — Harmonic vs LigaSure, LASER types & applications
  • 3D printing — preoperative planning, custom prosthetics, implants
  • Narrow Band Imaging (NBI) — principle, role in GI & ENT oncology
  • Navigation-aided surgery — stereotactic systems, clinical implications
  • Augmented reality in surgery — current applications, limitations
  • Staplers in surgery — circular, linear, powered; EEA, GIA, TA
  • TAMIS — transanal minimally invasive surgery
  • VAAFT & EPSiT — video-assisted treatments for fistula and pilonidal sinus
ONCOLOGY ADVANCES
  • HIPEC — CRS principles, indications, outcomes
  • PIPAC — pressurized intraperitoneal aerosol chemotherapy, palliative role
  • Sentinel lymph node biopsy — ICG-guided, current evidence
  • Targeted therapy — HER2, VEGF, EGFR inhibitors
  • Immunotherapy — checkpoint inhibitors (PD-1/PD-L1), CTLA-4
  • Liquid biopsy — ctDNA, clinical applications
  • Neoadjuvant therapy advances — breast, rectal, gastric cancer
  • Oncoplastic breast surgery — volume displacement vs replacement
  • Lobular carcinoma in situ & molecular subtypes of breast cancer
GI & HERNIA ADVANCES
  • TaTME — technique, indications, outcomes
  • POEM for achalasia — vs Heller’s, current evidence
  • Newer GERD treatments — Stretta, TIF/EsophyX, LINX
  • eTEP-RS & eTEP-TAR — technique, advantages, complications
  • Component separation (anterior & posterior/TAR) — indications, loss of domain
  • MILOS / EMILOS — mini/less open sublay repair
  • Biological meshes — decellularised matrices, xenograft vs allograft
  • Recent advances in short bowel syndrome — intestinal rehabilitation
CRITICAL CARE & ACADEMIC
  • Damage control surgery & resuscitation — lethal triad, MTP (1:1:1)
  • Surviving Sepsis Campaign — updated bundles, vasopressors, steroids
  • Balanced crystalloids vs NS — SMART trial, hyperchloraemic acidosis
  • Abdominal compartment syndrome — IAP measurement, decompressive laparotomy
  • ERAS — components, colorectal, HPB application
  • Evidence-based medicine — levels of evidence I–V, CONSORT, GRADE
  • WHO surgical safety checklist — Sign-In, Time-Out, Sign-Out
  • Simulation & skills training — OSATS, FLS, virtual reality platforms
  • NPWT (negative pressure wound therapy) — mechanism, ciNPWT

Topics repeated across 3 or more DNB General Surgery papers. If a topic appears here, it must be exam-ready.

#TopicSystem
1Robotic surgery vs laparoscopic — advantages, limitations Asked 10×Technology
2Total thyroidectomy — steps & complications Asked 9×Endocrine
3Renal transplantation — full management Asked 9×Urology/Transplant
4ICG fluorescence imaging in surgery Asked 8×Technology
5Undescended testis — embryology to management Asked 8×Urology
6Varicose veins — CEAP, EVLT, surgery Asked 8×Vascular
7Laparoscopic cholecystectomy — CVS, difficult LC, bail-out Asked 8×HPB
8HIPEC / PIPAC — peritoneal surface malignancy Asked 7×Oncology
9Sentinel lymph node biopsy — current status Asked 7×Breast/Oncology
10TME / TaTME — rectal cancer surgery Asked 7×Colorectal
11Whipple’s / PPPD — steps & complications Asked 7×HPB
12Radical nephrectomy — steps, IVC thrombus Asked 7×Urology
13Hydronephrosis / PUJ obstruction Asked 7×Urology
14Prostate — BPH & carcinoma prostate Asked 7×Urology
15Acute mesenteric ischaemia — management Asked 7×Vascular/GI
16GERD — surgical management & newer techniques Asked 7×Oesophagus
17eTEP repair — inguinal & ventral hernia Asked 6×Hernia
18Biological & composite meshes Asked 6×Hernia
19Carcinoma oesophagus — transhiatal oesophagectomy Asked 6×Oesophagus
20Pheochromocytoma — prep & surgery Asked 6×Endocrine
21Obstructive jaundice — work-up & management Asked 6×HPB
22Urinary stones — ESWL, RIRS, PCNL Asked 6×Urology
23Ventral hernia — EHS classification, component separation Asked 6×Hernia
24POEM for achalasia cardia Asked 5×Oesophagus
25Targeted therapy & immunotherapy in cancer Asked 5×Oncology
26Breast cancer — BCS, oncoplastic, axillary management Asked 5×Breast
27Neck dissection — classification, levels, complications Asked 5×Head & Neck
28Superficial parotidectomy — facial nerve preservation Asked 5×Head & Neck
29Inguinal hernia — Lichtenstein, TAPP, TEP Asked 5×Hernia
30Acute pancreatitis — Atlanta, severity, necrosectomy Asked 5×HPB
31CBD injury — Strasberg classification, management Asked 5×HPB
32Colorectal liver metastases — resection, ablation, sequencing Asked 5×HPB/Colorectal
33MRM & breast conservation surgery Asked 5×Breast
34Thyroid cancer — differentiated, medullary, central node dissection Asked 5×Endocrine
35Skin grafts & flaps — types, principles Asked 5×Plastic Surgery
36AI in surgery & computer-aided surgery Asked 5×Technology
37DVT — pathophysiology, prophylaxis, management Asked 4×Vascular
38Pancreatic cancer resectability (NCCN criteria) Asked 4×HPB
39Radical cholecystectomy — incidental GBC Asked 4×HPB
40Damage control surgery — lethal triad, MTP Asked 4×Trauma
41Penile carcinoma — staging, inguinal node management Asked 4×Urology
42Hydrocele & acute scrotum Asked 4×Urology
43Peripheral arterial disease — CLI, revascularisation Asked 4×Vascular
44Paediatric surgery — malrotation, intussusception, IHPS, TEF Asked 4×Paediatric
45Bariatric surgery — sleeve, bypass, metabolic basis Asked 4×Bariatric
46ERAS — components, evidence, colorectal & HPB Asked 4×Perioperative
473D printing in surgery Asked 4×Technology
48Energy devices — Harmonic, LigaSure, LASER Asked 4×Technology
49Abdominal compartment syndrome Asked 4×Critical Care
50Evidence-based surgery — levels of evidence, CONSORT Asked 4×Academic