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100+ Free Facharzt FMH Pneumologie Practice Questions

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2026 Statistics

Key Facts: Facharzt FMH Pneumologie Exam

HERMES + SGP

Exam Format

SIWF / SGP Examination Regulations

90

Written HERMES MCQs

European Respiratory Society (ERS)

6 Years

Postgraduate Training

SIWF Weiterbildungsprogramm

180 min

Written Exam Duration

ERS HERMES Standard

Lifetime

FMH Title Validity

Swiss Medical Association (FMH)

100

Practice Questions

OpenExamPrep

The Facharzt FMH Pneumologie credential certifies specialist pulmonologists in Switzerland through SIWF and SGP. The assessment combines the written European HERMES Examination (90 MCQs) and the SGP oral clinical board, covering obstructive airways, physiology, ILD, thoracic oncology, pulmonary vascular diseases, infections, and sleep medicine.

Sample Facharzt FMH Pneumologie Practice Questions

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

1A 34-year-old woman with moderate persistent asthma presents for regular follow-up. She experiences daytime wheezing and dyspnea 3 to 4 days per week and wakes up coughing once a week. She currently uses low-dose inhaled budesonide (200 mcg twice daily) and as-needed salbutamol. According to the Global Initiative for Asthma (GINA) Track 1 recommendations, what is the most appropriate management step?
A.Switch to low-dose budesonide-formoterol as both daily maintenance and as-needed reliever (MART strategy)
B.Double the dose of budesonide to 400 mcg twice daily and continue as-needed salbutamol
C.Add an oral leukotriene receptor antagonist (montelukast 10 mg daily) and maintain SABA monotherapy for relief
D.Initiate maintenance long-acting muscarinic antagonist (tiotropium Respimat) while stopping inhaled corticosteroids
Explanation: According to GINA Track 1 (the preferred approach), low-dose ICS-formoterol is recommended as both regular maintenance and as-needed reliever therapy (MART) for patients with moderate persistent asthma (Step 3). This strategy significantly reduces severe exacerbations and emergency department visits compared to SABA-reliever regimens by providing timely anti-inflammatory doses during symptom spikes.
2A 48-year-old non-smoker with severe refractory asthma has experienced three oral corticosteroid-treated exacerbations in the past 12 months despite adherence to high-dose fluticasone-salmeterol plus tiotropium. Peripheral blood testing reveals an absolute eosinophil count of 480 cells/µL (0.48 × 10⁹/L), total serum IgE of 42 IU/mL, and fractional exhaled nitric oxide (FeNO) of 38 ppb. Skin prick testing for common aeroallergens is negative. Which biologic therapy is most specifically indicated for this patient's phenotype?
A.Omalizumab (anti-IgE antibody)
B.Mepolizumab or Benralizumab (targeting the IL-5 pathway)
C.Infliximab (anti-TNF-alpha antibody)
D.Roflumilast (phosphodiesterase-4 inhibitor)
Explanation: This patient exhibits severe refractory eosinophilic asthma (blood eosinophils ≥300 cells/µL with frequent exacerbations) in the absence of allergic sensitization (low IgE, negative skin prick test). Targeted anti-IL-5 therapies (mepolizumab, reslizumab) or anti-IL-5 receptor alpha antibodies (benralizumab) selectively deplete eosinophils, significantly reduce annual exacerbation rates, and improve asthma control in this specific T2-eosinophilic phenotype.
3A 26-year-old male with perennial allergic rhinitis and severe allergic asthma requires frequent short courses of systemic corticosteroids. Laboratory evaluation shows total serum IgE of 320 IU/mL, blood eosinophils 210 cells/µL, and positive RAST testing for Dermatophagoides pteronyssinus. Before initiating omalizumab, how is the correct therapeutic dose and administration frequency determined?
A.A fixed subcutaneous dose of 300 mg administered every 4 weeks for all adult patients
B.Peripheral blood eosinophil count and post-bronchodilator FEV1 percentage predicted
C.Body weight and baseline pre-treatment total serum IgE level using a standardized dosing nomogram
D.Serial fractional exhaled nitric oxide (FeNO) measurements titrated to reach FeNO < 25 ppb
Explanation: Omalizumab is a humanized monoclonal antibody that binds to circulating free IgE, preventing its interaction with high-affinity FcεRI receptors on mast cells and basophils. The precise subcutaneous dose (75 to 600 mg every 2 or 4 weeks) is determined by the patient's baseline pre-treatment serum total IgE level and body weight according to an official manufacturer dosing table.
4A 52-year-old woman with severe asthma, recurrent chronic rhinosinusitis with nasal polyps (CRSwNP), and maintenance oral corticosteroid dependence (prednisone 10 mg daily) is evaluated for biologic therapy. Her FeNO is 65 ppb and blood eosinophils are 350 cells/µL. Which biologic targeting the alpha subunit of the interleukin-4 receptor (IL-4Rα) inhibits both IL-4 and IL-13 signaling and is highly effective at reducing oral steroid dependence and nasal polyp burden?
A.Reslizumab
B.Tezepelumab
C.Mepolizumab
D.Dupilumab
Explanation: Dupilumab is a fully human monoclonal antibody directed against the IL-4Rα subunit, which is shared by the IL-4 and IL-13 receptor complexes. By blocking dual IL-4 and IL-13 signaling, dupilumab suppresses Type 2 inflammation, lowers FeNO, reduces exacerbations, allows oral corticosteroid tapering/discontinuation (VENTURE trial), and significantly shrinks nasal polyps in CRSwNP (LIBERTY NP trials).
5A 45-year-old man has severe uncontrolled asthma with frequent winter exacerbations. Biomarker testing repeatedly demonstrates blood eosinophils <150 cells/µL, total IgE 18 IU/mL, and FeNO 14 ppb (T2-low / non-eosinophilic phenotype). Which biologic agent targeting an upstream epithelial-derived alarmin is approved for severe asthma irrespective of baseline eosinophil counts or allergic status?
A.Tezepelumab
B.Benralizumab
C.Omalizumab
D.Reslizumab
Explanation: Tezepelumab is a human monoclonal antibody that specifically binds to and inhibits thymic stromal lymphopoietin (TSLP), an epithelial alarmin released in response to viruses, allergens, and pollutants at the top of the inflammatory cascade. In the NAVIGATOR trial, tezepelumab demonstrated significant reductions in annualized asthma exacerbations across both T2-high and T2-low (eosinophil-low, FeNO-low) severe asthma populations.
6A 39-year-old man with severe chronic rhinosinusitis and recurrent nasal polyposis presents to the emergency department with acute severe bronchospasm 45 minutes after taking 500 mg of acetylsalicylic acid for a headache. What is the fundamental pathophysiology underlying Aspirin-Exacerbated Respiratory Disease (AERD / Samter's triad)?
A.IgE-mediated Type I immediate hypersensitivity against acetylsalicylic acid hapten complexes
B.Inhibition of cyclooxygenase-1 (COX-1) leading to shunting of arachidonic acid to the 5-lipoxygenase pathway and massive cysteinyl leukotriene overproduction
C.Direct non-specific mast cell degranulation mediated via complement receptor activation
D.Complement-mediated immune complex deposition in the bronchial subepithelial basement membrane
Explanation: AERD is a non-allergic (pseudoallergic) hypersensitivity reaction caused by COX-1 enzyme inhibition. In susceptible individuals, blocking COX-1 removes the brake of protective prostaglandin E2 (PGE2), thereby shunting arachidonic acid metabolism toward the 5-lipoxygenase pathway. This results in massive overproduction of cysteinyl leukotrienes (LTC4, LTD4, LTE4) and profound bronchoconstriction and rhinosinusitis symptoms.
7A 42-year-old woman with longstanding asthma presents with worsening cough, production of brownish mucus plugs, episodic low-grade fever, and progressive dyspnea. Chest HRCT reveals central bronchiectasis and fleeting pulmonary opacities. Total serum IgE is 2,400 IU/mL, Aspergillus fumigatus-specific IgE is markedly elevated, and peripheral blood eosinophils are 1,100 cells/µL. What is the standard first-line pharmacotherapeutic approach for this condition?
A.High-dose inhaled amphotericin B nebulizations for 6 months
B.Intravenous micafungin monotherapy for 4 weeks followed by surgical lobectomy
C.Systemic oral corticosteroids (prednisone) combined with oral itraconazole
D.Nebulized hypertonic saline monotherapy without anti-inflammatory agents
Explanation: The clinical presentation and imaging confirm Allergic Bronchopulmonary Aspergillosis (ABPA). The cornerstone of ABPA management is systemic oral corticosteroids (e.g., prednisone 0.5 mg/kg/day tapered over 3–6 months) to suppress hyperactive immunologic inflammation, typically combined with an oral triazole antifungal (itraconazole 200 mg twice daily with therapeutic drug monitoring) to reduce fungal burden and lower the risk of relapse and steroid exposure.
8A 29-year-old woman at 10 weeks of gestation with well-controlled moderate asthma on inhaled budesonide-formoterol expresses concern that her inhaler might harm the fetus and wants to stop all medications. What is the evidence-based recommendation regarding asthma management during pregnancy?
A.Discontinue all inhaled corticosteroids immediately and rely solely on oral theophylline if symptoms appear
B.Switch all controller therapies to high-dose oral prednisone bursts throughout the pregnancy
C.Discontinue inhalers and initiate long-term prophylactic systemic antihistamines and leukotriene modifiers
D.Maintain adequate asthma control with inhaled corticosteroids (such as budesonide) and LABA, as the risk of fetal hypoxia from uncontrolled maternal asthma far exceeds any potential medication risk
Explanation: Active, uncontrolled maternal asthma carries significant risks to the fetus, including perinatal mortality, pre-eclampsia, intrauterine growth restriction, preterm delivery, and low birth weight due to fetal hypoxia. Inhaled corticosteroids—particularly budesonide, which has the most extensive human pregnancy safety data—and formoterol or salbutamol are safe and should be continued to maintain strict asthma control.
9A 22-year-old elite cross-country skier presents with severe cough and chest tightness occurring 5 to 10 minutes after strenuous cold-weather training. Baseline spirometry is normal (FEV1 104% predicted). To objectively confirm the diagnosis of exercise-induced bronchoconstriction (EIB), which diagnostic challenge test is considered the most specific indirect bronchial provocation test recommended for competitive athletes?
A.Eucapnic voluntary hyperpnea (EVH) challenge with dry gas
B.Direct methacholine bronchoprovocation challenge
C.Standard resting single-breath carbon monoxide diffusing capacity (DLCO)
D.Overnight polygraphy with transcutaneous carbon dioxide monitoring
Explanation: Eucapnic voluntary hyperpnea (EVH) using dry gas is the gold-standard indirect bronchial provocation challenge recognized by the International Olympic Committee (IOC) and ERS/ATS guidelines for confirming exercise-induced bronchoconstriction (EIB) in elite athletes. A post-challenge fall in FEV1 ≥ 10% (or ≥ 12%) relative to baseline demonstrates airway hyperresponsiveness triggered by airway mucosal dehydration and hyperosmolarity.
10A 64-year-old man with a 45 pack-year smoking history has chronic dyspnea on exertion (mMRC score 2). Post-bronchodilator spirometry reveals FEV1/FVC 0.58 and FEV1 54% predicted. In the preceding 12 months, he experienced two acute exacerbations treated by his general practitioner with oral amoxicillin-clavulanate and prednisone, though neither required hospital admission. His blood eosinophil count is 80 cells/µL. According to the GOLD report, what is his GOLD category and recommended initial maintenance pharmacotherapy?
A.GOLD Group B; initiate SABA monotherapy as needed
B.GOLD Group E; initiate dual long-acting bronchodilator therapy (LABA + LAMA)
C.GOLD Group A; initiate inhaled corticosteroid (ICS) monotherapy
D.GOLD Group E; initiate triple therapy (ICS + LABA + LAMA) immediately
Explanation: Under the updated GOLD classification, patients with ≥2 moderate exacerbations or ≥1 hospitalization in the prior year are classified into Group E (Exacerbation-prone). The recommended initial maintenance therapy for Group E is dual long-acting bronchodilation with LABA + LAMA. Because his blood eosinophil count is <100 cells/µL (80 cells/µL), initial addition of an ICS is not indicated and confers minimal benefit while increasing pneumonia risk.

About the Facharzt FMH Pneumologie Exam

The Facharzt FMH für Pneumologie (Specialist in Pulmonology / Respiratory Medicine FMH) is the Swiss Federal specialist title granting full independent practice rights in adult respiratory medicine across Switzerland. Governed by the SIWF (Swiss Institute for Postgraduate and Continuous Medical Training) and the SGP/SSP (Swiss Society of Pulmonology), board qualification requires passing the international ERS HERMES Examination (Harmonised Education in Respiratory Medicine for European Specialists) as the official written component, followed by the SGP oral-practical board examination. The syllabus spans obstructive lung diseases (asthma, COPD, bronchiectasis, CF), pulmonary function testing and exercise physiology, interstitial lung diseases, thoracic oncology, pulmonary vascular disorders (PE, PAH, CTEPH), respiratory infections and tuberculosis, sleep-disordered breathing and mechanical ventilation, and pleural/interventional pulmonology. Note on format and language: While the official written HERMES examination is administered in English and the SGP oral examination is conducted in Swiss national languages (German/French) or English, this question bank is an English-language multiple-choice study adaptation created by OpenExamPrep—not an official ERS/SGP examination release—specifically designed to train high-yield clinical reasoning, diagnostic interpretation, and guideline-based therapeutic algorithms.

Assessment

Two-part qualifying examination: 1) The written ERS HERMES Examination consisting of 90 multiple-choice questions in English (3 hours), and 2) The SGP oral-practical board examination consisting of standardized clinical case stations evaluated by senior Swiss pulmonology examiners.

Time Limit

180 minutes written examination plus approximately 45–60 minutes structured oral examination

Passing Score

Psychometrically determined passing score using Angoff and Rasch equating for the written HERMES examination, and a structured passing evaluation across all clinical case stations assessed by the SGP examination committee

Exam Fee

Combined SGP examination fee ~CHF 1,500–2,500; SIWF FMH Title Application fee CHF 1,000–2,500 (Schweizerisches Institut für ärztliche Weiter- und Fortbildung (SIWF / FMH) and Schweizerische Gesellschaft für Pneumologie (SGP / SSP), utilizing the ERS HERMES Examination)

Facharzt FMH Pneumologie Exam Content Outline

22%

Obstructive Airway Diseases (Asthma, COPD, Bronchiectasis, CF)

Pathophysiology, phenotypic characterization, guideline-directed pharmacotherapy (GINA, GOLD), biologic therapies (anti-IgE, anti-IL5/5R, anti-IL4Rα, anti-TSLP), CFTR modulators, acute exacerbations, and non-pharmacological interventions including lung volume reduction.

16%

Pulmonary Physiology, Function Testing & Diagnostic Procedures

Spirometry, body plethysmography (lung volumes, airway resistance), carbon monoxide diffusing capacity (DLCO/KCO), arterial blood gas interpretation, cardiopulmonary exercise testing (CPET), bronchial provocation testing, and FeNO.

18%

Interstitial Lung Diseases & Diffuse Parenchymal Disorders

High-resolution CT pattern recognition (UIP, NSIP, organizing pneumonia), idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) antifibrotic management, sarcoidosis staging and organ manifestations, hypersensitivity pneumonitis, CTD-associated ILDs, and rare cystic lung diseases (LAM, PLCH).

14%

Thoracic Oncology & Mediastinal Tumors

Solitary pulmonary nodule workup (Fleischner criteria), TNM 8th/9th edition staging, invasive mediastinal staging (EBUS-TBNA, mediastinoscopy), molecular driver alterations (EGFR, ALK, ROS1, BRAF, KRAS, PD-L1), multimodality therapy for early, locally advanced, and metastatic NSCLC/SCLC, and malignant pleural mesothelioma.

12%

Pulmonary Vascular Diseases (PE, PAH, CTEPH)

Risk stratification and acute management of pulmonary embolism (ESC/ERS guidelines), chronic thromboembolic pulmonary hypertension (CTEPH screening, pulmonary endarterectomy, BPA, riociguat), and hemodynamic classification and targeted combination therapy of pulmonary arterial hypertension (WHO Groups 1–5).

18%

Respiratory Infections, Tuberculosis & Pleural/Sleep Disorders

Community- and hospital-acquired pneumonia, active and latent tuberculosis, non-tuberculous mycobacterial (NTM) pulmonary disease, fungal infections (aspergillosis, PJP), pleural diseases (effusions, pneumothorax, empyema), sleep-disordered breathing (OSA, OHS, central sleep apnea / Cheyne-Stokes), and non-invasive/invasive mechanical ventilation.

How to Pass the Facharzt FMH Pneumologie Exam

What You Need to Know

  • Passing score: Psychometrically determined passing score using Angoff and Rasch equating for the written HERMES examination, and a structured passing evaluation across all clinical case stations assessed by the SGP examination committee
  • Assessment: Two-part qualifying examination: 1) The written ERS HERMES Examination consisting of 90 multiple-choice questions in English (3 hours), and 2) The SGP oral-practical board examination consisting of standardized clinical case stations evaluated by senior Swiss pulmonology examiners.
  • Time limit: 180 minutes written examination plus approximately 45–60 minutes structured oral examination
  • Exam fee: Combined SGP examination fee ~CHF 1,500–2,500; SIWF FMH Title Application fee CHF 1,000–2,500

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

Facharzt FMH Pneumologie Study Tips from Top Performers

1Master Pulmonary Function Test (PFT) Interpretation: Be able to instantly differentiate obstructive from restrictive defects using LLN vs fixed ratios, assess hyperinflation (elevated TLC) and air trapping (elevated RV/TLC), interpret DLCO/KCO discrepancies, and analyze CPET parameters (VO2max, anaerobic threshold, VE/VCO2 slope, breathing reserve).
2Memorize High-Resolution CT Patterns in ILD: Confidently distinguish UIP (subpleural basal reticulation and honeycombing without inconsistent features) from NSIP, organizing pneumonia (reverse halo sign), hypersensitivity pneumonitis (mosaic attenuation and three-density sign), and cystic diseases (PLCH vs LAM).
3Master Severe Asthma Phenotyping & Biologics: Know biomarker cutoffs and clinical indications for omalizumab (anti-IgE), mepolizumab/benralizumab/reslizumab (anti-IL5/IL5R), dupilumab (anti-IL4Rα), and tezepelumab (anti-TSLP).
4Know Haemodynamic Classifications of Pulmonary Hypertension: Memorize the 2022 ESC/ERS criteria (mPAP >20 mmHg, PAWP ≤15 mmHg, PVR >2 Wood units for precapillary PH) and understand risk stratification algorithms and initial combination ERA + PDE-5 inhibitor therapy.
5Understand Acute Respiratory Failure & Ventilatory Settings: Master ARDS Berlin criteria, lung-protective ventilation (6 mL/kg PBW, plateau pressure ≤30 cmH2O, driving pressure <15 cmH2O), prone positioning indications (PaO2/FiO2 <150), and COPD acute acidosis NIV settings.

Frequently Asked Questions

What is the Facharzt FMH für Pneumologie title?

The Facharzt FMH für Pneumologie is the federally recognized specialist medical title awarded by the SIWF / FMH (Swiss Medical Association) upon completion of at least 6 years of accredited postgraduate training (including general internal medicine and pulmonology), passing both the written European HERMES examination and the SGP oral board examination, and satisfying all e-logbook procedure requirements.

How is the Swiss Pulmonology specialist examination structured?

The examination comprises two mandatory parts: 1) The written European Examination in Adult Respiratory Medicine (HERMES), developed by the European Respiratory Society (ERS) and consisting of 90 MCQs administered in English, and 2) The SGP oral board examination, conducted in Switzerland to evaluate clinical cases, diagnostic PFT interpretation, imaging, and therapeutic decision-making.

When can Swiss pulmonology trainees register for the exam?

Candidates typically take the written HERMES examination during their final two years of specialty training. Registration is coordinated directly through the Swiss Society of Pulmonology (SGP/SSP), which automatically registers Swiss candidates for the ERS HERMES written examination.

What clinical guidelines form the primary foundation for the examination?

The examination is based on international and European consensus guidelines, including ERS/ATS clinical guidelines, GINA (Global Initiative for Asthma), GOLD (Global Initiative for Chronic Obstructive Lung Disease), ESC/ERS Pulmonary Hypertension guidelines, Fleischner Society recommendations, and Swiss respiratory disease management standards.

Why is this practice bank written in English?

The official written HERMES Examination is authored and administered exclusively in English across all participating European countries, including Switzerland. Major respiratory literature and clinical trials are published in English. This question bank prepares candidates directly in the terminology and format used in the written European board.

What are the required logbook competencies for Swiss pulmonology certification?

Trainees must document certified minimum numbers of flexible bronchoscopies (including BAL, endobronchial biopsies, and transbronchial biopsies), EBUS-TBNA procedures, pleural ultrasound and thoracenteses, chest tube insertions, complete pulmonary function tests (body plethysmography, DLCO, blood gases), CPET interpretations, and sleep diagnostic studies/NIV titrations.