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100+ Free HERMES Adult Respiratory Medicine Practice Questions

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Key Facts: HERMES Adult Respiratory Medicine Exam

90 questions

ERS HERMES adult respiratory exam has 90 multiple-choice questions in English

ERS - HERMES examinations

3 hours

The examination runs three hours, online and proctored, without breaks

ERS - HERMES adult respiratory medicine

Type-A + K-prime

Items mix Type-A (one of five) and K-prime (four true/false) with no negative marking

ERS - HERMES examinations

EUR 310

European Diploma registration fee for ERS members (EUR 410 for non-members)

ERS HERMES Online Examination Terms and Conditions

Standard-set

Passing score is set by the committee with the Institute for Medical Education, Bern

ERS HERMES Online Examination Terms and Conditions

Since 2008

HERMES exams have been the European knowledge-assessment standard in respiratory medicine since 2008

ERS - About the HERMES examinations

EBAP and UEMS

The exam is accredited by EBAP and approved by UEMS

ERS - About the HERMES examinations

100

Free original practice questions in this bank

OpenExamPrep

The ERS HERMES Adult Respiratory Medicine examination is the European Respiratory Society's knowledge-based test leading to the European Diploma in adult respiratory medicine. It has 90 multiple-choice questions in English over three hours, online and proctored, mixing Type-A (one of five) and K-prime (four true/false) items with no negative marking. There is no fixed pass mark; the passing score is standard-set by the examination committee with the Institute for Medical Education in Bern. The European Diploma category costs EUR 310 for members and EUR 410 for non-members, paid via myERS. This 100-question bank gives original clinical-vignette practice mapped to the HERMES adult blueprint and is kept distinct from the paediatric HERMES exam.

Sample HERMES Adult Respiratory Medicine Practice Questions

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

1A 24-year-old with intermittent wheeze has normal spirometry in clinic. Which test best confirms a diagnosis of asthma by demonstrating variable airflow obstruction?
A.Single resting arterial blood gas
B.Bronchodilator reversibility or bronchial challenge testing
C.Chest radiograph
D.Full blood count for eosinophils alone
Explanation: Asthma is defined by variable airflow obstruction. When baseline spirometry is normal, demonstrating reversibility after bronchodilator (FEV1 rise of 12% and 200 mL) or airway hyperresponsiveness on a bronchial (methacholine/mannitol) challenge confirms the diagnosis.
2According to GINA, what is the preferred reliever and the foundation of asthma treatment in adults and adolescents, rather than short-acting beta-agonist (SABA) alone?
A.As-needed inhaled corticosteroid-formoterol
B.Regular oral corticosteroids
C.As-needed SABA monotherapy
D.Long-acting muscarinic antagonist monotherapy
Explanation: GINA recommends against SABA-only treatment. The preferred approach across steps is anti-inflammatory reliever therapy using as-needed low-dose ICS-formoterol, which reduces severe exacerbations compared with SABA reliever alone.
3A 52-year-old with severe eosinophilic asthma (blood eosinophils 600 cells/microL) remains uncontrolled on high-dose ICS-LABA. Which biologic class specifically targets the interleukin-5 pathway?
A.Omalizumab
B.Mepolizumab
C.Dupilumab
D.Tezepelumab
Explanation: Mepolizumab (like reslizumab and the IL-5 receptor antibody benralizumab) targets the IL-5 pathway, reducing eosinophil numbers and exacerbations in severe eosinophilic asthma.
4Which spirometric finding is required to confirm persistent airflow obstruction in COPD according to GOLD?
A.Post-bronchodilator FEV1/FVC below 0.70
B.FEV1 below 80% predicted alone
C.Raised total lung capacity
D.Reduced DLCO alone
Explanation: GOLD requires a post-bronchodilator FEV1/FVC ratio below 0.70 to confirm persistent airflow limitation. The degree of FEV1 reduction is then used to grade severity.
5In the GOLD ABE assessment tool, which factor places a patient in group E?
A.Low symptom burden only
B.A history of frequent or severe exacerbations
C.FEV1 above 80% predicted
D.Absence of dyspnoea
Explanation: The 2023 GOLD revision uses groups A, B and E. Group E is defined by a high exacerbation history (2 or more moderate exacerbations or 1 leading to hospitalisation) regardless of symptom score, prompting consideration of LABA-LAMA and ICS where eosinophils are high.
6Which intervention has been shown to improve survival in patients with COPD and chronic severe resting hypoxaemia (PaO2 at or below 7.3 kPa / 55 mmHg)?
A.Long-term oxygen therapy used at least 15 hours per day
B.Inhaled corticosteroids
C.Oral theophylline
D.Mucolytic therapy
Explanation: Long-term oxygen therapy used for at least 15 hours a day improves survival in COPD patients with severe chronic resting hypoxaemia. It is one of the few interventions, alongside smoking cessation and lung volume reduction in selected patients, proven to prolong life.
7A patient hospitalised with a severe COPD exacerbation has a pH of 7.28 and PaCO2 of 9.0 kPa (68 mmHg) despite controlled oxygen and bronchodilators. What is the most appropriate next step?
A.Immediate invasive intubation
B.Non-invasive ventilation (NIV)
C.Intravenous doxapram
D.Increase inspired oxygen to 100%
Explanation: Non-invasive ventilation is indicated for acute hypercapnic respiratory failure (pH 7.25-7.35) due to COPD exacerbation that persists despite medical therapy. NIV reduces the need for intubation and mortality.
8A 35-year-old lifelong non-smoker has basal panacinar emphysema and a low serum alpha-1 antitrypsin level. Which deficiency genotype is most often associated with severe disease?
A.PiMM
B.PiZZ
C.PiMS
D.PiMZ
Explanation: The PiZZ genotype produces markedly low alpha-1 antitrypsin levels and is associated with early-onset, basal-predominant panacinar emphysema, particularly in smokers, and with liver disease.
9A 40-year-old has recurrent productive cough with large-volume purulent sputum and HRCT shows signet-ring sign and tram-track opacities. What is the most likely diagnosis?
A.Bronchiectasis
B.Centrilobular emphysema
C.Pulmonary fibrosis
D.Sarcoidosis
Explanation: Bronchiectasis is characterised by permanent bronchial dilatation. The HRCT 'signet-ring sign' (dilated bronchus larger than its accompanying artery) and tram-track lines, with chronic purulent sputum, are classic.
10Which chronic airway pathogen colonising patients with bronchiectasis or cystic fibrosis is most associated with accelerated lung function decline and worse prognosis?
A.Haemophilus influenzae
B.Pseudomonas aeruginosa
C.Moraxella catarrhalis
D.Streptococcus pneumoniae
Explanation: Chronic Pseudomonas aeruginosa colonisation in bronchiectasis and cystic fibrosis is linked to more frequent exacerbations, faster FEV1 decline and increased mortality, justifying eradication attempts at first isolation.

About the HERMES Adult Respiratory Medicine Exam

The ERS HERMES (Harmonising Education in Respiratory Medicine for European Specialists) examination in adult respiratory medicine is the knowledge-based assessment leading to the European Diploma in adult respiratory medicine. Run by the European Respiratory Society since 2008, it is accredited by the European Board for Accreditation in Pneumology (EBAP) and approved by UEMS. The examination consists of 90 multiple-choice questions delivered online in English over three hours, mixing Type-A items (one correct option of five) and K-prime items (four options, each true or false). Questions are clinical-case based and mapped to the consensus European syllabus and blueprint published in Breathe, covering airway diseases, respiratory infections including tuberculosis, thoracic tumours, interstitial and pulmonary vascular disease, pleural disease, sleep-disordered breathing, respiratory failure and ventilation, occupational lung disease, pulmonary function testing and bronchoscopy. Passing grants the HERMES European Diploma; candidates can also sit in-training or self-assessment categories that do not lead to the diploma.

Assessment

90 multiple-choice questions mapped to the adult respiratory medicine blueprint. Items are split between Type-A questions (five options, one correct) and K-prime questions (four options, 0-4 correct). No negative marking is applied.

Time Limit

Three hours (180 minutes), online and proctored, taken in a single sitting without scheduled breaks.

Passing Score

No fixed percentage. The passing score is standard-set by the examination committee with the Institute for Medical Education (University of Bern) after a multi-round statistical key validation; candidates pass by scoring at or above the determined points threshold.

Exam Fee

European Diploma: EUR 310 for ERS members and EUR 410 for non-members, paid in euros via myERS; an optional EUR 10 fee adds CME credits. In-training and self-assessment categories cost EUR 170 (member) / EUR 270 (non-member). (European Respiratory Society (ERS), accredited by EBAP and approved by UEMS.)

HERMES Adult Respiratory Medicine Exam Content Outline

18%

Airway diseases

Asthma, COPD, bronchiectasis and cystic fibrosis: GINA and GOLD assessment, inhaled and biologic therapy, exacerbation management, alpha-1 antitrypsin deficiency and chronic cough.

12%

Respiratory infections and mycobacterial disease

Community-acquired and hospital-acquired pneumonia, tuberculosis diagnosis and treatment, latent TB, non-tuberculous mycobacteria, fungal infection and infection in immunocompromised patients.

11%

Thoracic tumours

Lung cancer presentation, TNM staging, histology and molecular markers, mediastinal staging, treatment pathways, solitary pulmonary nodules and mesothelioma.

10%

Diffuse parenchymal (interstitial) lung disease

Idiopathic pulmonary fibrosis and antifibrotics, hypersensitivity pneumonitis, sarcoidosis, connective-tissue-disease-associated ILD and the multidisciplinary diagnosis approach.

8%

Pulmonary vascular disease

Acute pulmonary embolism risk stratification and treatment, pulmonary hypertension classification, and chronic thromboembolic pulmonary hypertension.

7%

Pleural disease

Pleural effusion evaluation and Light's criteria, pneumothorax management, pleural infection and empyema, and malignant pleural disease.

8%

Sleep and control of breathing

Obstructive and central sleep apnoea, obesity hypoventilation syndrome, polysomnography interpretation, and CPAP and non-invasive ventilation.

9%

Respiratory failure and ventilation

Type 1 and type 2 respiratory failure, oxygen and high-flow therapy, non-invasive ventilation indications, ARDS and respiratory critical care principles.

6%

Occupational and environmental lung disease

Pneumoconioses, occupational asthma, asbestos-related disease and other environmental and inhalational exposures.

6%

Pulmonary function testing

Spirometry, lung volumes, gas transfer (DLCO), bronchial provocation testing and interpretation of obstructive and restrictive patterns.

5%

Bronchoscopy and diagnostic procedures

Flexible bronchoscopy, endobronchial ultrasound (EBUS), transbronchial biopsy, bronchoalveolar lavage and procedural indications and complications.

How to Pass the HERMES Adult Respiratory Medicine Exam

What You Need to Know

  • Passing score: No fixed percentage. The passing score is standard-set by the examination committee with the Institute for Medical Education (University of Bern) after a multi-round statistical key validation; candidates pass by scoring at or above the determined points threshold.
  • Assessment: 90 multiple-choice questions mapped to the adult respiratory medicine blueprint. Items are split between Type-A questions (five options, one correct) and K-prime questions (four options, 0-4 correct). No negative marking is applied.
  • Time limit: Three hours (180 minutes), online and proctored, taken in a single sitting without scheduled breaks.
  • Exam fee: European Diploma: EUR 310 for ERS members and EUR 410 for non-members, paid in euros via myERS; an optional EUR 10 fee adds CME credits. In-training and self-assessment categories cost EUR 170 (member) / EUR 270 (non-member).

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

HERMES Adult Respiratory Medicine Study Tips from Top Performers

1Download the official adult respiratory blueprint and weight your revision time across topics; airway disease, infections and thoracic tumours together make up roughly 40% of the exam.
2Practise K-prime items deliberately: treat each of the four statements as a separate true or false decision rather than picking a single best answer, because every statement is scored.
3Drill guideline thresholds you can be tested on directly: GOLD COPD grading, Light's criteria for exudates, Wells score and PESI for pulmonary embolism, and the modified British Thoracic Society pneumonia tools.
4Use clinical vignettes to rehearse interpreting investigations together (spirometry plus DLCO, HRCT patterns, pleural fluid biochemistry) rather than memorising isolated facts.
5Work through the ERS self-assessment course and the ERS Handbook self-assessment book, which are written by the HERMES committee and mirror the exam style.
6There is no negative marking, so answer every question; for K-prime items, commit to a true or false for each statement rather than leaving any blank.

Frequently Asked Questions

How many questions are on the ERS HERMES adult respiratory medicine exam?

The examination has 90 multiple-choice questions delivered in English over three hours. It mixes Type-A items (five options, one correct) and K-prime items (four options, each true or false), with no negative marking.

Is there a fixed pass mark for the HERMES European Diploma?

No. The passing score is standard-set by the examination committee together with the Institute for Medical Education at the University of Bern after a multi-round statistical key validation, so the threshold can vary between sittings.

How much does the HERMES European Diploma examination cost?

The European Diploma category costs EUR 310 for ERS members and EUR 410 for non-members, paid in euros via myERS. An optional EUR 10 fee adds CME credits. In-training and self-assessment categories cost EUR 170 for members and EUR 270 for non-members.

What topics does the HERMES adult exam cover?

It follows the European syllabus and blueprint: airway diseases, respiratory infections including tuberculosis, thoracic tumours, interstitial lung disease, pulmonary vascular disease, pleural disease, sleep-disordered breathing, respiratory failure and ventilation, occupational lung disease, pulmonary function testing and bronchoscopy.

How is the adult HERMES exam different from the paediatric one?

Both are 90-question ERS HERMES exams, but they map to separate syllabi and blueprints. The adult exam tests adult respiratory medicine, while the paediatric exam covers childhood respiratory disease, and the paediatric European Diploma carries a higher registration fee.

Who can sit the HERMES adult respiratory medicine examination?

It is open to respiratory professionals. The European Diploma category targets qualified specialists and final-year trainees; the Swiss Society of Pulmonology uses it as the mandatory written exit exam for final-year respiratory trainees in Switzerland.