100+ Free Atestace Chirurgie Practice Questions
Prepare for the Atestační zkouška v oboru Chirurgie / Czech Medical Specialty Board Examination in Surgery exam with instant access — no signup required.
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Key Facts: Atestace Chirurgie Exam
Official Qualification
Administering Bodies
Legal Regulations
Official Examination Fee
Examination Components
Required Postgraduate Residency
The Czech Specialty Examination in Surgery is a practical and oral board assessment before an appointed committee. This independent 100-question English MCQ bank covers the published curriculum using its own study allocation: Surgical Principles & Perioperative Care (20%), Abdominal & GI Surgery (30%), Trauma, Emergency Surgery & Critical Care (20%), Vascular, Thoracic & Endocrine Surgery (15%), and Surgical Oncology & Minimally Invasive Surgery (15%); MZ ČR does not publish these percentages as an official exam weighting.
Sample Atestace Chirurgie Practice Questions
Try these sample questions to test your Atestace Chirurgie exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 48-year-old man is scheduled for an elective open right hemicolectomy for colon adenocarcinoma. According to the Czech Surgical Society (ČCHS ČLS JEP) and international surgical site infection (SSI) prevention guidelines, what is the most appropriate timing and choice for intravenous antimicrobial prophylaxis?
2During a prolonged open pancreaticoduodenectomy (Whipple procedure) that has reached 4.5 hours of operative time, the circulating nurse notes that the patient's intraoperative blood loss is 600 mL. The initial pre-incision prophylactic antibiotic was cefazolin (2 g IV, half-life approximately 1.8 hours). What is the evidence-based recommendation for intraoperative redosing?
3A 67-year-old male with a BMI of 31 kg/m² undergoes an elective low anterior resection for rectal cancer. He has no personal or family history of bleeding diathesis. Based on the Caprini score for venous thromboembolism (VTE) risk assessment, what is his risk category and the standard prophylaxis regimen endorsed by European and Czech guidelines?
4Enhanced Recovery After Surgery (ERAS) pathways have transformed modern perioperative management. Which of the following is a key element of the preoperative ERAS protocol in elective colorectal surgery?
5A 55-year-old female undergoes an uneventful elective laparoscopic sleeve gastrectomy. On postoperative day 2, she develops a heart rate of 124 bpm, blood pressure of 88/54 mmHg, and urine output of 15 mL/h over the past 3 hours. Arterial blood gas shows pH 7.29, HCO3⁻ 16 mmol/L, and lactate 3.4 mmol/L. What is the most critical initial intervention under Sepsis-3 resuscitation bundles?
6A 72-year-old patient who underwent emergency sigmoidectomy for perforated diverticulitis receives 6 liters of 0.9% normal saline during the first 24 hours of resuscitation. Laboratory testing reveals serum sodium 144 mmol/L, chloride 118 mmol/L, potassium 4.2 mmol/L, pH 7.28, and standard base excess -7.5 mEq/L. What is the physiological mechanism of this acid-base disturbance?
7According to the Clavien-Dindo classification of surgical complications, how is a postoperative event classified if a patient develops an intra-abdominal abscess requiring percutaneous CT-guided drain placement under local anesthesia on postoperative day 6?
8On postoperative day 7 following an exploratory laparotomy, a 62-year-old obese diabetic patient reports a sudden 'popping' sensation during a coughing fit, accompanied by a large volume of salmon-pink, serosanguinous fluid soaking through his abdominal dressing. On inspection, the skin sutures have separated and loop of small intestine is visible in the wound base. What is the diagnosis and immediate surgical management?
9A 58-year-old male with severe chronic malnutrition (BMI 15.2 kg/m², 18% unintentional weight loss over 3 months) is admitted for obstructing esophageal carcinoma. Total parenteral nutrition (TPN) is started at full caloric goal (35 kcal/kg/day). Within 48 hours, the patient develops profound muscle weakness, confusion, respiratory distress, and ventricular arrhythmias. What is the biochemical hallmark of this condition?
10Skin preparation in the operating suite is a critical step in surgical site infection prevention. Based on national SAK guidelines and WHO surgical safety standards, which antiseptic solution provides superior efficacy for surgical field antisepsis in clean and clean-contaminated operations?
About the Atestace Chirurgie Exam
The Atestační zkouška v oboru Chirurgie (Czech Specialty Examination in Surgery) is the official post-graduate board qualification conferring specialized professional competence ('specializovaná způsobilost') in General Surgery in the Czech Republic under Zákon č. 95/2004 Sb. and Vyhláška č. 282/2019 Sb. Administered by the Ministry of Health (MZ ČR) in partnership with Czech medical faculties and IPVZ, this high-stakes board examination certifies that a physician possesses comprehensive clinical discernment, operative capability, critical care expertise, and ethical-legal competence to practice surgery independently. This practice bank provides 100 expert clinical MCQs adapted into English directly mapping to the official Věstník MZ ČR educational program curriculum.
Assessment
Performance-based assessment
Time Limit
No fixed total duration is published; oral preparation is at least 30 minutes, with practical and operative assessment as required by the specialty program.
Passing Score
Prospěl / Neprospěl (Pass/Fail standard determined by official Examination Committee)
Exam Fee
500 CZK (Base exam) / 3,500 CZK (1st retake) / 5,000 CZK (2nd retake) (Ministerstvo zdravotnictví České republiky (MZ ČR) / Lékařské fakulty / Institut postgraduálního vzdělávání ve zdravotnictví (IPVZ))
Atestace Chirurgie Exam Content Outline
Surgical Principles & Perioperative Care
Comprehensive perioperative surgical principles, wound healing biology, fluid and electrolyte physiology, surgical nutrition, infection prevention, antithrombotic management, and complication classification. Key areas include surgical site infection (SSI) prophylaxis (preoperative cephalosporin timing within 30-60 min, redosing criteria, skin antisepsis with chlorhexidine-alcohol); venous thromboembolism (VTE) risk stratification (Caprini score, LMWH dosing and duration, mechanical compression); Enhanced Recovery After Surgery (ERAS) protocols (preoperative carbohydrate loading, avoidance of prolonged fasting and routine drains, early enteral nutrition and mobilization); wound healing phases, surgical dehiscence (burst abdomen / dehiscence laparotomie), negative pressure wound therapy (NPWT); fluid resuscitation (balanced crystalloids vs normal saline hyperchloremic acidosis, goal-directed fluid therapy); surgical shock identification and Sepsis-3 resuscitation bundles; evaluation of postoperative pyrexia; and standardized classification of surgical complications according to the Clavien-Dindo system (Grade I to V).
Abdominal & Gastrointestinal Surgery
Diagnostic workup, surgical indications, and operative techniques across visceral and gastrointestinal emergencies and elective conditions. Core focus areas include acute abdomen differential diagnosis and imaging protocols (ultrasound, biphasic contrast CT); acute appendicitis stratification (Alvarado score, laparoscopic appendectomy technique, stump closure); acute cholecystitis management according to Tokyo Guidelines 2018 (TG18/TG20 Grade I–III, Critical View of Safety / Strasberg criteria, early laparoscopic cholecystectomy within 72 hours, bail-out subtotal cholecystectomy, percutaneous drainage); abdominal wall hernia surgery (inguinal hernia repair via Lichtenstein open mesh vs laparoscopic TAPP/TEP, femoral hernia urgency, incisional hernia retro-rectus Rives-Stoppa repair, component separation); small bowel obstruction (adhesions, strangulation indicators, Gastrografin challenge protocol); large bowel obstruction and volvulus (sigmoid detorsion vs emergency resection, cecal bascule/volvulus); acute diverticulitis classification (Hinchey I–IV, Hansen-Stock, outpatient vs resection vs Hartmann's procedure); upper gastrointestinal perforations (perforated peptic ulcer Graham omental patch, Boerhaave syndrome); acute pancreatitis surgical strategy (infected pancreatic necrosis, step-up approach, catheter drainage, necrosectomy); and emergency colorectal resections.
Trauma, Emergency Surgery & Critical Care
Systematic trauma evaluation, emergency operative intervention, and critical care resuscitation based on Advanced Trauma Life Support (ATLS) and European trauma guidelines. Core topics include ATLS primary and secondary surveys (Airway with cervical spine protection, Breathing, Circulation with hemorrhage control, Disability, Exposure/Hypothermia prevention); damage control surgery (DCS) philosophy and physiological triggers (lethal triad: hypothermia < 35°C, severe metabolic acidosis pH < 7.2, coagulopathy); damage control laparotomy steps (four-quadrant packing, rapid surgical hemostasis, contamination control via stapling without anastomosis, temporary abdominal closure TAC / open abdomen); severe pelvic ring fractures (pelvic binder placement over greater trochanters, pre-peritoneal pelvic packing, angioembolization); extremity compartment syndrome pathophysiology, measurement (delta pressure = diastolic BP - compartment pressure <= 30 mmHg), and urgent four-compartment lower-leg fasciotomy; thoracic trauma (massive hemothorax > 1500 mL or > 200 mL/h indicating emergency thoracotomy, tension pneumothorax needle decompression vs finger thoracostomy, cardiac tamponade Beck's triad); solid organ trauma grading (AAST liver and spleen injury scores, non-operative management NOM criteria, angioembolization vs splenectomy/packing); open fracture debridement (Gustilo-Anderson); and REBOA principles.
Vascular, Thoracic & Endocrine Surgery
Emergency evaluation, operative tactics, and management of vascular, thoracic, and endocrine surgical pathology encountering general surgeons. Core topics include acute limb ischemia (the 6 Ps: pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia; Rutherford classification Category I, IIa, IIb, III; urgent Fogarty catheter balloon embolectomy vs bypass within the 6-hour warm ischemia window, reperfusion syndrome and prophylactic fasciotomy); abdominal aortic aneurysm (AAA: screening criteria, elective repair thresholds >= 5.5 cm in men, >= 5.0 cm in women, rupture clinical triad, open vs endovascular EVAR repair with permissive hypotension); acute mesenteric ischemia (superior mesenteric artery embolus vs thrombosis vs non-occlusive mesenteric ischemia NOMI vs mesenteric venous thrombosis; urgent biphasic CT angiography, embolectomy, bowel resection and second-look laparotomy); spontaneous and tension pneumothorax (safe triangle chest tube placement, VATS pleurodesis and wedge resection); pleural empyema staging (Light criteria, exudative, fibrinopurulent, organizing; VATS decortication); and endocrine surgery fundamentals (thyroid nodules, Bethesda classification, total thyroidectomy vs lobectomy, recurrent laryngeal nerve identification, parathyroid preservation, hypocalcemia management, primary hyperparathyroidism, and adrenal incidentaloma workup).
Surgical Oncology & Minimally Invasive Surgery
Foundational surgical oncology, multimodal treatment sequencing, multidisciplinary tumor boards (MDT / indikační seminář), and advanced minimally invasive surgical techniques. Core focus areas include UICC/AJCC TNM 8th edition staging principles (clinical cTNM vs pathological pTNM vs post-neoadjuvant ypTNM); oncological surgical margins (R0 microscopic negative, R1 microscopic positive, R2 macroscopic residual, circumferential resection margin CRM); total mesorectal excision (TME) with autonomic pelvic nerve preservation and complete mesocolic excision (CME) with central vascular ligation; sentinel lymph node biopsy (SLNB) techniques (radiocolloid, blue dye, indocyanine green ICG fluorescence); neoadjuvant chemotherapy and chemoradiotherapy indications (FLOT regimen in gastric/GEJ cancer, total neoadjuvant therapy TNT in rectal cancer, CROSS regimen in esophageal cancer); cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) indications and Peritoneal Cancer Index (PCI); and minimally invasive surgery principles (laparoscopic ergonomics, port placement, pneumoperitoneum physiological consequences, trocar injury prevention, robotic surgery advantages).
How to Pass the Atestace Chirurgie Exam
What You Need to Know
- Passing score: Prospěl / Neprospěl (Pass/Fail standard determined by official Examination Committee)
- Assessment: Performance-based assessment
- Time limit: No fixed total duration is published; oral preparation is at least 30 minutes, with practical and operative assessment as required by the specialty program.
- Exam fee: 500 CZK (Base exam) / 3,500 CZK (1st retake) / 5,000 CZK (2nd retake)
Keys to Passing
- Work through all 100 available questions
- Review every answer and explanation
- Track weak areas and revisit them
- Use our AI tutor for tough concepts
Atestace Chirurgie Study Tips from Top Performers
Frequently Asked Questions
What is the Atestační zkouška v oboru Chirurgie and what does it certify in the Czech Republic?
The Atestační zkouška v oboru Chirurgie is the official state medical specialty board examination in General Surgery in the Czech Republic, administered by the Ministry of Health (MZ ČR) in collaboration with accredited university medical faculties and the Institute for Postgraduate Medical Education (IPVZ). Passing this examination confers 'specializovaná způsobilost' (specialist competence) under Zákon č. 95/2004 Sb., allowing the physician to practice surgery independently as a fully qualified specialist surgeon throughout the Czech Republic and the European Union.
How is the official Czech surgical specialty examination organized and conducted?
Under Vyhláška č. 282/2019 Sb., the examination comprises two mandatory parts: (1) A practical clinical examination (praktická část) conducted at an accredited clinical department, where the candidate examines an assigned surgical patient, formulates a differential diagnostic workup, proposes operative and conservative management, and performs or assists with operative procedures under direct evaluation; and (2) An oral theoretical examination (teoretická část) held before an at least 3-member examination committee appointed by the Ministry of Health, where the candidate answers 3 comprehensive question sets drawn from the official board catalog.
What are the official examination fees under Czech government regulations?
Under Nařízení vlády č. 324/2018 Sb., the fee for the regular initial specialty board examination is 500 CZK (divided into 250 CZK for the practical part and 250 CZK for the theoretical part). For retakes, the statutory fee increases substantially: 3,500 CZK for the first retake examination and 5,000 CZK for the second retake examination.
What is the retake policy if a candidate fails one or both parts of the atestace?
Under Zákon č. 95/2004 Sb. and Vyhláška č. 282/2019 Sb., a candidate who fails the practical part is not admitted to the theoretical part. If a candidate passes the practical part but fails the oral theoretical examination, they must repeat only the theoretical part. The examination may be repeated at most twice (maximum 3 attempts total). A mandatory preparation interval (typically at least 6 months) is mandated before repeating the exam.
Why is this practice question bank presented in English with MCQs?
Although the official Czech state board examination is conducted orally and clinically in Czech, English is the primary language of international surgical literature, European surgical board exams (UEMS / EBSQ General Surgery), and major international clinical guidelines (ATLS, Tokyo Guidelines TG18, EAES, Sepsis-3). This question bank provides an English-language MCQ study adaptation based on official Věstník MZ ČR educational catalogs, allowing candidates to consolidate clinical reasoning, evidence-based surgical guidelines, and rapid diagnostic decision-making.
What Czech-specific laws and healthcare standards are relevant to surgical practice?
Key Czech regulations include Zákon č. 95/2004 Sb. (physician postgraduate education and competence), Vyhláška č. 282/2019 Sb. (examination rules), Zákon č. 372/2011 Sb. o zdravotních službách (statutory informed consent, medical record keeping, advance directives / dříve vyslovená přání), Transplantační zákon č. 285/2002 Sb. (organ donation and brain death criteria), and national hospital accreditation standards from the United Accreditation Commission of the Czech Republic (SAK) concerning patient safety checklists and surgical Time-Out protocols.