100+ Free ACVS Veterinary Surgery Practice Questions

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What is the recommended dose and timing of perioperative ampicillin for surgical prophylaxis in a clean-contaminated small animal procedure?

5 mg/kg IM 2 hours before incision

22 mg/kg IV 30-60 minutes before skin incision, redosed every 90 minutes

50 mg/kg PO the morning of surgery

10 mg/kg IV at closure only

to track

2026 Statistics

Key Facts: ACVS Veterinary Surgery Exam

~350

Total MCQ Items

ACVS Certifying Exam — Phase I + Phase II

2 days

Total Exam Duration

Phase I (General) + Phase II (LA or SA track)

~12%

Equine Soft Tissue & Colic

Largest single domain across Large Animal track

~$1,800-2,500

2026 Exam Fee Range

ACVS (verify current schedule)

3 yr

ACVS-Approved Residency

Large Animal or Small Animal surgical residency

~60-75%

First-Time Pass Rate

ACVS examination statistics (Phase I and Phase II)

The ACVS Veterinary Surgery Certifying Examination is a 2-day computer-based test from the American College of Veterinary Surgeons, comprising ~350 MCQs across Phase I (General Surgery, common) and Phase II (Large Animal OR Small Animal track). Content spans equine soft tissue/colic (~12%), small animal soft tissue (~10%), small animal orthopedic (~10%), surgical oncology (~10%), equine orthopedic (~8%), bovine/food animal (~8%), surgical principles (~8%), anesthesia/critical care (~6%), neurosurgery (~6%), thoracic/cardiovascular (~5%), reconstruction (~4%), urogenital (~4%), imaging (~3%), ethics (~3%), and exotics (~3%). Exam fee is ~$1,800-$2,500; requires an ACVS-approved 3-year surgical residency with case logs and peer-reviewed publications.

Sample ACVS Veterinary Surgery Practice Questions

Try these sample questions to test your ACVS Veterinary Surgery exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1What is the recommended dose and timing of perioperative ampicillin for surgical prophylaxis in a clean-contaminated small animal procedure?

A.5 mg/kg IM 2 hours before incision

B.22 mg/kg IV 30-60 minutes before skin incision, redosed every 90 minutes

C.50 mg/kg PO the morning of surgery

D.10 mg/kg IV at closure only

Explanation: Perioperative antimicrobial prophylaxis should achieve therapeutic tissue concentrations at the time of incision. Ampicillin 22 mg/kg IV is given 30-60 min preoperatively and redosed every 90-120 min intraoperatively (roughly two half-lives). Prophylaxis is discontinued within 24 hours of surgery end.

2According to the CDC/NRC wound classification, a gastrotomy for foreign body removal without gross spillage is classified as which wound class?

A.Clean

B.Clean-contaminated

C.Contaminated

D.Dirty/infected

Explanation: Entry into the GI, respiratory, or urogenital tract under controlled conditions without unusual contamination is clean-contaminated. Gross spillage of GI contents would make it contaminated, and established infection (peritonitis) would make it dirty. Expected infection rates: clean 2-5%, clean-contaminated 3-11%, contaminated 10-17%, dirty >27%.

3Which Halsted principle is MOST directly violated by using heavy crushing clamps on delicate visceral tissue?

A.Strict asepsis

B.Gentle tissue handling

C.Accurate hemostasis

D.Obliteration of dead space

Explanation: Halsted's principles are: gentle tissue handling, meticulous hemostasis, preservation of blood supply, strict asepsis, minimum tension on tissues, accurate tissue apposition, and obliteration of dead space. Crushing viscera with heavy hemostats devitalizes tissue and increases dehiscence risk — atraumatic forceps (Debakey, Doyen) are preferred.

4How many hair/skin 'doublings' of clipper blade width are appropriate as the surgical margin around a planned skin incision?

A.Do not clip beyond the incision line

B.Clip 1-2 cm beyond planned incision

C.Clip at least 20 cm in all directions regardless of incision

D.Clip widely — generally 10-20 cm beyond the planned incision to allow for extension and drape fenestration

Explanation: Standard teaching is to clip widely — typically 10-20 cm beyond the planned incision — to allow for incision extension, drape repositioning, and drain/stab incisions. A #40 blade is used immediately before surgery (not the night before) to minimize microtrauma colonized by skin flora.

5Chlorhexidine gluconate surgical scrub is superior to povidone-iodine for skin antisepsis PRIMARILY because of what property?

A.It is sporicidal

B.It has persistent (residual) antimicrobial activity that is not inactivated by organic debris

C.It penetrates bone

D.It is active against Clostridium difficile spores

Explanation: Chlorhexidine binds stratum corneum and retains activity 6+ hours and is not inactivated by blood/serum. Povidone-iodine is inactivated by organic material and has minimal residual effect. Neither is reliably sporicidal. Alcohol-based chlorhexidine preparations provide the fastest and most persistent skin antisepsis.

6During gowning, which is considered part of the sterile field?

A.Neckline, shoulders, and back of the gown

B.Front of the gown from axilla to waist and sleeves from 2 inches above elbow to cuff

C.The entire gown including cuffs and all seams

D.Only the cuffs

Explanation: The sterile zone of a surgical gown is from the axillary line to the waist in front and the sleeves from 2 inches above the elbow to the cuff. The back, neckline, shoulders, and below the waist (or below the level of a sterile table) are considered non-sterile. Cuffs are non-sterile once hands pass through and are covered by gloves.

7Which suture material retains tensile strength longest and is appropriate for linea alba closure in an adult dog?

A.Plain catgut

B.Polyglactin 910 (Vicryl)

C.Polydioxanone (PDS) — ~50% at 6 weeks, absorbed ~6 months

D.Poliglecaprone 25 (Monocryl)

Explanation: Linea alba requires prolonged tensile strength because abdominal fascia regains only ~20% strength at 3 weeks and ~70% at several months. Polydioxanone (PDS) is a monofilament absorbable that retains ~70% strength at 2 weeks and ~50% at 6 weeks, making it ideal. Monocryl loses strength too quickly (50% at 7 days). Polypropylene (non-absorbable) is an alternative.

8What is the recommended minimum number of throws for a knot tied with monofilament suture?

A.2

B.3

C.6-7 square throws (or more) because monofilament has a lower coefficient of friction

D.Any number, knots do not slip

Explanation: Monofilament sutures (PDS, Monocryl, nylon, prolene) have low surface friction and are more prone to knot slippage. Minimum recommended is 6-7 alternating square throws for monofilament versus 3-4 for braided multifilament. Knot ears should be left 3 mm to reduce untying.

9A dog presenting for elective cruciate surgery has stable mitral valve disease (Stage B2) with no clinical signs. What is the appropriate ASA classification?

A.ASA I

B.ASA II

C.ASA III

D.ASA IV

Explanation: ASA I = normal healthy. ASA II = mild systemic disease without functional limitation (e.g., compensated heart disease, obesity, controlled endocrinopathy). ASA III = severe systemic disease with functional limitation. ASA IV = severe systemic disease that is a constant threat to life. This stable asymptomatic MVD is ASA II.

10The minimum alveolar concentration (MAC) of isoflurane in the dog is approximately:

A.0.4%

B.1.3%

C.2.6%

D.4.5%

Explanation: Canine MAC of isoflurane is ~1.3%, sevoflurane ~2.3%, desflurane ~7.2%. MAC is reduced by opioids, alpha-2 agonists, ketamine CRIs, hypothermia, pregnancy, and severe hypotension. Adjunctive analgesia enables surgical anesthesia at sub-MAC vaporizer settings, preserving cardiac output.

About the ACVS Veterinary Surgery Exam

The ACVS Veterinary Surgery Certifying Examination validates core knowledge for Diplomate status in veterinary surgery. The 2-day exam consists of Phase I (General Surgery, common to all candidates) and Phase II (species track — Large Animal OR Small Animal), totaling approximately 350 MCQs. Content spans small animal soft tissue (GDV, PSS, BOAS, splenectomy), small animal orthopedic (CCL — TPLO/TTA, MPL, hip dysplasia, AO fracture fixation), equine soft tissue and colic (colic exploratory, laryngeal hemiplegia tieback, DDSP), equine orthopedic (arthroscopy, fracture repair, angular limb deformities), bovine/food animal (LDA/RDA, rumenotomy, cesarean), surgical oncology (margins, MCT grading, sarcoid), surgical principles (Halsted, wound healing, asepsis, SSI), anesthesia and critical care, neurosurgery (IVDD, atlantoaxial, ventral slot), thoracic (PDA, PRAA, TDL+SP for chylothorax), reconstruction (axial pattern flaps), urogenital, imaging, ethics, and exotics. Requires completion of an ACVS-approved 3-year residency with case logs and publications.

Questions

350 scored questions

Time Limit

2-day CBT — Phase I General + Phase II LA or SA track

Passing Score

Criterion-referenced scaled score set by ACVS (modified Angoff standard)

Exam Fee

~$1,800-$2,500 Certifying Examination fee (ACVS 2026 — verify current schedule) (American College of Veterinary Surgeons (ACVS))

ACVS Veterinary Surgery Exam Content Outline

~12%

Equine Soft Tissue & Colic

Equine colic (large colon volvulus, strangulating lipoma, epiploic foramen entrapment, enteroliths, nephrosplenic entrapment), exploratory celiotomy (ventral midline), enterotomy/resection and anastomosis, upper airway surgery (laryngeal hemiplegia — prosthetic laryngoplasty/tieback + ventriculocordectomy, epiglottic entrapment, DDSP — tie-forward), sinus/guttural pouch disease, umbilical/inguinal hernia, cryptorchidectomy, castration complications (eventration, hemorrhage), wound management.

~10%

Small Animal Soft Tissue

Gastrointestinal surgery (GDV — right-sided gastropexy, intestinal resection/anastomosis, foreign body), hepatobiliary (portosystemic shunt — ameroid constrictor/cellophane banding, cholecystectomy, liver lobectomy), splenectomy (hemangiosarcoma), BOAS (brachycephalic — staphylectomy, stenotic nares, everted laryngeal saccules), tracheal collapse (stents), thyroidectomy/parathyroidectomy, adrenalectomy, perineal hernia, anal sacculectomy.

~10%

Small Animal Orthopedic

CCL disease (TPLO, TTA, lateral suture), patellar luxation (MPL trochleoplasty, tibial tuberosity transposition), hip dysplasia (THR, FHO, JPS, TPO/DPO), fracture repair (AO principles — plate, IM pin, ESF, interlocking nail, locking plate), elbow dysplasia (FCP, OCD, UAP), shoulder OCD, Achilles tendon, arthroscopy, limb amputation, angular limb deformities.

~10%

Surgical Oncology

Principles of surgical oncology (margins — staging biopsy, incisional vs excisional, lateral and deep margins per tumor type), soft tissue sarcoma (2-3 cm lateral + 1 fascial plane deep), mast cell tumor (grading — Patnaik/Kiupel, Kit exon 11), canine oral melanoma/fibrosarcoma/SCC, equine sarcoid and melanoma, injection-site sarcoma (feline — 3-2-1 rule), hemangiosarcoma, reconstruction after tumor resection, adjuvant therapy (radiation, chemotherapy, toceranib).

~8%

Equine Orthopedic

Fracture repair (internal fixation — condylar, sesamoid, pastern arthrodesis, transfixation casting), arthroscopy (OCD tarsocrural/stifle/fetlock, subchondral bone cysts, chip fragments), navicular/heel pain, proximal suspensory desmitis, DDFT tenotomy, angular/flexural limb deformities (periosteal stripping, desmotomy), osteomyelitis/septic joint lavage, laminitis (deep digital flexor tenotomy).

~8%

Bovine / Food Animal Surgery

Displaced abomasum (LDA right paralumbar omentopexy, Utrecht toggle suture, left laparoscopic abomasopexy), cesarean section, rumenotomy (hardware disease — traumatic reticuloperitonitis), teat and udder surgery, obstetrical intervention (fetotomy, malpresentation), claw amputation, digit and interdigital surgery, urolithiasis (tube cystotomy in small ruminants), dehorning, castration.

~8%

Surgical Principles & Biology

Wound healing (phases, collagen, growth factors — TGF-β/PDGF/VEGF), suture material and patterns (absorbable vs nonabsorbable, monofilament vs multifilament), tension/apposition techniques, asepsis and Spaulding classification, surgical site infection (SSI — NNIS wound class), antimicrobial prophylaxis timing, Halsted principles, hemostasis, electrosurgery/vessel sealing, minimally invasive surgery.

~6%

Anesthesia & Critical Care

Species-specific protocols (equine TIVA, inhalational isoflurane/sevoflurane, alpha-2 agonists — xylazine/detomidine/romifidine; small animal multimodal — opioids, alpha-2, ketamine, local blocks), regional anesthesia (epidural, RUMM, brachial plexus, intercostal), MAC concepts, hypotension management, recovery complications, shock/resuscitation (crystalloid, colloid, hypertonic), transfusion medicine, NSAID safety.

~6%

Neurosurgery

IVDD (Hansen I/II, MRI localization, hemilaminectomy, mini-hemilaminectomy, ventral slot C-spine), atlantoaxial instability (dorsal vs ventral stabilization), cervical spondylomyelopathy (wobbler), lumbosacral stenosis, Chiari-like malformation/syringomyelia, spinal fracture/luxation, brain tumor/craniotomy basics, peripheral nerve injury and repair.

~5%

Thoracic & Cardiovascular Surgery

Thoracotomy (intercostal vs median sternotomy), lung lobectomy, pyothorax and chylothorax (thoracic duct ligation + subtotal pericardiectomy — TDL+SP), PDA (ligation, Amplatz canine ductal occluder), persistent right aortic arch (vascular ring anomaly), diaphragmatic hernia, pericardiectomy, chest wall reconstruction, thoracoscopy.

~4%

Reconstructive Surgery

Skin flaps (subdermal plexus — random pattern; axial pattern flaps — caudal superficial epigastric, thoracodorsal, omocervical, caudal auricular, superficial brachial, genicular), free skin grafts (full-thickness vs mesh), tension-relieving techniques (undermining, relaxing incisions, walking sutures), reconstructive ladder, vascularized muscle/myocutaneous flaps.

~4%

Urogenital Surgery

Perineal urethrostomy (feline), scrotal urethrostomy (canine), cystotomy and urolith management, ectopic ureter (neoureterostomy, laser ablation), renal transplant basics, prostatic disease (omentalization for abscess/cyst), pyometra (ovariohysterectomy), uterine prolapse, cesarean section (canine/feline), cryptorchidectomy, testicular and ovarian neoplasia.

~3%

Diagnostic Imaging & Interventional

Radiographic/ultrasound/CT/MRI interpretation for surgical planning, contrast studies (myelography largely replaced by MRI/CT myelogram), fluoroscopy-guided procedures (tracheal stent, urethral stent, intrahepatic PSS), arthroscopy, laparoscopy and thoracoscopy principles, interventional radiology (vascular occlusion, embolization).

~3%

Ethics, Regulatory & Scholarly

Informed consent, AVMA Principles of Veterinary Medical Ethics, animal welfare (5 domains), humane endpoints, FDA extra-label drug use (AMDUCA), prohibited drugs in food animals, biostatistics (sensitivity/specificity, PPV/NPV), evidence-based veterinary medicine, IACUC and research design, authorship and publication ethics.

~3%

Exotic / Zoo / Avian Surgery

Avian coelomic surgery (egg binding, proventricular dilation), reptile surgery (ovariectomy/salpingectomy, coeliotomy, shell repair), lagomorph and small mammal surgery (rabbit GI stasis, guinea pig urolithiasis), fish surgery basics, anesthesia considerations for exotics, zoo species restraint and surgical planning.

How to Pass the ACVS Veterinary Surgery Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by ACVS (modified Angoff standard)
Exam length: 350 questions
Time limit: 2-day CBT — Phase I General + Phase II LA or SA track
Exam fee: ~$1,800-$2,500 Certifying Examination fee (ACVS 2026 — verify current schedule)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ACVS Veterinary Surgery Study Tips from Top Performers

1AO principles of fracture fixation — high-yield framework: Anatomic reduction (articular fractures — absolute stability with lag screw + neutralization plate), Stable fixation (choose construct matched to fracture personality — simple transverse/short oblique = compression plating; comminuted = bridging plate or interlocking nail), Preservation of blood supply (minimally invasive osteosynthesis — MIO, biological fixation), Early active motion. Locking plates (LCP) provide angle-stable fixation useful in osteopenic bone and bridging constructs.

2GDV surgical management — decision pearls: Always decompress before or during induction (orogastric tube or trocar), ventral midline celiotomy, derotate counterclockwise (in right lateral recumbency viewpoint), assess stomach viability (color, peristalsis, serosal tearing), splenectomy only for avulsion/thrombosis, right-sided incisional gastropexy is the standard prophylactic technique (90%+ effective at preventing recurrence), evaluate for mucosal necrosis with partial gastrectomy if needed. Check post-op for reperfusion arrhythmias (VPCs — lidocaine CRI).

3Soft tissue sarcoma vs mast cell tumor margins: STS — 2-3 cm lateral margins with 1 fascial plane deep (low/intermediate grade); excisional biopsy adequate for low-grade with clean margins. Mast cell tumor — Patnaik (3-tier) and Kiupel (2-tier: low vs high grade). Historic 3 cm recommendation has been modernized; proportional margins (1-2 cm lateral and 1 fascial plane deep) with clean histologic margins yield excellent local control for low-grade MCT. Kit exon 11 internal tandem duplication predicts toceranib/masitinib response.

4Equine laryngeal hemiplegia (recurrent laryngeal neuropathy) — left-sided in 95%+: grades on Havemeyer/Lane scale at rest and during exercise. Prosthetic laryngoplasty ('tie-back') with ventriculocordectomy is the standard for racehorses/sport horses with grade IV (complete paralysis) and exercise intolerance/abnormal respiratory noise. Complications include suture failure, coughing, aspiration pneumonia, and dysphagia. Arytenoid cartilage chondropathy is a distinct problem requiring partial arytenoidectomy.

5Bovine LDA repair options — surgeon's choice based on economics, chronicity, and environment: Right paralumbar omentopexy (Utrecht approach — most common in North America, standing under local anesthesia, good visualization), left paralumbar abomasopexy, right flank pyloromyotomy + omentopexy, blind toggle suture technique (fast/cheap but blind — risk of ventral organ entrapment), and laparoscopic-assisted abomasopexy (two-step or one-step Janowitz/Christiansen). RDA with volvulus is an emergency requiring right paralumbar laparotomy with decompression, derotation, and omentopexy.

Frequently Asked Questions

What is the ACVS Veterinary Surgery Certifying Examination?

The ACVS Certifying Examination is administered by the American College of Veterinary Surgeons and is required for Diplomate status (board certification) in veterinary surgery. The 2-day exam consists of Phase I (General Surgery, common to all candidates) and Phase II (species track — Large Animal OR Small Animal), validating breadth and species-specific depth of surgical knowledge. Total ~350 single-best-answer items cover surgical principles, soft tissue and orthopedic surgery, oncology, neurosurgery, thoracic, anesthesia, reconstruction, and ethics.

Who is eligible to take the ACVS Certifying Exam?

Candidates must hold a D.V.M., V.M.D., or equivalent veterinary degree from an AVMA-accredited college (or equivalent credentialing) and must complete an ACVS-approved surgical residency (typically 3 years) in Large Animal Surgery or Small Animal Surgery. Requirements include a rotating internship or equivalent experience, satisfactory case logs attested by the program mentor, peer-reviewed publication(s), and a credentials packet reviewed and approved by ACVS.

What is the format of the ACVS Certifying Exam?

The ACVS Certifying Exam is a 2-day computer-based examination. Day 1 (Phase I) covers General Surgery content common to all candidates. Day 2 (Phase II) covers species-specific content — candidates choose the Large Animal or Small Animal track based on their residency. The exam uses approximately 350 single-best-answer multiple-choice items with clinical photographs, radiographs, and surgical images. Passing both phases is required for Diplomate status.

How much does the 2026 ACVS Certifying Exam cost?

The 2026 ACVS Certifying Examination fee is approximately $1,800-$2,500 — always verify the current schedule on the ACVS website. Candidates also pay credentials application fees and ongoing ACVS Maintenance of Certification (MOC) dues after achieving Diplomate status. Cancellation and refund policies follow the ACVS schedule, and retakes of a failed phase require re-registration and fee payment within the defined eligibility window.

When is the 2026 exam administered?

The ACVS Certifying Examination is typically offered once annually. Applications and credentials packets are generally submitted the year prior to the exam with specific deadlines per the ACVS schedule. Candidates schedule specific test-center appointments after application approval. Exact 2026 dates should be confirmed on the ACVS Certifying Exam page.

How is the exam scored?

ACVS uses criterion-referenced scaled scoring with a passing standard set by subject-matter experts using the modified Angoff method. A candidate's result depends on performance relative to the fixed cut-score, not relative to other candidates. Both Phase I (General Surgery) and Phase II (species track) must be passed for Diplomate status. If only one phase is failed, the candidate typically retakes only that failed phase within the eligibility window.

What are the highest-yield topics?

Highest-yield topics include AO fracture fixation principles, CCL disease management (TPLO/TTA biomechanics), GDV and right-sided gastropexy, portosystemic shunt attenuation, equine colic surgical lesions and decision-making, laryngeal hemiplegia tieback and DDSP, bovine LDA repair options (omentopexy vs toggle vs laparoscopic), soft tissue sarcoma margins (2-3 cm lateral + 1 fascial plane deep), mast cell tumor grading (Patnaik/Kiupel), IVDD localization and hemilaminectomy, PDA ligation, PRAA vascular ring anomaly, chylothorax TDL+SP, axial pattern flap anatomy, and Halsted principles.

How should I study for this exam?

Use a structured 18-24 month plan layered on your ACVS-approved residency. Map to the ACVS content outline: begin with surgical principles, wound healing, suture, and anesthesia; then master small animal soft tissue and orthopedic surgery (or equine/large animal depending on track); integrate cross-species content (oncology, neurosurgery, thoracic, reconstruction). Core references include Tobias and Johnston's Veterinary Surgery: Small Animal, Auer and Stick's Equine Surgery, and Fubini and Ducharme's Farm Animal Surgery, plus current Veterinary Surgery journal articles. Complete 2-3 full-length timed mock exams.