General surgery — in the LEK question base
The acute abdomen, gastrointestinal surgery, trauma, clinical nutrition, fitness for surgery.
- Questions in base
- 371
- Share of base
- 12.1%
- Roughly on the paper
- ~17
The "on the paper" figure assumes the 140 questions drawn from the base are distributed in proportion to its composition. CEM does not publish per-field quotas, so treat it as an order of magnitude rather than a promise.
Required reading — general surgery
The list CEM publishes for this field. Questions are written from these titles, so where a lecture and a listed textbook disagree, the textbook decides.
They appear here in Polish, exactly as CEM lists them — these are the specific editions that count, and most have no English translation. That is not an oversight on our part; it is the central practical problem of sitting this exam in English.
- 01 Grzegorz Wallner i in. (red.) — Chirurgia. Podręcznik dla studentów, PZWL, 2025 (obowiązkowe)
- 02 O. James Garden i in. (red.) — Chirurgia, wyd. II polskie, Edra Urban & Partner, 2021 (obowiązkowe)
- 03 Wojciech Noszczyk (red.) — Chirurgia. Repetytorium, PZWL, 2019 (uzupełniające)
- 04 Grzegorz Wallner i in. (red.) — Ostre schorzenia jamy brzusznej, PZWL, 2024 (uzupełniające)
- 05 Jacek Sobocki, Anna Zmarzły (red.) — Żywienie kliniczne, PZWL, 2026 (uzupełniające)
Source: the CEM reading list . As at August 2026 — check before your session in case CEM has revised it.
Sample questions from the base
Ten items from CEM's public listing for this field, in the official English wording used on the exam paper. The correct answer is highlighted. Detailed explanations live in our Polish application (source of preparation).
Which of the following operations can be performed in the case of adenocarcinoma localized in the sigmoid colon?
- A laparoscopy, sigmoid resection.
- B Hartmann's procedure by means of laparotomy.
- C sigmoid resection by means of laparotomy.
- D laparoscopy, Hartmann operation.
- E all the above. ✓
The patient in poor general condition was transported to the hospital admission room. He reports a retrosternal pain and high fever. On the physical examination the crackling of the skin was palpable around the neck. The patient had been diagnosed with advanced oesophageal cancer. The chest CT showed the presence of air in the mediastinum, contrast leakage in the thoracic section of the esophagus and fluid effusion in the right pleural cavity. Indicate the optimal surgical procedures in this case:
- A a gastric probe, a ban on oral nutrition, antibiotic therapy.
- B stitching the oesophagus with an access via right-sided thoracotomy.
- C exclusion of the oesophagus through the emergence of oesophagostomy on the neck, mediastinal drainage, occlusion of the gastric gullet, further nutrition by nutritional gastrostomy.
- D oesophageal resection with gastroesophageal anastomosis in the cage chest.
- E implantation of a self-expanding stent with optional drainage of the right pleural cavity. ✓
Which of the following can be classified as the grade II according to Hinchey classification of complications caused by diverticulitis?
- A diverticulitis with para-colonic abscess.
- B diverticulitis with pelvic abscess. ✓
- C diverticulitis with purulent peritonitis.
- D diverticulitis with feculent peritonitis.
- E Hinchey classification is not related to diverticulitis.
A 25-year-old woman found a lump of 2 cm x 1 cm in size in the upper lateral quadrant while self-examining her right breast. The biopsy result was ductal carcinoma. Considering the lymphatic drainage through the Roth path, the lymph node metastases may be expected in:
- A first level of axillary lymph nodes.
- B second level of axillary lymph nodes.
- C third level of axillary lymph nodes.
- D first and second level of axillary lymph nodes.
- E second and third level of axillary lymph nodes. ✓
Secondary peritonitis does not include:
- A peritonitis related to chronic peritoneal dialysis.
- B necrosis of the intestinal wall.
- C peritonitis related to the leakage of an intestinal anastomosis.
- D granulomatous peritonitis. ✓
- E fungal peritonitis.
Which of the following is an indication for the surgical treatment of the abdominal aortic aneurysm?
- A diameter of the asymptomatic aneurysm exceeding 5.5 cm.
- B diameter of the symptomatic aneurysm exceeding 2 cm.
- C ruptured aneurysm.
- D A,C are true. ✓
- E A,B,C are true.
The absolute indications for the surgical treatment of acute pancreatitis do not include:
- A lack of improvement after conservative treatment. ✓
- B infected pancreatic necrosis.
- C bleeding to the abdominal cavity.
- D gastrointestinal perforation.
- E abdominal compartment syndrome.
The treatment of tracheo-esophageal fistulas, which are a pathological connection between tracheal and esophageal lumena through an epithelium-covered canal, is very difficult and marked by numerous failures. Indicate the methods used for the treatment of tracheo-esophageal fistulas: 1) placing a tube into the stomach or intestine and conducting enteral nutrition; 2) placing a permanent self-expanding esophageal stent; 3) placing a temporary self-expanding stent in the trachea and esophagus; 4) attempts to close the fistula canal by means of repetitive ablation, biological glues and obliteration; 5) excision of the fistula with a segmental resection of the trachea and a primary esophageal sewage strengthened with a pedunculated tissue flap taken from the neighbourhood. The correct answer is:
- A 1,3,5.
- B 1,4,5. ✓
- C 2,3,4.
- D 2,4,5.
- E 3,4,5.
Which of the following is the most common cause of the mechanical ileus in the lower gastrointestinal tract?
- A diverticulosis of the colon.
- B peritoneal adhesions. ✓
- C Meckel's diverticulum.
- D neoplastic tumors.
- E bezoars.
Abdominal compartment syndrome does not arise as a result of:
- A growing ascites.
- B excessive swelling of the intestine wall.
- C bleeding into the peritoneal cavity.
- D intestine distention due to gas accumulation.
- E lack of urine outflow. ✓
Full listing for this field contains 371 questions — these ten are a preview. Detailed rationales, spaced-repetition scheduling and citations are in the Polish app (English coverage is in progress).
How to get through this field
371 questions is a finite, countable set — at twenty a day you are through it in 19 days. The difficulty is not the volume. It is that the CEM listing gives you the questions and nothing else: no answer key, no explanation and no indication which of the books above the answer came from.
In our bank every question in this field carries an explanation and a citation to its source. Instead of memorising a letter you see why the other four options are wrong — and that is the part which transfers to the 60 unpublished questions you cannot prepare for in advance. The English edition is in progress; these pages come first.