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100+ Free Respiratory SCE Practice Questions

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Question 1
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A 58-year-old smoker has haemoptysis and weight loss. Chest radiograph shows a right hilar mass. What is the most appropriate pathway?

A
B
C
D
to track
2026 Statistics

Key Facts: Respiratory SCE Exam

200

best-of-five MCQs in the official exam

Federation SCE FAQs

2 September 2026

2026/01 Respiratory Medicine SCE exam date

Federation SCE exam dates and fees

13 May-10 June 2026

2026/01 application period

Federation SCE exam dates and fees

GBP 700

2026 UK-centre fee

Federation SCE exam dates and fees

457

current Respiratory Medicine passing score until next standards review

Federation Respiratory Medicine SCE 2025 exam metrics report

67%

2025 all-candidate pass rate

Federation Respiratory Medicine SCE 2025 exam metrics report

Respiratory Medicine SCE is a Federation Specialty Certificate Examination for higher specialty respiratory medicine trainees and equivalent candidates. The official format is 200 best-of-five MCQs: Paper 1 and Paper 2 each contain 100 questions and last 3 hours, separated by a one-hour break. The 2026/01 Respiratory Medicine SCE is scheduled for 2 September 2026, with applications open 13 May-10 June 2026. The published 2026 UK-centre fee is GBP 700. The Federation's Respiratory Medicine SCE metrics report lists a current passing score of 457, valid until the next standards review, and reports a 2025 pass rate of 67% for all candidates and 80.5% for UK resident doctors. The blueprint weights are airways disease 35, infections 35, thoracic oncology 35, interstitial lung disease 25, pleura and mediastinum 25, pulmonary vascular disease 20, other respiratory medicine 20, and sleep and ventilation 5 out of 200 questions.

Sample Respiratory SCE Practice Questions

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

1A 72-year-old man with severe COPD is admitted with an infective exacerbation. His oxygen saturation is 84% on air, he is drowsy, and he has a previous admission with hypercapnic respiratory failure. What oxygen prescription is safest while an arterial blood gas is obtained?
A.Controlled oxygen aiming for saturations of 88-92%
B.High-flow oxygen aiming for saturations above 98%
C.No oxygen until the arterial blood gas result is available
D.Oxygen only if he becomes cyanosed
Explanation: Patients at risk of hypercapnic respiratory failure should receive controlled oxygen with a target saturation of 88-92% while urgent ABG assessment is performed. Hypoxaemia must still be treated.
2A 24-year-old with acute asthma is unable to complete sentences. Respiratory rate is 32/min, pulse is 126/min, oxygen saturation is 91% on air, and peak flow is 28% of best. Which feature makes this a life-threatening attack?
A.Peak flow below 33% of best or predicted
B.Pulse above 110/min
C.Respiratory rate above 25/min
D.Inability to complete sentences
Explanation: A peak expiratory flow below 33% of best or predicted is a life-threatening asthma feature. The other findings indicate severe asthma, but the very low peak flow escalates risk.
3Spirometry shows FEV1 1.2 L, FVC 3.1 L, FEV1/FVC ratio 0.39, and little reversibility after bronchodilator. Which interpretation is most appropriate?
A.Obstructive ventilatory defect
B.Restrictive ventilatory defect
C.Normal spirometry
D.Isolated gas transfer defect
Explanation: A reduced FEV1/FVC ratio indicates airflow obstruction. Poor reversibility supports fixed obstruction such as COPD, although clinical context remains essential.
4A patient with COPD has two moderate exacerbations despite regular LABA/LAMA therapy. Blood eosinophil count is 360 cells/uL and there is no history of recurrent pneumonia. What escalation is most appropriate?
A.Add inhaled corticosteroid as triple therapy
B.Stop long-acting bronchodilators and use inhaled corticosteroid alone
C.Start maintenance oral prednisolone
D.Add nebulised salbutamol as the only maintenance treatment
Explanation: Frequent COPD exacerbations with a high eosinophil count favour adding ICS to LABA/LAMA as triple therapy, provided pneumonia risk is acceptable.
5A 68-year-old with bronchiectasis has chronic Pseudomonas aeruginosa isolation and three infective exacerbations in the last year. Which management principle is most appropriate?
A.Optimise airway clearance and consider specialist long-term anti-pseudomonal therapy
B.Ignore Pseudomonas unless blood cultures are positive
C.Treat every positive sputum culture with a 3-day antibiotic course
D.Stop physiotherapy because it spreads infection within the lungs
Explanation: Frequent exacerbations with chronic Pseudomonas should prompt airway-clearance optimisation, sputum-guided treatment and specialist consideration of inhaled or long-term antibiotic strategies.
6A 19-year-old with cystic fibrosis has recurrent productive cough, pancreatic insufficiency and chronic airway infection. Which organism is most associated with long-term decline once chronically established?
A.Pseudomonas aeruginosa
B.Mycoplasma pneumoniae
C.Streptococcus pyogenes
D.Moraxella catarrhalis
Explanation: Chronic Pseudomonas aeruginosa infection in cystic fibrosis is associated with increased exacerbations and accelerated lung function decline, so eradication and suppression strategies are important.
7A 45-year-old never-smoker has basal panacinar emphysema and mild liver enzyme abnormalities. Which test is most appropriate to confirm the suspected inherited diagnosis?
A.Serum alpha-1 antitrypsin level with phenotype or genotype testing
B.Serum angiotensin-converting enzyme level
C.Sweat chloride test only
D.Exhaled nitric oxide
Explanation: Early-onset basal panacinar emphysema suggests alpha-1 antitrypsin deficiency. Confirmation needs serum level and phenotype or genotype testing because levels can be affected by inflammation.
8A baker has cough and wheeze on workdays, improves on weekends, and has normal baseline spirometry in clinic. What investigation best supports occupational asthma in routine specialist practice?
A.Serial peak expiratory flow measurements at and away from work
B.Single normal spirometry trace
C.Chest radiograph alone
D.Resting oxygen saturation during annual leave
Explanation: Serial peak expiratory flow recorded several times daily during work and rest periods can demonstrate work-related variability and supports occupational asthma.
9A COPD exacerbation patient has pH 7.28, PaCO2 8.8 kPa and persistent tachypnoea after controlled oxygen, nebulised bronchodilators, steroids and antibiotics. What is the next respiratory support step if there is no contraindication?
A.Start acute non-invasive ventilation
B.Increase oxygen to 15 L/min via non-rebreathe mask only
C.Give intravenous bicarbonate as definitive treatment
D.Delay ventilatory support until pH is below 7.00
Explanation: Acute NIV is indicated in COPD exacerbation with persistent respiratory acidosis and hypercapnia despite initial medical therapy, if there are no contraindications.
10A patient with asthma develops fleeting pulmonary infiltrates, central bronchiectasis, eosinophilia and very high total IgE. Which diagnosis best fits?
A.Allergic bronchopulmonary aspergillosis
B.Idiopathic pulmonary fibrosis
C.Goodpasture syndrome
D.Pulmonary embolism
Explanation: Asthma, central bronchiectasis, eosinophilia, high IgE and transient infiltrates are classic for allergic bronchopulmonary aspergillosis.

About the Respiratory SCE Exam

The Respiratory Medicine Specialty Certificate Examination is the Federation SCE for physicians training in respiratory medicine. The official blueprint allocates 200 best-of-five questions across airways disease, interstitial lung disease, pleura and mediastinum, infections, pulmonary vascular disease, sleep and ventilation, thoracic oncology, and other respiratory medicine. The exam is computer-based, delivered as two 3-hour papers of 100 questions with a one-hour break. For the 2026/01 Respiratory Medicine diet, applications run from 13 May to 10 June 2026 and the exam date is 2 September 2026.

Assessment

Two papers, each with 100 best-of-five multiple-choice questions

Time Limit

Two 3-hour papers with a one-hour break

Passing Score

457 for Respiratory Medicine, published in the Federation's 2025 exam metrics report and applied until the next standards review

Exam Fee

GBP 700 UK centre fee for 2026; GBP 875 international centre fee (Federation of Royal Colleges of Physicians of the UK)

Respiratory SCE Exam Content Outline

35/200

Airways Disease

Asthma, COPD, bronchiectasis, cystic fibrosis, airway obstruction, alpha-1 antitrypsin deficiency, inhaled therapy selection and chronic respiratory failure.

25/200

Interstitial Lung Disease

IPF and UIP, sarcoidosis, connective tissue disease ILD, hypersensitivity pneumonitis, occupational ILD, HRCT interpretation and multidisciplinary decision-making.

25/200

Pleura and Mediastinum

Pleural effusion, pneumothorax, empyema, malignant pleural disease, thoracic ultrasound, pleural procedures and mediastinal pathology.

35/200

Infections

Community and hospital-acquired pneumonia, tuberculosis, NTM lung disease, bronchiectasis exacerbations, fungal infection and infection in immunocompromised patients.

20/200

Pulmonary Vascular Disease

Pulmonary embolism, right heart strain, anticoagulation, pulmonary hypertension classification, right heart catheterisation and CTEPH pathways.

5/200

Sleep and Ventilation

Obstructive sleep apnoea, obesity hypoventilation, COPD-OSA overlap, long-term NIV and domiciliary ventilation service decisions.

35/200

Thoracic Oncology

Lung cancer presentation, urgent referral, CT and PET-CT staging, EBUS, bronchoscopy, molecular testing, pleural malignancy and treatment fitness.

20/200

Other Respiratory Medicine

Respiratory physiology, imaging, procedures, oxygen and NIV, critical care interface, occupational/environmental lung disease, patient safety and service-level decisions.

How to Pass the Respiratory SCE Exam

What You Need to Know

  • Passing score: 457 for Respiratory Medicine, published in the Federation's 2025 exam metrics report and applied until the next standards review
  • Assessment: Two papers, each with 100 best-of-five multiple-choice questions
  • Time limit: Two 3-hour papers with a one-hour break
  • Exam fee: GBP 700 UK centre fee for 2026; GBP 875 international centre fee

Keys to Passing

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

Respiratory SCE Study Tips from Top Performers

1Start with the official Federation Respiratory Medicine SCE blueprint and map revision time to the published 200-question weighting.
2Use UK pathways for oxygen targets, NIV escalation, TB notification, urgent cancer referral and pleural procedure safety.
3Practise mixed best-answer cases that force investigation selection, comorbidity trade-offs and escalation decisions.
4Review HRCT, CT pulmonary angiography, pleural ultrasound and lung cancer staging images rather than revising text only.
5Keep patient-safety themes visible: anticoagulation risk, oxygen prescription, procedural consent, drain checks and infection control.

Frequently Asked Questions

What is the Respiratory Medicine SCE format?

The Federation states that SCEs are computer-based examinations with two papers. Each paper contains 100 best-of-five multiple-choice questions, each paper lasts 3 hours, and there is a one-hour break between papers.

When is the 2026 Respiratory Medicine SCE?

The Federation 2026 dates page lists the Respiratory Medicine 2026/01 exam date as 2 September 2026, with applications open from 13 May to 10 June 2026.

How much is the 2026 Respiratory Medicine SCE?

The Federation 2026 exam dates and fees page lists the Respiratory Medicine SCE fee as GBP 700 for UK centres and GBP 875 for international centres.

What passing score should candidates know?

The Federation Respiratory Medicine SCE 2025 metrics report lists the current passing score as 457, valid until the next standards review. The report also states that pass standards are reviewed periodically.

Is MRCP(UK) required before applying?

The Federation how-to-apply guidance states that candidates do not need to have passed MRCP(UK) before applying for an SCE. UK trainees are normally advised to sit the exam in their penultimate year of higher specialty training.