100+ Free Cert Pulmonology(SA) Paed Practice Questions

Prepare for the CMSA Sub-specialty Certificate in Pulmonology Cert Pulmonology(SA) Paed — South Africa exam with instant access — no signup required.

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2026 Statistics

Key Facts: Cert Pulmonology(SA) Paed Exam

2 components

Written + oral/OSCE

CMSA Regulations

50% each

Subminimum per component

CMSA Regulations

R24 650

Exam Fee

CMSA Sub-specialty Fee Schedule

50% overall

Pass Mark

CMSA Regulations

CMSA

Exam Body

College of Paediatricians of SA

The Cert Pulmonology(SA) Paed is a rigorous two-component sub-specialty exit examination (written short-answer papers plus an oral/OSCE/clinical component, each 50%) assessing expert paediatric pulmonology knowledge for doctors completing sub-specialist training in South Africa. This bank provides 100 practice MCQs as a study aid.

Sample Cert Pulmonology(SA) Paed Practice Questions

Try these sample questions to test your Cert Pulmonology(SA) Paed exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1According to Global Initiative for Asthma (GINA) guidelines for children aged 6–11 years, what is the recommended Track 1 preferred controller therapy for mild persistent asthma?

A.Low-dose inhaled corticosteroid (ICS) taken whenever a short-acting beta2-agonist (SABA) is taken, or daily low-dose ICS

B.Short-acting beta2-agonist (SABA) monotherapy as needed

C.Oral leukotriene receptor antagonist (LTRA) monotherapy as needed for symptoms

D.Long-acting beta2-agonist (LABA) monotherapy taken twice daily

Explanation: GINA Track 1 recommendations for children 6–11 years specify taking low-dose ICS whenever SABA is taken, or regular daily low-dose ICS to suppress airway inflammation and prevent exacerbations.

2A 7-year-old child presents to the emergency department in acute mild-to-moderate asthma exacerbation. What is the initial pharmacological treatment of choice?

A.Intravenous aminophylline infusion

B.Inhaled short-acting beta2-agonist (salbutamol) via pressurized metered-dose inhaler (pMDI) with a spacer

C.Oral montelukast single dose

D.Inhaled long-acting anticholinergic (tiotropium)

Explanation: Inhaled SABA (salbutamol) administered via pMDI with a dedicated spacer (4–10 puffs repeated every 20 minutes for the first hour) is the first-line bronchodilator therapy for acute paediatric asthma exacerbations.

3A 2-year-old boy presents with recurrent wheezing occurring exclusively during upper respiratory tract viral infections, with complete absence of symptoms between episodes. What is the most accurate classification for this wheezing phenotype?

A.Multiple-trigger wheeze

B.Eosinophilic allergic asthma

C.Viral-induced episodic wheeze

D.Cystic fibrosis airway disease

Explanation: Viral-induced episodic wheeze (episodic viral wheeze) is characterized by wheezing episodes associated exclusively with viral upper respiratory tract infections, with the child remaining entirely asymptomatic between viral illnesses.

4Which drug delivery interface is recommended for the administration of inhaled medications in a 3-year-old child with asthma?

A.Dry powder inhaler (DPI) without spacer

B.Pressurized metered-dose inhaler (pMDI) directly inserted into the mouth without spacer

C.Standard jet nebulizer without face mask

D.Pressurized metered-dose inhaler (pMDI) with a valved holding chamber (spacer) and face mask

Explanation: Children under 4–5 years of age cannot coordinate actuation and inhalation. A pMDI attached to a valved holding chamber (spacer) with an appropriately fitting face mask ensures optimal lung deposition.

5What is the standard recommended dose and duration of oral prednisolone for an acute asthma exacerbation requiring systemic corticosteroids in a 6-year-old child?

A.1–2 mg/kg/day (maximum 40 mg) for 3–5 days

B.0.1 mg/kg/day for 14 days with gradual tapering

C.5 mg/kg single dose given intravenously

D.10 mg/kg/day for 7 days followed by alternate-day dosing

Explanation: The standard dose of oral prednisolone for acute pediatric asthma exacerbations is 1–2 mg/kg/day (up to a maximum of 40 mg daily) for 3 to 5 days. Tapering is not required for short courses (<14 days).

6A 10-year-old competitive swimmer experiences cough and shortness of breath specifically during high-intensity training. What is the initial preventive measure before exercise?

A.Inhaled ipratropium bromide 30 minutes before exercise

B.Inhaled SABA (salbutamol 2 puffs) 10 to 15 minutes prior to exercise

C.Oral systemic corticosteroid dose 1 hour before exercise

D.Intravenous aminophylline bolus immediately before exercise

Explanation: Pre-exercise administration of an inhaled SABA (e.g., salbutamol 2 puffs via spacer 10–15 minutes before activity) effectively prevents exercise-induced bronchoconstriction.

7What advice should be routinely given to paediatric patients using regular inhaled corticosteroid (ICS) therapy to prevent local adverse effects such as oral candidiasis and dysphonia?

A.Take the inhaler only immediately before bedtime

B.Avoid using a spacer device

C.Rinse the mouth with water and spit it out after each dose

D.Discontinue ICS as soon as symptoms improve for 2 consecutive days

Explanation: Rinsing the mouth with water and spitting (or drinking/eating in infants/toddlers) after taking inhaled corticosteroids removes deposited drug from the oropharyngeal mucosa, preventing oral thrush and hoarseness.

8In severe acute paediatric asthma exacerbations unresponsive to initial SABA monotherapy, what is the main rationale for adding inhaled ipratropium bromide?

A.To replace the need for systemic corticosteroids

B.To provide direct long-term anti-inflammatory activity

C.To prevent bacterial superinfection in the airways

D.To produce additive bronchodilation and reduce hospital admission rates

Explanation: Adding ipratropium bromide (an anticholinergic) to SABA in the first hour of treating severe acute asthma exacerbations produces complementary vagolytic bronchodilation, significantly reducing hospital admission rates and ED stay.

9A 9-year-old child with severe acute asthma remains dyspnoeic with persistent chest indrawing after 1 hour of continuous nebulized salbutamol, ipratropium, and IV hydrocortisone. What is the recommended next intravenous therapy?

A.Intravenous magnesium sulfate (40–50 mg/kg, max 2 g over 20 minutes)

B.Intravenous bolus of adrenaline (1 mg/kg)

C.Intravenous furosemide bolus (2 mg/kg)

D.Intravenous sodium bicarbonate infusion

Explanation: IV magnesium sulfate (40–50 mg/kg infusion over 20 minutes) acts as a smooth muscle relaxant by inhibiting calcium uptake into bronchial smooth muscle cells and is recommended for acute severe asthma unresponsive to initial intensive bronchodilator/steroid therapy.

10An 11-year-old girl with severe persistent allergic asthma experiences frequent exacerbations despite high-dose ICS-LABA and daily LTRA. Her total serum IgE is 450 IU/mL and skin prick testing is positive for perennial house dust mite. Which biologic agent targeting IgE is indicated?

A.Mepolizumab (anti-IL-5)

B.Omalizumab (anti-IgE)

C.Dupilumab (anti-IL-4R alpha)

D.Benralizumab (anti-IL-5R alpha)

Explanation: Omalizumab is a humanized monoclonal antibody that binds selectively to free circulating IgE, preventing its binding to high-affinity Fc-epsilon-RI receptors on mast cells and basophils. It is approved for severe allergic asthma with elevated serum IgE.

About the Cert Pulmonology(SA) Paed Exam

The Certificate in Pulmonology(SA) Paediatric is the credentialing sub-specialty examination administered by the College of Paediatricians of South Africa. It assesses advanced clinical knowledge, diagnostic precision, and management in paediatric respiratory medicine including childhood asthma, tuberculosis, severe pneumonia, cystic fibrosis, bronchiectasis, chronic lung disease of prematurity (BPD), flexible bronchoscopy, paediatric lung function testing, congenital airway malformations, and sleep-disordered breathing.

Assessment

Two components each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Content spans 5 domain areas: Paediatric Asthma & Wheezing Disorders (25%), Childhood Tuberculosis & Severe Pneumonias (30%), Cystic Fibrosis, Bronchiectasis & Chronic Lung Disease of Prematurity (20%), Paediatric Bronchoscopy & Pulmonary Function Testing (15%), Congenital Airway Anomalies & Sleep Disordered Breathing (10%).

Time Limit

Written short-answer papers plus an OSCE and viva component.

Passing Score

Overall pass mark 50% with a 50% subminimum in each of the two components (written and oral/OSCE/OSPE/clinical).

Exam Fee

R24 650 (College of Paediatricians (Colleges of Medicine of South Africa))

Cert Pulmonology(SA) Paed Exam Content Outline

25%

Paediatric Asthma & Wheezing Disorders

Pathophysiology, phenotypes, acute severe asthma management, controller therapies (ICS, LABA, biologics), preschool wheeze classification, and asthma exacerbation pathways.

30%

Childhood Tuberculosis & Severe Pneumonias

Epidemiology, diagnosis (GeneXpert Ultra, tuberculin skin test, IGRA, gastric washings), drug-resistant TB, severe bacterial/viral pneumonias, empyema, HIV-associated respiratory infections.

20%

Cystic Fibrosis, Bronchiectasis & Chronic Lung Disease of Prematurity

CFTR genetics and modulator therapies, sweat chloride testing, non-CF bronchiectasis, bronchopulmonary dysplasia (BPD) prevention and long-term care, interstitial lung disease in infants.

15%

Paediatric Bronchoscopy & Pulmonary Function Testing

Flexible and rigid bronchoscopy indications and complications, BAL cellularity and microbiology, spirometry interpretation, impulse oscillometry, plethysmography, multiple breath washout (LCI).

10%

Congenital Airway Anomalies & Sleep Disordered Breathing

Laryngomalacia, tracheomalacia, vascular rings, congenital pulmonary airway malformations (CPAM), polysomnography interpretation, paediatric obstructive sleep apnea (OSA), hypoventilation.

How to Pass the Cert Pulmonology(SA) Paed Exam

What You Need to Know

Passing score: Overall pass mark 50% with a 50% subminimum in each of the two components (written and oral/OSCE/OSPE/clinical).
Assessment: Two components each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Content spans 5 domain areas: Paediatric Asthma & Wheezing Disorders (25%), Childhood Tuberculosis & Severe Pneumonias (30%), Cystic Fibrosis, Bronchiectasis & Chronic Lung Disease of Prematurity (20%), Paediatric Bronchoscopy & Pulmonary Function Testing (15%), Congenital Airway Anomalies & Sleep Disordered Breathing (10%).
Time limit: Written short-answer papers plus an OSCE and viva component.
Exam fee: R24 650

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

Cert Pulmonology(SA) Paed Study Tips from Top Performers

1Master the South African Thoracic Society (SATS) and GINA pediatric asthma management algorithms.

2Understand the diagnostic yield and interpretation of GeneXpert MTB/RIF Ultra on gastric aspirates and induced sputum in children.

3Review sweat chloride thresholds, CFTR gene mutations common in South Africa (such as F508del and 3120+1G->A), and indication for CFTR modulators.

4Practice interpreting paediatric spirometry volume-time and flow-volume curves, impulse oscillometry (R5, R20, X5), and polysomnography parameter metrics.

Frequently Asked Questions

What is the format of the CMSA Cert Pulmonology(SA) Paed examination?

The exit examination has two components, each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Candidates must achieve an overall 50% with a 50% subminimum in each component. This free question bank provides 100 practice MCQs as a study aid and does not replicate the official format.

What is the fee for the Cert Pulmonology(SA) Paed exam?

The examination fee is R24 650 according to the Colleges of Medicine of South Africa fee structure.

What are the core domains tested in the exam blueprint?

The blueprint comprises: Paediatric Asthma & Wheezing (25%), Childhood TB & Severe Pneumonias (30%), Cystic Fibrosis, Bronchiectasis & BPD (20%), Paediatric Bronchoscopy & PFTs (15%), and Congenital Airway Anomalies & Sleep Disordered Breathing (10%).