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Sample UKOM Sp.B Practice Questions

Try these sample questions to review concepts for the UKOM Sp.B exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 32-year-old motorcyclist is brought to the emergency department following a high-speed collision. He is agitated, cyanotic, and exhibits stridor with gurgling respirations. What is the priority first step in management according to ATLS principles?
A.Obtain an immediate cross-table lateral cervical spine radiograph
B.Secure the airway with in-line cervical spine stabilization
C.Perform a needle thoracostomy in the second intercostal space
D.Infuse two liters of warmed isotonic crystalloid solution
Explanation: According to ATLS (Advanced Trauma Life Support) principles, the primary survey begins with airway assessment and maintenance while ensuring strict cervical spine protection. Gurgling and stridor indicate upper airway compromise that requires immediate airway clearing and definitive airway control with manual in-line cervical spine stabilization.
2A 24-year-old man presents with a stab wound to the right hemithorax. He is in severe respiratory distress, hypotensive (blood pressure 75/40 mmHg), tachycardic (heart rate 138 bpm), with distended neck veins and absent breath sounds over the right hemithorax. What is the immediate emergency intervention?
A.Immediate finger or needle thoracostomy without waiting for imaging, followed promptly by tube thoracostomy
B.Wait for an urgent portable upright chest radiograph to confirm the diagnosis
C.Immediate endotracheal intubation and positive pressure ventilation
D.Emergency subxiphoid pericardial window
Explanation: Tension pneumothorax is a clinical diagnosis requiring immediate pleural decompression. Finger thoracostomy or appropriately placed needle decompression is a rapid temporizing maneuver; a functioning tube thoracostomy provides definitive pleural drainage and should follow promptly. Imaging must not delay decompression in an unstable patient.
3A 40-year-old man involved in a motor vehicle collision arrives with a heart rate of 128 bpm, blood pressure of 88/60 mmHg, tachypnea (respiratory rate 32 breaths/min), cold clammy extremities, and marked confusion. What class of hemorrhagic shock is this patient exhibiting according to ATLS guidelines?
A.Class I hemorrhage (blood loss < 15%)
B.Class II hemorrhage (blood loss 15–30%)
C.Class III hemorrhage (blood loss 31–40%)
D.Class IV hemorrhage (blood loss > 40%)
Explanation: ATLS Class III hemorrhagic shock corresponds to a 31–40% circulating blood volume loss (approximately 1500–2000 mL in a 70-kg adult). It is characterized by marked tachycardia (>120 bpm), overt hypotension (decreased systolic BP), tachypnea (30–40/min), decreased urine output (5–15 mL/h), and altered mental status. These patients require blood component transfusion in addition to crystalloids.
4A polytrauma patient in severe hemorrhagic shock requires activation of the Massive Transfusion Protocol (MTP). What is the evidence-based balanced ratio of Packed Red Blood Cells (PRBC), Fresh Frozen Plasma (FFP), and Platelets recommended in damage control resuscitation?
A.1:1:1 ratio of PRBC, FFP, and platelets
B.4:1:1 ratio prioritizing PRBC over plasma and platelets
C.6:2:1 ratio using crystalloids as volume expansion
D.2:1:0 ratio withholding platelets until platelet count drops below 20,000/mcL
Explanation: Modern damage control resuscitation (demonstrated in trials such as PROPPR) emphasizes early balanced haemostatic resuscitation using a 1:1:1 ratio of packed red blood cells, fresh frozen plasma, and platelets. This balanced strategy prevents acute traumatic coagulopathy, hypofibrinogenemia, and dilutional coagulopathy compared to red-cell-heavy protocols.
5During an emergency exploratory laparotomy for severe liver and mesenteric injury, the anesthesiologist reports a core body temperature of 33.8°C, arterial pH of 7.18, and diffuse microvascular oozing without clot formation. What is the most appropriate surgical decision?
A.Proceed with definitive anatomic liver resection and complete bowel anastomoses
B.Initiate damage control surgery: pack the liver, temporarily close or cover the abdomen, and transfer to the ICU for resuscitation
C.Continue surgery while administering high-dose dopamine and waiting for lab coagulation results
D.Insert multiple large closed-suction drains and perform layered abdominal wall closure
Explanation: The patient has reached the lethal triad of trauma: hypothermia (<35°C), severe metabolic acidosis (pH <7.20), and clinical coagulopathy (diffuse non-mechanical oozing). In this setting, prolonged definitive reconstruction leads to irreversible physiological collapse. Damage control surgery mandates rapid surgical control of hemorrhage and contamination, temporary abdominal closure (open abdomen), and transfer to the ICU for physiological correction.
6In a patient undergoing focused assessment with sonography for trauma (FAST), which anatomic space in the right upper quadrant is the most sensitive dependent area for detecting hemoperitoneum in the supine position?
A.Subphrenic space above the spleen
B.Hepatorenal recess (Morison's pouch)
C.Pouch of Douglas (rectouterine pouch)
D.Lesser sac (omental bursa)
Explanation: Morison's pouch (the hepatorenal recess) is the most dependent potential space in the upper peritoneal cavity in the supine position. Free peritoneal blood gravitates here, making it the most sensitive single acoustic window on the FAST examination, capable of detecting as little as 250–500 mL of free fluid.
7A 28-year-old woman is brought to the resuscitation bay after a severe blunt abdominal impact in a car crash. Her blood pressure is 78/45 mmHg and fails to respond to 1 liter of crystalloids. FAST examination reveals abundant free fluid in Morison's pouch and the pelvis. What is the next immediate step in management?
A.Transport the patient immediately to the radiology suite for a contrast-enhanced abdominal CT scan
B.Perform diagnostic peritoneal lavage (DPL) to quantify red blood cell count
C.Transfer the patient immediately to the operating theatre for emergent exploratory laparotomy
D.Admit to the surgical intensive care unit for serial abdominal examinations
Explanation: A hemodynamically unstable patient with blunt abdominal trauma and a positive FAST scan indicating hemoperitoneum requires immediate emergent exploratory laparotomy. Contrast-enhanced CT scanning is strictly contraindicated in unstable trauma patients because transport to radiology can result in unmonitored cardiovascular arrest.
8A 22-year-old man sustains an anterior abdominal stab wound 3 cm below the umbilicus. Physical examination reveals an 8 cm laceration with evisceration of viable small bowel loops. He is hemodynamically stable. What is the most appropriate management?
A.Cover the eviscerated bowel with moist sterile saline dressings and proceed to emergency exploratory laparotomy
B.Manually reduce the eviscerated bowel back into the abdominal cavity in the emergency room and close the skin
C.Perform local wound exploration under local anesthesia to check fascial integrity
D.Perform an abdominal CT scan with oral and intravenous contrast to rule out visceral perforation
Explanation: Omental or bowel evisceration following penetrating abdominal injury is an absolute indication for emergency exploratory laparotomy because up to 75–80% of patients with evisceration have significant intra-abdominal visceral or vascular injuries. The eviscerated bowel should be protected with warm, sterile saline-soaked dressings and never forced back through the wound in the emergency room.
9A 19-year-old football player sustains blunt left flank trauma. He is alert and hemodynamically stable (BP 125/78 mmHg, HR 76 bpm). Contrast CT of the abdomen reveals a Grade III splenic laceration with a small subcapsular hematoma and no active contrast extravasation (blush). What is the standard management strategy?
A.Immediate open total splenectomy
B.Immediate laparoscopic partial splenectomy
C.Non-operative management in a monitored setting with serial vital signs, examinations, and hemoglobin assessment
D.Immediate splenic artery coil embolization regardless of contrast blush
Explanation: Non-operative management is standard for a hemodynamically stable patient without peritonitis or active bleeding that requires intervention. It uses an appropriate monitored setting, serial examinations and vital signs, and targeted hemoglobin reassessment. Activity restriction is individualized to the injury and follow-up plan; prolonged strict bed rest is not a therapeutic requirement.
10A 45-year-old pedestrian is struck by a truck and sustains an open-book pelvic fracture (APC-II). He remains in hemorrhagic shock (BP 80/50 mmHg, HR 135 bpm) despite pelvic binder placement and transfusion of two units of PRBC. FAST is negative for intraperitoneal fluid. What is the most appropriate next intervention?
A.Urgent exploratory laparotomy with opening of the pelvic retroperitoneal hematoma
B.Pelvic angiography with transcatheter arterial embolization, or surgical preperitoneal pelvic packing
C.Transfer to the ward for continuous pelvic skeletal traction
D.Immediate internal fixation with anterior pelvic plating
Explanation: In an unstable pelvic fracture with a negative FAST, bleeding originates primarily from the presacral/prevesical venous plexus (85%) or branches of the internal iliac artery (15%). Once mechanical stabilization (pelvic binder) is applied, ongoing instability mandates preperitoneal pelvic packing (PPP) to tamponade venous bleeding and/or emergent pelvic angiographic embolization to occlude arterial hemorrhage.

About the UKOM Sp.B Exam

The UKOM Sp.B (Uji Kompetensi Dokter Spesialis Bedah) is the national qualifying assessment series for eligible graduating surgery residents in Indonesia, administered by Kolegium Ilmu Bedah Indonesia under the published specialist education standard. Current registration afterward follows the Konsil Kesehatan Indonesia and health-authority framework.

Exam sponsor: Kolegium Ilmu Bedah Indonesia / Konsil Kesehatan Indonesia (KKI). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Computer-based testing (CBT) consisting of 120 single-best-answer multiple-choice questions (Kognitif Bedah Lanjut) assessing advanced operative and clinical reasoning, followed by national objective structured clinical examination (OSCE) stations.

Time Limit

Not published in the official sources reviewed.

Passing Score

Not published in the official sources reviewed.

Exam / Certification Fees

Not published in the official sources reviewed.

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

25%

Surgical Principles, Trauma, Shock & Critical Care

Primary and secondary trauma survey, ATLS protocols, hemorrhagic shock stages, massive transfusion resuscitation, damage control surgery, FAST ultrasound, thoracic and abdominal trauma, burn injury resuscitation, surgical nutrition, enterocutaneous fistula care, and necrotizing soft-tissue infections.

25%

Upper Gastrointestinal, Hepatobiliary & Pancreatic Surgery

Perforated and bleeding peptic ulcer management, gastric adenocarcinoma staging and D2 gastrectomy, acute cholecystitis, Critical View of Safety in laparoscopy, iatrogenic bile duct injury reconstruction, acute pancreatitis step-up management, pancreatic head adenocarcinoma Whipple resection, liver trauma, and portal hypertensive bleeding.

20%

Lower Gastrointestinal, Colorectal & Perianal Surgery

Complicated and uncomplicated appendicitis, small bowel mechanical obstruction, closed-loop ischemia, sigmoid and cecal volvulus, colorectal cancer surgical oncology, total mesorectal excision (TME), complicated diverticulitis, toxic megacolon in ulcerative colitis, strictureplasty in Crohn's, and perianal fistulae, fissures, and hemorrhoids.

20%

Abdominal Wall, Hernia, Breast & Endocrine Surgery

Inguinal and femoral hernia anatomy, open Lichtenstein and laparoscopic TAPP/TEP repair, strangulated hernia emergencies, component separation techniques, benign breast conditions, breast cancer triple assessment, breast-conserving surgery, modified radical mastectomy, thyroid nodules, thyroid carcinomas, post-thyroidectomy emergencies, and parathyroid adenomas.

10%

Vascular, Pediatric & Urologic Surgical Emergencies

Acute limb ischemia Rutherford classification, Fogarty thromboembolectomy, four-compartment leg fasciotomy, ruptured abdominal aortic aneurysm resuscitation, infantile hypertrophic pyloric stenosis, pediatric intussusception, malrotation with midgut volvulus, Hirschsprung disease, testicular torsion, bladder trauma, and posterior urethral disruption.

Preparing for the UKOM Sp.B Exam

What You Need to Know

  • Passing score: Not published in the official sources reviewed.
  • Assessment: Computer-based testing (CBT) consisting of 120 single-best-answer multiple-choice questions (Kognitif Bedah Lanjut) assessing advanced operative and clinical reasoning, followed by national objective structured clinical examination (OSCE) stations.
  • Time limit: Not published in the official sources reviewed.
  • Exam / certification fees: Not published in the official sources reviewed. Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

UKOM Sp.B: Suggested Study Strategy

1Master the ATLS 10th edition resuscitation algorithms and damage control principles, as trauma and surgical critical care comprise a major foundation of the national exit exam.
2Focus heavily on emergency surgical decision-making: timing of laparotomy, classification of peritonitis (e.g., Hinchey criteria), acute bowel obstruction, and management of acute biliary sepsis.
3Thoroughly review oncologic principles and surgical anatomy, particularly the Critical View of Safety in laparoscopic cholecystectomy, D2 lymphadenectomy boundaries for gastric cancer, and Total Mesorectal Excision planes for rectal cancer.
4Practice timed single-best-answer clinical vignettes, paying careful attention to laboratory markers (e.g., arterial blood gas, base deficit, electrolytes in pyloric stenosis) and specific physical exam signs (Beck's triad, Courvoisier's sign, Goodsall's rule).

Frequently Asked Questions

What is the UKOM Sp.B examination and who is required to take it?

The UKOM Sp.B (Uji Kompetensi Dokter Spesialis Bedah) is the Indonesian national specialist assessment series administered by Kolegium Ilmu Bedah Indonesia for eligible general-surgery residency graduates. Current registration afterward follows the Konsil Kesehatan Indonesia and health-authority framework.

What is the format and duration of the UKOM Sp.B cognitive examination?

The documented Kognitif Bedah Lanjut component is a 120-item single-best-answer CBT. Its duration was not published in the official sources reviewed, and it is one component within the broader national surgery assessment series.

What is the passing score for the UKOM Sp.B CBT exam?

The current passing score and standard-setting method were not published in the official sources reviewed; candidates should confirm with Kolegium Ilmu Bedah Indonesia.

What official curriculum defines the scope of the UKOM Sp.B exam?

The published national general-surgery education standard is Peraturan Konsil Kedokteran Indonesia No. 73 Tahun 2020, recorded in Berita Negara No. 60 Tahun 2020. It covers core general surgery, surgical critical care and trauma, gastrointestinal surgery, oncologic surgery, pediatric surgery emergencies, vascular emergencies, and urologic trauma.

Is this practice question bank officially affiliated with Kolegium Ilmu Bedah Indonesia?

No. This practice bank is an independent educational question bank developed by OpenExamPrep. It offers an English-language MCQ study adaptation designed to help surgical trainees master advanced clinical reasoning, operative concepts, and evidence-based surgical guidelines.