EBSQ Examination in General Surgery

A candidate is checking whether the 2026 General Surgery EBSQ exam they are applying for is the correct examination. Which description best matches the official exam identity?

• AA national specialist exit examination administered by the Irish Medical Council for lega…
• BThe EBSQ Examination in General Surgery offered by the European Board of Surgery and Divi…
• CA multilingual online-only European surgical diploma run independently of UEMS
• DA hospital-based fellowship interview for appointment to a consultant post in Dublin

For the 2026 EBSQ Examination in General Surgery, which application plan is correct?

• AEmail the logbook and references to the secretariat, then upload only the CV to QuizOne
• BBring missing eligibility documents to Dublin on the first examination day
• CSend paper copies by post if QuizOne has already accepted the eligibility fee
• DSubmit all application material through QuizOne because documents sent outside the platfo…

Which statement correctly summarizes the official two-step quality validation process for FEBS General Surgery certification?

• AEligibility assessment is Part I, followed by the Examination as Part II
• BThe written paper is Part I, followed by a logbook review as Part II
• CA national license check is Part I, followed by automatic FEBS award as Part II
• DThe oral examination is Part I, followed by hospital appointment review as Part II

A surgeon passes the EBSQ General Surgery eligibility and examination process. What is the most accurate interpretation of the FEBS General Surgery title?

• AIt is an EU-wide license that automatically permits independent surgical practice in ever…
• BIt replaces all national specialist registration requirements for participation in social…
• CIt is a European board fellowship indicating professional competence, but it does not aut…
• DIt is valid only as a certificate of attendance and does not indicate successful assessme…

Which fee statement is correct for the EBSQ Examination in General Surgery?

• AThe total fee is EUR 750, paid only after passing the oral examination
• BThe eligibility fee is refundable if the application is incomplete at the deadline
• CThe total fee is EUR 1,200, consisting of EUR 450 for eligibility assessment and EUR 750…
• DThe examination fee is always transferred automatically regardless of cancellation notice

A candidate has completed eligibility and asks what the examination itself involves. Which answer is correct?

• AA 3-hour written paper of 150 best-answer-out-of-five Type A MCQs and an oral clinical ex…
• BA 2-hour short-answer paper and a single 45-minute viva with two examiners
• CA remote written paper of 100 true-false questions and no oral component
• DA 1-day operative skills assessment with no written examination

A candidate planning for the 2026 EBSQ General Surgery exam asks which logistical detail is correct.

• AThe exam is scheduled for 5 June 2026 in Brussels, with applications accepted until arriv…
• BThe exam is scheduled for 2-4 September 2026 online, with applications accepted by email
• CThe exam is scheduled for 31 December 2026 in Dublin, with no published deadline
• DThe exam is scheduled for 2-4 September 2026 in Dublin, with an application deadline of 5…

A patient scheduled for elective colorectal surgery has diabetes, anemia, and poor exercise tolerance. What is the best preoperative approach?

• AProceed without further assessment because colorectal surgery is routine
• BIdentify and optimize modifiable risks, assess functional and cardiopulmonary risk, and p…
• CCancel surgery permanently because any comorbidity makes elective surgery unsafe
• DRely only on a normal resting ECG to clear the patient for surgery

During the pre-incision pause for a right inguinal hernia repair, the scrub team notices the consent form says left inguinal hernia. What is the best action?

• AProceed with the side marked on the operating list because the list is usually correct
• BStop the procedure until the discrepancy is resolved using the patient record, consent, s…
• CAsk the anesthetist to decide because the patient is already anesthetized
• DRepair both sides to avoid the risk of missing the intended operation

Which perioperative antibiotic plan best supports surgical site infection prevention for an indicated clean-contaminated abdominal operation?

• AStart prophylactic antibiotics only after wound closure to avoid masking intraoperative i…
• BContinue broad-spectrum prophylaxis for 7 days in all patients regardless of contaminatio…
• CAvoid prophylaxis if the patient is afebrile and has a normal white cell count
• DGive an appropriate prophylactic antibiotic so effective tissue levels are present at inc…

A 72-year-old patient is admitted for emergency laparotomy. Which VTE prevention strategy is most appropriate?

• AAssess both VTE and bleeding risk, use mechanical prophylaxis if bleeding risk is high, a…
• BGive full-dose therapeutic anticoagulation to all emergency surgical patients
• CAvoid VTE prophylaxis because emergency surgery itself is the only relevant risk factor
• DUse anti-embolism stockings only after a postoperative DVT has been confirmed

A postoperative patient is febrile, confused, hypotensive, tachycardic, and has a lactate of 4.3 mmol/L. What is the best immediate management priority?

• AWait for culture results before giving antibiotics to improve diagnostic accuracy
• BTreat fever with antipyretics and review in 6 hours if the blood pressure remains low
• CRecognize possible sepsis with shock, obtain cultures promptly, start broad-spectrum anti…
• DGive a diuretic because lactate elevation usually indicates fluid overload

A patient with intra-abdominal sepsis remains hypotensive after appropriate initial crystalloid resuscitation. Which vasopressor strategy is best?

• AUse dopamine first line in all patients because it has fewer arrhythmias
• BDelay vasopressors until a central venous catheter is placed, regardless of ongoing shock
• CStart norepinephrine to target a mean arterial pressure of about 65 mmHg while continuing…
• DGive repeated fixed-volume fluid boluses without reassessment until blood pressure normal…

A trauma patient after splenectomy has ongoing bleeding, tachycardia, hypotension, cold peripheries, and worsening base deficit. What is the best resuscitation principle?

• AActivate hemorrhage control and balanced blood component resuscitation while preventing h…
• BPrioritize large volumes of hypotonic crystalloid until the hemoglobin concentration falls
• CDelay transfusion until all imaging has been completed
• DTreat the shock primarily with vasodilators to improve peripheral perfusion

A stable postoperative patient needs routine maintenance IV fluids because they cannot drink overnight. Which prescription principle is best?

• AUse 0.9% saline at a fixed high rate for every adult until oral intake resumes
• BAvoid potassium in all postoperative fluids because hyperkalemia is inevitable after surg…
• CUse dextrose-only fluid for all maintenance needs because it prevents hyponatremia
• DPrescribe daily water, sodium, potassium, and glucose needs, adjusting for renal function…

A patient with bowel obstruction has profuse vomiting, dehydration, hypochloremia, hypokalemia, and metabolic alkalosis. What is the most appropriate initial fluid strategy?

• AGive hypotonic dextrose alone because the main problem is free water loss
• BRestore intravascular volume with isotonic crystalloid and replace potassium once urine o…
• CRestrict all IV fluids until the alkalosis corrects spontaneously
• DGive sodium bicarbonate to treat the metabolic alkalosis

A postoperative patient has potassium 6.8 mmol/L with broad QRS complexes on ECG. What is the best immediate treatment?

• AGive oral potassium replacement because total body potassium is usually depleted after su…
• BGive intravenous calcium to stabilize the myocardium, then shift potassium intracellularl…
• CWait for repeat blood tests before acting because ECG changes are nonspecific
• DTreat with loop diuretics only and avoid cardiac membrane stabilization

A malnourished patient with a functioning gut is recovering after emergency laparotomy and cannot meet needs orally. What is the preferred nutrition route if there is no contraindication?

• AParenteral nutrition as first line in all postoperative patients
• BNo nutritional support until full oral intake is possible
• CHigh-concentration dextrose infusion alone as complete nutrition
• DEnteral nutrition because the gastrointestinal tract is usable

A severely malnourished patient is about to start nutritional support after 10 days of minimal intake. Which plan best reduces refeeding risk?

• AStart cautiously, give thiamine and multivitamins, and monitor and replace phosphate, pot…
• BStart full caloric targets immediately to reverse catabolism as fast as possible
• CAvoid electrolyte monitoring unless symptoms develop
• DGive insulin routinely before feeding to prevent hyperglycemia

A unit finds that only 62% of emergency laparotomy patients receive antibiotics within 1 hour of suspected intra-abdominal sepsis. What is the next best audit action after defining the standard?

• APublish the finding as final proof of poor care without changing practice
• BChange the standard after seeing the results so compliance appears higher
• CCollect and analyze local data, implement targeted changes, then re-audit to confirm impr…
• DRepeat data collection indefinitely without feedback to the clinical team

A competent adult with acute cholecystitis refuses laparoscopic cholecystectomy after discussion. What is the best ethical response?

• AProceed with surgery because the surgeon believes it is in the patient's best interests
• BAsk relatives to override the refusal if they agree with the operation
• CRespect the refusal after confirming capacity, explaining material risks, benefits, alter…
• DWithhold all nonoperative treatment because the patient declined the recommended operation

A patient needs emergency laparotomy for perforated viscus but is confused, septic, and lacks decision-making capacity. No advance directive is known. What is the best approach?

• AProceed with urgent treatment in the patient's best interests while documenting capacity…
• BDelay all treatment until the patient regains capacity, regardless of deterioration
• CAsk the most senior nurse to sign consent as a substitute for the patient
• DAvoid surgery because consent is impossible in any incapacitated patient

A 68-year-old presents with sudden severe abdominal pain, guarding, hypotension, and tachycardia. What is the best initial management?

• AWithhold analgesia until a definitive diagnosis is made because it prevents reliable exam…
• BSend the patient for outpatient ultrasound because most acute abdominal pain is benign
• CStart oral laxatives and observe because guarding is common in constipation
• DResuscitate immediately with an ABCDE approach, obtain senior surgical review, give analg…

A patient with previous laparotomy presents with colicky abdominal pain, vomiting, distension, and no flatus. They are dehydrated but have no peritonitis. What is the best initial management bundle?

• AGive oral bowel preparation and discharge if pain improves
• BKeep nil by mouth, give IV isotonic fluids with electrolyte correction, insert a nasogast…
• CStart loperamide and high-fiber diet because adhesive obstruction is functional
• DAvoid imaging because adhesions cannot be seen directly

A patient with acute abdominal pain has pain out of proportion to examination, atrial fibrillation, metabolic acidosis, and elevated lactate. What diagnosis and action should be prioritized?

• ATreat as uncomplicated gastroenteritis and discharge with oral fluids
• BSuspect acute mesenteric ischemia and arrange urgent resuscitation, contrast CT angiograp…
• CAssume renal colic and delay review until hematuria is confirmed
• DGive antispasmodics only because the abdomen is soft

A 68-year-old man presents with haematemesis, melaena, confusion and a systolic blood pressure of 78 mmHg. He has a history of ischaemic heart disease and takes aspirin. What is the best immediate management priority?

• AUrgent diagnostic endoscopy before any transfusion to identify the bleeding point
• BHigh-dose oral proton pump inhibitor and discharge if haemoglobin is above 100 g/L
• CImmediate CT angiography as the first investigation in all suspected upper gastrointestin…
• DTwo large-bore intravenous lines, blood tests including group and crossmatch, haemodynami…

A 52-year-old woman has sudden severe epigastric pain, generalised peritonitis and free intraperitoneal air on erect chest radiograph. She has taken ibuprofen daily for osteoarthritis. What is the most appropriate definitive management after initial resuscitation?

• AUrgent operative management with peritoneal lavage and closure of the perforation, usuall…
• BOutpatient Helicobacter pylori eradication and repeat review in 6 weeks
• CImmediate oral contrast follow-through to confirm a duodenal leak before treatment
• DEndoscopic clipping as first-line therapy for all perforated peptic ulcers with peritonit…

A 76-year-old man has a spurting posterior duodenal ulcer bleed. Endoscopic injection and clipping fail to control bleeding, and he remains transfusion-dependent. Interventional radiology is immediately available. What is the best next step?

• ARepeat oral proton pump inhibitor therapy and observe for 24 hours
• BEmergency total gastrectomy
• CCatheter angiography with embolisation of the gastroduodenal arterial supply
• DElective vagotomy and pyloroplasty after discharge

A 59-year-old man has recurrent non-bilious vomiting, early satiety and weight loss. He has a long history of duodenal ulcer disease. Examination shows dehydration and a succussion splash. What is the most appropriate initial management?

• AImmediate oral refeeding to stimulate gastric emptying
• BEmpirical pyloric dilatation without endoscopic assessment
• CNasogastric decompression, intravenous fluid and electrolyte correction, then upper endos…
• DLong-term antibiotics alone because this is diagnostic of Helicobacter pylori infection

A 44-year-old woman presents with acute pancreatitis, fever, jaundice, rigors and right upper quadrant pain. Ultrasound shows gallstones and a dilated common bile duct. What is the best management of the biliary obstruction?

• AUrgent ERCP with biliary decompression after initial resuscitation
• BDelay all biliary intervention for 6 weeks until pancreatic inflammation has completely r…
• CImmediate open common bile duct exploration without imaging
• DTreat with analgesia only because ERCP is contraindicated in acute pancreatitis

A 38-year-old man has acute pancreatitis confirmed by typical pain and lipase more than three times the upper limit of normal. He is haemodynamically stable, has no cholangitis and presents within 12 hours of symptom onset. Which management strategy is most appropriate?

• ARoutine prophylactic broad-spectrum antibiotics to prevent sterile necrosis becoming infe…
• BImmediate contrast-enhanced CT in every case to grade severity on admission
• CTotal parenteral nutrition and nil by mouth for at least 7 days
• DEarly supportive care with intravenous fluids, opioid analgesia, monitoring for organ fai…

A patient with severe necrotising pancreatitis deteriorates 3 weeks after admission with fever, rising inflammatory markers and gas in a peripancreatic collection on CT. What is the preferred approach if the patient can be stabilised?

• AImmediate open pancreatic necrosectomy for all infected necrosis
• BA step-up strategy with antibiotics and image-guided or endoscopic drainage, delaying nec…
• CNo intervention because gas in a collection is expected in sterile necrosis
• DElective distal pancreatectomy as the standard treatment

A 70-year-old man presents with painless jaundice, weight loss, pale stools and a palpable non-tender gallbladder. He has no fever or abdominal pain. What is the most appropriate next investigation to assess likely pancreatic head malignancy?

• AImmediate laparotomy without cross-sectional imaging
• BPancreatic protocol contrast-enhanced CT to stage disease and assess vascular involvement
• CPlain abdominal radiograph
• DDiagnostic ERCP as the first test solely to visualise the papilla

A 61-year-old woman with biliary colic has bilirubin 86 micromol/L, alkaline phosphatase 420 IU/L and ultrasound showing gallstones, a 9 mm common bile duct and a visible distal duct stone. What is the best next management step?

• AProceed directly to laparoscopic cholecystectomy without addressing the duct stone
• BDischarge with ursodeoxycholic acid
• CPercutaneous liver biopsy to explain the cholestatic liver tests
• DERCP for common bile duct stone clearance, followed by cholecystectomy during the same ad…

During assessment of a jaundiced patient with gallstones, MRCP shows a large stone impacted in the cystic duct compressing the common hepatic duct. Which statement best describes the surgical significance?

• AThis is Mirizzi syndrome and it increases the risk of bile duct injury, so careful operat…
• BThis is gallstone ileus and treatment is always colonoscopy
• CThis finding excludes the need for cholecystectomy
• DThis is diagnostic of primary sclerosing cholangitis

A 49-year-old otherwise fit woman has 24 hours of right upper quadrant pain, fever, Murphy sign and ultrasound-confirmed gallbladder wall thickening with stones. What is the preferred treatment plan?

• AAntibiotics and interval cholecystectomy only if symptoms recur
• BEndoscopic sphincterotomy alone as definitive treatment for acute cholecystitis
• CEarly laparoscopic cholecystectomy during the index admission with antibiotics and suppor…
• DObservation without antibiotics because gallbladder inflammation is self-limiting

A 46-year-old man has incidental gallstones found on ultrasound performed for renal colic. He has never had biliary pain, jaundice, pancreatitis or cholecystitis. What is the most appropriate advice?

• ARoutine prophylactic cholecystectomy is indicated for all asymptomatic gallstones
• BAnnual ERCP is needed to prevent common bile duct stones
• CNo cholecystectomy is required unless symptoms or selected high-risk features develop
• DLong-term broad-spectrum antibiotics prevent future acute cholecystitis

A 35-year-old woman has an incidental 4 cm liver lesion. MRI shows peripheral nodular discontinuous enhancement with progressive centripetal fill-in and very high T2 signal. Liver tests are normal and she is asymptomatic. What is the best management?

• AReassurance without treatment if imaging is diagnostic and there are no concerning featur…
• BPercutaneous biopsy because all vascular liver lesions require histology
• CEmergency hepatic resection because rupture is common
• DEmpirical chemotherapy

A 63-year-old man with compensated cirrhosis has a new 2.3 cm liver lesion. Dynamic MRI shows arterial phase hyperenhancement with portal venous washout and capsule appearance. Alpha-fetoprotein is mildly elevated. What is the best interpretation?

• AThe lesion is most likely a simple cyst and can be ignored
• BPercutaneous biopsy is mandatory before any treatment can be considered
• CThe finding is diagnostic of colorectal liver metastasis
• DThe lesion is radiologically characteristic of hepatocellular carcinoma in a cirrhotic li…

A patient with sigmoid cancer has four bilobar colorectal liver metastases and no extrahepatic disease. The hepatobiliary team believes all disease could be cleared with staged resection and portal vein embolisation to ensure an adequate future liver remnant. Which principle best defines resectability?

• AMore than three liver metastases are an absolute contraindication to liver surgery
• BResectability depends on the ability to remove or ablate all disease with negative margin…
• CBilobar disease is always palliative
• DSynchronous colorectal liver metastases must never be treated surgically

A 42-year-old woman presents 5 days after sleeve gastrectomy with tachycardia, fever and left shoulder-tip pain. She looks septic. What complication must be assumed until proven otherwise?

• ANormal postoperative pain that should be treated with discharge analgesia
• BStaple-line leak requiring urgent resuscitation, broad-spectrum antibiotics, imaging and…
• CChronic marginal ulcer, best managed with outpatient antacids
• DVitamin B12 deficiency as the immediate cause of sepsis

A 37-year-old woman presents 18 months after Roux-en-Y gastric bypass with intermittent severe crampy abdominal pain and vomiting. CT is equivocal but shows subtle mesenteric swirl. Between episodes she appears well. What is the best management principle?

• AExclude internal hernia because CT is not definitive
• BTreat with pancreatic enzymes only
• CAdvise permanent liquid diet and no surgical review
• DMaintain a low threshold for urgent diagnostic laparoscopy because internal hernia can be…

A 50-year-old man who smokes and takes NSAIDs develops epigastric pain and occult bleeding 8 months after Roux-en-Y gastric bypass. Endoscopy shows an ulcer at the gastrojejunal anastomosis. What is the most appropriate initial management?

• AHigh-dose proton pump inhibitor, stop NSAIDs, smoking cessation and assess for Helicobact…
• BImmediate total gastrectomy in all cases
• CNo treatment because marginal ulcers always heal spontaneously
• DOral iron only, with no need to address ulcer risk factors

A patient awaiting thyroidectomy for Graves disease develops fever, agitation, tachyarrhythmia and heart failure after iodinated contrast exposure. Thyroid storm is suspected. Which medication sequence is most appropriate?

• AIodine first, then thionamide 24 hours later
• BLevothyroxine replacement and calcium infusion
• CBeta-blockade and supportive care, thionamide therapy, then iodine after thionamide has b…
• DImmediate thyroidectomy before medical stabilisation in all cases

A 64-year-old woman with toxic multinodular goitre is scheduled for elective thyroidectomy because of compressive symptoms. She has atrial fibrillation and biochemical thyrotoxicosis. What is the safest preoperative strategy?

• AProceed directly to surgery while thyrotoxic because the gland will be removed
• BStart levothyroxine to suppress TSH further
• COptimise medically to a euthyroid or near-euthyroid state with beta-blockade and antithyr…
• DAvoid anaesthetic assessment because thyroid status is irrelevant to operative risk

Two hours after total thyroidectomy, a patient develops neck swelling, stridor and increasing respiratory distress on the ward. What is the correct immediate action?

• AOpen the cervical wound at the bedside to decompress the haematoma while calling for airw…
• BWait for a CT neck before intervening
• CGive oral antibiotics and review in the morning
• DPlace the patient flat and apply a tight pressure dressing

A patient develops perioral tingling, carpopedal spasm and a prolonged QT interval the morning after total thyroidectomy with central neck dissection. Corrected calcium is 1.78 mmol/L. What is the best immediate treatment?

• ARestrict dietary calcium and observe
• BHigh-dose loop diuretic therapy
• CUrgent reoperation to remove all parathyroid tissue
• DIntravenous calcium gluconate with cardiac monitoring, followed by oral calcium and activ…