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Free Practice Questions for Palestinian Board Part II

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Key Facts: Palestinian Board Part II Exam

100

Written MCQs

PMC General Surgery Part II TOS

10

Oral/clinical stations

PMC General Surgery Part II TOS

Usually 60%

Fixed MCQ pass mark

PMC General Surgery exam manual

350 JOD

First-attempt fee

PMC category 21/119

5 years

General Surgery residency before Part II

PMC General Surgery Board Exams (2022)

13 Nov 2026

Next written paper

PMC announcement 4559

The Palestinian Board Part II (امتحان شهادة المجلس الطبي الفلسطيني) is the exit exam taken after completing specialty training; for General Surgery that means the five-year residency. PMC's General Surgery format is a 100-question written MCQ paper followed by a 10-station oral and clinical exam, and the fee is 350 JOD for a first attempt or 300 JOD for a repeat. OpenExamPrep offers independent English-language practice MCQs on the 13 written blueprint areas and on judgment themes from the oral/clinical stations; this is an MCQ study adaptation, not a simulation of the oral or clinical exam.

Sample Palestinian Board Part II Practice Questions

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

1A 56-year-old male presents with a recurrent midline incisional hernia measuring 12 cm in transverse defect width with substantial loss of abdominal domain. Which surgical technique provides the most durable medial advancement of the rectus abdominis muscle complexes while creating a vascularized retrorectus plane for sublay mesh placement?
A.Transversus abdominis muscle release (posterior component separation / TAR)
B.Anterior component separation with external oblique aponeurotic release alone
C.Direct primary suture closure under high tension with relaxing incisions
D.Bridged intraperitoneal onlay mesh (IPOM) placement without fascial closure
Explanation: Posterior component separation with transversus abdominis release (TAR) is the modern standard for complex, wide ventral incisional hernias (>10-12 cm). By dividing the transversus abdominis muscle medially, it allows significant medial advancement of the posterior rectus sheath and linea alba (up to 8-10 cm per side), preserves the neurovascular bundles of the rectus muscle, and creates a large vascularized retromuscular preperitoneal space extending laterally to the psoas muscles for sublay mesh reinforcement.
2A 42-year-old male presents with a perforated anterior duodenal ulcer (first part of the duodenum) of 12 hours' duration with generalized peritonitis. At emergency laparotomy, a 6 mm perforation with clean edges is identified. What is the standard surgical repair of choice?
A.Simple closure with a pedicled omental patch
B.Distal gastrectomy with truncal vagotomy
C.Duodenal exclusion with gastrojejunostomy and biliary diversion
D.Tube duodenostomy with wide local drainage alone
Explanation: Omental patch repair (the Graham and Cellan-Jones techniques; the commonly used 'modified Graham' repair adds primary suture closure) is the standard operation for small (<2 cm) perforated duodenal ulcers. Sutures are placed across the perforation and tied over a pedicled tongue of greater omentum without tension to seal the defect, followed by postoperative acid suppression and H. pylori eradication.
3A critically ill surgical patient undergoing massive fluid resuscitation following an emergency aortic aneurysm repair develops tense abdominal distension, oliguria (< 15 mL/hr), elevated peak airway pressures (42 cmH2O), and an intra-abdominal bladder pressure of 24 mmHg. What is the definitive management?
A.Immediate surgical decompressive laparotomy with temporary open abdominal closure
B.Aggressive infusion of an additional 2 liters of hypertonic crystalloid
C.Placement of bilateral pleural pigtail catheters to decompress the chest
D.Administration of high-dose intravenous loop diuretics and paracentesis
Explanation: Abdominal compartment syndrome (ACS) is defined by the World Society of the Abdominal Compartment Syndrome (WSACS) as a sustained intra-abdominal pressure (IAP) > 20 mmHg (with or without abdominal perfusion pressure < 60 mmHg) associated with new organ dysfunction (e.g., oliguria, respiratory failure, elevated airway pressures). Immediate surgical decompressive laparotomy with temporary abdominal wall closure (e.g., negative-pressure wound therapy/Bogota bag) is the definitive life-saving intervention.
4A 74-year-old female with chronic atrial fibrillation presents with sudden-onset, severe, poorly localized abdominal pain out of proportion to physical examination findings. Contrast CT angiography reveals an abrupt cutoff in the superior mesenteric artery (SMA) 4 cm distal to its origin with intestinal pneumatosis. What is the immediate surgical strategy upon laparotomy?
A.SMA embolectomy, resection of dead bowel, and planned second look
B.Immediate massive small bowel resection from ligament of Treitz to ileocecal valve without vascular intervention
C.Immediate systemic thrombolytic infusion into the peripheral intravenous line
D.Transcatheter coil embolization of the SMA branches
Explanation: Acute SMA embolism typically lodges 3-8 cm distal to the SMA origin (sparing the middle colic or proximal jejunal branches). In the presence of peritonitis or bowel ischemia, emergent laparotomy with transverse arteriotomy and Fogarty balloon catheter embolectomy is mandatory to restore mesenteric blood flow. Resection is restricted to clearly necrotic, gangrenous bowel, preserving questionable segments for reassessment during a mandatory second-look laparotomy 24-48 hours later.
5A 58-year-old male is found to have a well-circumscribed 15 cm retroperitoneal liposarcoma abutting the right kidney and colon. Core needle biopsy confirms well-differentiated liposarcoma. What is the primary oncologic principle governing surgical resection of primary retroperitoneal sarcomas?
A.En bloc resection with adherent adjacent organs, aiming for R0
B.Simple intracapsular enucleation of the tumor mass to preserve adjacent kidney and colon
C.Routine formal regional retroperitoneal lymph node dissection
D.Debulking of 50% of tumor mass followed by high-dose systemic chemotherapy
Explanation: Complete, en bloc resection at the first operation is the main determinant of local control and survival in primary retroperitoneal sarcoma. Because these tumors have only a pseudocapsule and infiltrate the surrounding fat, achieving clear margins often requires removing adherent organs such as the ipsilateral kidney, adrenal, or colon. Enucleation, debulking, and routine lymphadenectomy do not meet this oncologic principle.
6A 48-year-old male with polycythemia vera presents with subacute dull abdominal pain for 5 days. Contrast-enhanced CT reveals superior mesenteric vein thrombosis with patent SMA and viable, engorged small bowel loops without free air or peritonitis. What is the initial treatment of choice?
A.Immediate therapeutic anticoagulation with intravenous unfractionated heparin
B.Immediate emergency exploratory laparotomy and mesenteric thrombectomy
C.Immediate transjugular intrahepatic portosystemic shunt (TIPS) creation
D.Bowel rest, intravenous fluids, and observation without anticoagulation
Explanation: In acute mesenteric venous thrombosis (MVT) without peritonitis or hemodynamic collapse, prompt therapeutic anticoagulation with intravenous heparin (or LMWH) is the cornerstone of therapy. Anticoagulation prevents thrombus propagation, promotes recanalization, and achieves successful non-operative resolution in >80-90% of patients. Laparotomy is reserved for frank peritonitis, bowel perforation, or failure of medical management.
7A 68-year-old female presents with acute colonic obstruction. Abdominal radiograph and CT demonstrate a massive 'comma-shaped' dilated loop of bowel extending from the right lower quadrant toward the left upper quadrant, with absence of gas in the distal colon. What is the definitive management of this cecal volvulus?
A.Right hemicolectomy (ileocecal resection) with anastomosis
B.Rigid sigmoidoscopic detorsion and placement of a rectal flatus tube
C.Colonoscopic decompression with placement of a transanal decompression catheter
D.Conservative management with intravenous neostigmine
Explanation: Cecal volvulus results from inadequate peritoneal fixation of the cecum and ascending colon. Unlike sigmoid volvulus, endoscopic detorsion rarely succeeds and risks perforation, so definitive treatment is resection (right hemicolectomy or ileocecal resection) with primary ileocolic anastomosis, or end ileostomy if the patient is unstable or the bowel is gangrenous. Cecopexy alone has higher recurrence.
8Through which anatomical defect does a Spigelian hernia protrude?
A.Spigelian fascia lateral to the rectus, near the arcuate line
B.Opening in the obturator canal adjacent to the obturator neurovascular bundle
C.Widening of the esophageal hiatus through the right diaphragmatic crus
D.Defect in the lumbar triangle of Petit bounded by the iliac crest and latissimus dorsi
Explanation: A Spigelian hernia occurs through the Spigelian fascia (the aponeurotic layer between the lateral border of the rectus muscle and the semilunar line of the transversus abdominis). The vast majority occur in the 'Spigelian hernia belt'—a transverse zone between the umbilicus and anterior superior iliac spine, near the arcuate line where the posterior rectus sheath terminates. It is interparietal, lying deep to the external oblique aponeurosis.
9A 70-year-old female presents with acute perforated diverticulitis with feculent peritonitis and septic shock (Hinchey Class IV). What is the standard emergency surgical procedure?
A.Hartmann's procedure (sigmoid resection with end colostomy and Hartmann's rectal pouch)
B.Primary sigmoid resection with colorectal anastomosis and no diverting stoma
C.Laparoscopic peritoneal lavage without bowel resection
D.Transverse loop colostomy with oversewing of the perforation
Explanation: In patients with acute perforated diverticulitis with generalized feculent peritonitis (Hinchey IV) and septic shock, Hartmann's procedure (resection of the diseased sigmoid colon, creation of an end colostomy, and closure of the rectal stump) is the safest, most reliable life-saving operation. Primary anastomosis with or without diverting loop ileostomy is reserved for hemodynamically stable patients without severe fecal contamination (Hinchey III). Laparoscopic lavage alone in Hinchey IV is contraindicated.
10A 38-year-old medically fit female presents with full-thickness external rectal prolapse and severe fecal incontinence. Which abdominal surgical procedure provides the lowest recurrence rate and improved fecal continence in fit patients?
A.Laparoscopic ventral mesh rectopexy
B.Delorme transanal mucosal sleeve resection
C.Altemeier perineal rectosigmoidectomy
D.Thiersch anal encircling cerclage wire
Explanation: In young, healthy, surgically fit patients with full-thickness rectal prolapse, abdominal rectopexy (specifically laparoscopic ventral mesh rectopexy) is the preferred procedure. It provides low recurrence rates (<2-5%), preserves parasympathetic rectal innervation (avoiding postoperative de novo constipation), and restores normal pelvic floor anatomy to improve continence. Perineal approaches (Altemeier, Delorme) have higher recurrence rates (10-30%) and are reserved for elderly, frail patients.

About the Palestinian Board Part II Exam

The Palestinian Medical Council's General Surgery Part II exam: a 100-question written MCQ paper followed by 10 oral/clinical stations, leading to the Palestinian Board certificate.

Exam sponsor: Palestinian Medical Council (PMC / المجلس الطبي الفلسطيني). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The Palestinian Board (Part II) exam for General Surgery has a written MCQ paper followed, for those who pass it, by an oral and clinical (VIVA/OSCE) exam of 10 stations within two weeks of the written results. The stations assess disease pathophysiology, diagnostic skills, management, physical examination, operative and procedural decision-making, interpersonal and communication skills, leadership and teaching, professionalism and ethics, and problem solving. The written paper is held twice a year (18-19 May 2026, when 221 doctors sat it in Ramallah and Gaza across 26 specialties, and 13 November 2026 with 14 November in reserve, at Ramallah, Gaza, and Cairo). Passing both parts leads to the Palestinian Board certificate in the specialty.

Time Limit

Written paper: 2.5 hours (PMC General Surgery exam manual); oral/clinical: 10 stations

Passing Score

Usually 60% on the written MCQ paper (fixed pass mark per PMC exam manual); oral/clinical result determined separately

Exam / Certification Fees

350 JOD first attempt, 300 JOD repeat, plus 50 JOD per unpaid national-programme residency year

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.

10 of 100 questions

Abdomen (General, Hernia and Abdominal Wall, Peritoneum, Retroperitoneum and Soft Tissue)

Practice items cover complex ventral hernia repair, perforated ulcer, abdominal compartment syndrome, mesenteric ischemia and venous thrombosis, retroperitoneal sarcoma, volvulus, Spigelian hernia, perforated diverticulitis, and rectal prolapse.

13 of 100 questions

GI and HPB (Upper GI, Small Intestine, Appendix, Lower GI and HPB)

Practice items cover gastroesophageal junction and gastric cancer, liver remnant volume, bile duct injury, necrotizing pancreatitis, pancreatic resectability, liver lesions, ulcerative colitis, Crohn's strictures, hydatid disease, hilar cholangiocarcinoma, Boerhaave syndrome, and GIST.

10 of 100 questions

Trauma

Practice items cover damage control, penetrating abdominal and neck injury, retroperitoneal hematoma zones, diaphragmatic, liver, pancreatic and bladder injury, cardiac tamponade, and flail chest.

15 of 100 questions

Surgical Complications, Critical Care, Surgical Infection, Sepsis and Shock

Practice items cover fistula management, anastomotic leak, AKI staging, vasopressors, intra-abdominal hypertension, tertiary peritonitis, line infection, VAP prevention, delirium, HIT, abdominal closure, stress ulcer risk, refeeding, post-splenectomy vaccination, and malignant hyperthermia.

5 of 100 questions

Breast and Endocrine

Practice items cover breast-conserving therapy, papillary thyroid cancer, parathyroidectomy, MEN 2A, and adrenal incidentaloma.

5 of 100 questions

Principles of Minimally Invasive Surgery and Bariatric Surgery

Practice items cover pneumoperitoneum physiology, the critical view of safety, bariatric eligibility, internal hernia after gastric bypass, and sleeve gastrectomy leak.

5 of 100 questions

Skin, Subcutaneous Tissue, Burn and Plastic Surgery

Practice items cover melanoma margins, soft tissue sarcoma margins, escharotomy, skin graft take, and Mohs surgery.

7 of 100 questions

Operative Principles and Perioperative Management

Practice items cover electrosurgical safety, positioning injuries, functional capacity, goal-directed fluids, energy devices, hypothermia, and anticoagulant interruption.

4 of 100 questions

Research, Ethics and Outcomes in Surgery

Practice items cover intention-to-treat analysis, emergency consent, morbidity and mortality review, and palliative decision-making.

15 of 100 questions

Surgical Subspecialties (Pediatric Surgery, Neurosurgery, Head and Neck, Cardiothoracic, Urology, Vascular)

Practice items cover ruptured AAA, acute limb ischemia, carotid endarterectomy, malrotation, NEC, CDH, biliary atresia, pneumothorax, empyema, lung cancer staging, testicular torsion, obstructed infected kidney, priapism, and epidural and subdural hematoma.

4 of 100 questions

Oncology and Palliative Care

Practice items cover tumor boards, TNM prefixes, total neoadjuvant therapy, and palliation of gastric outlet and biliary obstruction.

4 of 100 questions

Radiology and Anesthesia

Practice items cover pelvic angioembolization, fluid responsiveness, the CICO airway emergency, and TAP blocks.

3 of 100 questions

Communication Skills and Decision Making

Practice items cover breaking bad news, goals-of-care discussions with a proxy, and disclosure of a retained surgical item.

Preparing for the Palestinian Board Part II Exam

What You Need to Know

  • Passing score: Usually 60% on the written MCQ paper (fixed pass mark per PMC exam manual); oral/clinical result determined separately
  • Assessment: The Palestinian Board (Part II) exam for General Surgery has a written MCQ paper followed, for those who pass it, by an oral and clinical (VIVA/OSCE) exam of 10 stations within two weeks of the written results. The stations assess disease pathophysiology, diagnostic skills, management, physical examination, operative and procedural decision-making, interpersonal and communication skills, leadership and teaching, professionalism and ethics, and problem solving. The written paper is held twice a year (18-19 May 2026, when 221 doctors sat it in Ramallah and Gaza across 26 specialties, and 13 November 2026 with 14 November in reserve, at Ramallah, Gaza, and Cairo). Passing both parts leads to the Palestinian Board certificate in the specialty.
  • Time limit: Written paper: 2.5 hours (PMC General Surgery exam manual); oral/clinical: 10 stations
  • Exam / certification fees: 350 JOD first attempt, 300 JOD repeat, plus 50 JOD per unpaid national-programme residency year 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

Palestinian Board Part II: Suggested Study Strategy

1Prioritize the heaviest written areas: abdomen, GI/HPB, trauma, and complications/critical care together make up 48 of the 100 questions.
2Review operative decision-making for common emergencies, such as perforated viscus, bowel obstruction, trauma laparotomy, and bile duct injury, because both the written paper and the oral stations test it.
3Keep up with current guidelines, including the Surviving Sepsis Campaign, the current ATLS edition, and the revised Atlanta classification of pancreatitis.
4Practise structured verbal answers (diagnosis, investigations, management, complications) for the 10 oral/clinical stations; MCQs alone do not train this skill.
5Cover the 15 subspecialty questions across pediatric surgery, neurosurgery, head and neck, cardiothoracic, urology, and vascular surgery.

Frequently Asked Questions

What is the Palestinian Board Part II examination?

It is the Palestinian Medical Council's specialty certificate exam (امتحان شهادة المجلس الطبي الفلسطيني), taken after completing specialty training. Candidates who pass the written paper and then the oral/clinical exam receive the Palestinian Board certificate in their specialty.

What is the format of the General Surgery Part II exam?

PMC's General Surgery format is a 100-question written MCQ paper, followed for those who pass it by an oral and clinical (VIVA/OSCE) exam of 10 stations, scheduled within two weeks of the written results.

What is the pass mark and fee?

PMC's General Surgery exam manual describes a fixed MCQ pass mark, usually 60%. The fee is 350 JOD for a first attempt and 300 JOD for a repeat, plus 50 JOD for each national-programme residency year not already paid.

How are the oral and clinical stations represented here?

This is an English-language MCQ study adaptation. Judgment themes from the stations, such as operative decisions, emergency management, and communication, are written as MCQs alongside the written-paper topics. They cannot replace practising history taking, examination, or oral presentation.

Are these official Palestinian Medical Council questions?

No. They are independent practice questions written by OpenExamPrep using PMC's published General Surgery Part II table of specifications as a topic guide. They are not official PMC items and are not endorsed by PMC.