100+ Free Cert Pulmonology(SA) Phys Practice Questions

Prepare for the Sub-specialty Certificate in Pulmonology of the College of Physicians of South Africa exam with instant access — no signup required.

✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately

100+ Questions

100% Free

Loading practice questions...

Same family resources

Explore More CMSA Sub-specialty Certificate Examinations (South Africa)

Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.

CMSA Sub-specialty Certificate in Allergology Cert Allerg(SA) Phys — South Africa

Practice Questions100 questions

CMSA Sub-specialty Certificate in Cardiology Cert Cardiology(SA) Paed — South Africa

Practice Questions100 questions

CMSA Sub-specialty Certificate in Cardiology Cert Cardiology(SA) Phys — South Africa

Practice Questions100 questions

CMSA Sub-specialty Certificate in Clinical Haematology Cert Clin Haematology(SA) Paed — South Africa

Practice Questions100 questions

CMSA Sub-specialty Certificate in Clinical Haematology Cert Clin Haematology(SA) Path — South Africa

Practice Questions100 questions

CMSA Sub-specialty Certificate in Clinical Haematology Cert Clin Haematology(SA) Phys — South Africa

Practice Questions100 questions

2026 Statistics

Key Facts: Cert Pulmonology(SA) Phys Exam

2 components

Written + oral/OSCE

CMSA Regulations

50% each

Subminimum per component

CMSA Regulations

R24 650

Exam Fee

CMSA 2026 Fee Schedule

50% overall

Pass Mark

CMSA Regulations

CMSA

Exam Body

College of Physicians of SA

The Cert Pulmonology(SA) Phys is a rigorous two-component sub-specialty exit examination (written short-answer papers plus an oral/OSCE/clinical component, each 50%) assessing expert clinical competency in adult pulmonology for South African fellows. This bank provides 100 practice MCQs as a study aid.

Sample Cert Pulmonology(SA) Phys Practice Questions

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

1According to the South African National Tuberculosis Management Guidelines, how should a 'Trace' result on GeneXpert MTB/RIF Ultra be interpreted in an HIV-positive adult presenting with cough and fever who has no prior history of tuberculosis treatment?

A.Bacteriologically confirmed active pulmonary tuberculosis requiring initiation of first-line anti-TB therapy

B.False-positive result requiring repeat sputum testing before initiating anti-TB therapy

C.Latent tuberculosis infection requiring isoniazid preventive monotherapy only

D.Nontuberculous mycobacterial colonization requiring no active treatment

Explanation: In individuals with no history of TB treatment within the preceding 5 years, a 'Trace' result on GeneXpert Ultra represents true low-bacillary load Mycobacterium tuberculosis infection. In persons living with HIV (PLHIV), this is classified as bacteriologically confirmed active TB, and full first-line anti-TB treatment should be initiated immediately.

2A 34-year-old male with rifampicin-resistant pulmonary tuberculosis (RR-TB) without prior exposure to bedaquiline or linezolid is initiated on the BPaL regimen. Which drug combination constitutes this standardized 6-month all-oral regimen?

A.Bedaquiline, Pretomanid, and Linezolid

B.Bedaquiline, Prothionamide, and Linezolid

C.Bedaquiline, Pretomanid, and Levofloxacin

D.Bedaquiline, Pyrazinamide, and Levofloxacin

Explanation: The BPaL regimen consists of Bedaquiline, Pretomanid, and Linezolid. South African National TB guidelines recommend this 6-month all-oral regimen for patients with RR-TB/MDR-TB without prior exposure (>1 month) to bedaquiline, linezolid, or pretomanid. If moxifloxacin/levofloxacin is added, it forms the BPaLM regimen.

3A 42-year-old woman receiving BPaL for MDR-TB develops symptomatic peripheral neuropathy and hemoglobin drop to 7.8 g/dL at week 9 of therapy. Linezolid dose was initially 600 mg daily. What is the most appropriate management regarding Linezolid?

A.Permanently discontinue Bedaquiline and continue Linezolid at 600 mg daily with blood transfusion

B.Replace Linezolid with Ethambutol without dose reduction of other components

C.Increase Linezolid dose to 1200 mg daily to shorten total treatment duration

D.Temporarily interrupt Linezolid until toxicity resolves, then resume at 300 mg daily

Explanation: Linezolid toxicity (myelosuppression, peripheral neuropathy, optic neuritis) is dose- and duration-dependent. Per SA guidelines for BPaL/BPaLM, Linezolid should be held for significant toxicity (Hb <8 g/dL or symptomatic neuropathy) until recovery, then reinstated at a reduced dose of 300 mg daily.

4A newly diagnosed HIV-positive patient with smear-positive pulmonary tuberculosis has a baseline CD4 count of 28 cells/µL. According to South African National Guidelines, when should Antiretroviral Therapy (ART) be initiated?

A.Only after complete microbiological cure of tuberculosis

B.After completing 2 months of intensive-phase anti-TB therapy

C.Within 2 weeks of starting anti-tuberculosis therapy

D.On the same day as anti-tuberculosis therapy initiation

Explanation: In HIV-infected patients with severe immunosuppression (CD4 < 50 cells/µL), ART should be initiated within 2 weeks of starting anti-TB treatment to significantly reduce overall mortality. The exception is TB meningitis, where ART initiation is delayed to 4-6 weeks to avoid life-threatening intracranial IRIS.

5A 29-year-old HIV-infected male with pulmonary TB started ART 3 weeks ago (baseline CD4 18 cells/µL). He presents with worsening fever, cough, new cervical lymphadenopathy, and expanding pulmonary infiltrates on chest radiograph. Sputum Xpert Ultra shows no new drug resistance. What is the most appropriate management step?

A.Discontinue ART immediately and switch anti-TB drugs to second-line regimen

B.Continue ART and anti-TB therapy, and initiate oral Prednisone (1.5 mg/kg/day)

C.Add broad-spectrum antifungal cover with Fluconazole and stop ART

D.Stop anti-TB therapy and perform immediate lymph node excisional biopsy

Explanation: This patient presents with paradoxical Immune Reconstitution Inflammatory Syndrome (IRIS). Management requires continuation of both ART and effective anti-TB therapy, combined with systemic corticosteroids (Prednisone 1.5 mg/kg/day tapered over 4 weeks) to suppress hyper-inflammatory responses.

6A 58-year-old female with non-cystic fibrosis bronchiectasis has persistent cough and fatigue. Chest HRCT reveals nodular bronchiectasis in the right middle lobe. Sputum cultures grow Mycobacterium avium complex (MAC) on two separate occasions. What is the recommended first-line treatment regimen?

A.Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol daily for 6 months

B.Bedaquiline, Linezolid, and Clofazimine daily for 12 months

C.Azithromycin, Rifampicin, and Ethambutol administered three times weekly

D.Clarithromycin and Moxifloxacin daily for 3 months

Explanation: Per ATS/ERS/ESCMID/IDSA guidelines, nodular/bronchiectatic pulmonary MAC disease should be treated with a three-drug oral regimen of a macrolide (Azithromycin 500 mg or Clarithromycin 1000 mg), Rifampicin (600 mg), and Ethambutol (15 mg/kg) administered three times weekly until cultures are negative for at least 12 months.

7Line Probe Assay (GenoType MTBDRplus) performed on a sputum specimen from a 40-year-old male demonstrates an inhA promoter mutation with intact katG and rpoB genes. What type of resistance is present and what is the appropriate treatment?

A.Low-level isoniazid resistance; treat with Rifampicin, Ethambutol, Pyrazinamide, and Levofloxacin for 6 months (6 REZ-Lfx)

B.High-level isoniazid resistance; treat with standard 6-month RHZE regimen

C.Multidrug-resistant TB (MDR-TB); treat with 6-month BPaL regimen

D.Extensively drug-resistant TB (XDR-TB); treat with Capreomycin and PAS

Explanation: The inhA mutation confers low-level isoniazid resistance (and cross-resistance to ethionamide/prothionamide), while rpoB is wild-type (rifampicin sensitive). Per WHO and SA guidelines, isoniazid mono-resistant TB (Hr-TB) is treated with a 6-month regimen of Rifampicin, Ethambutol, Pyrazinamide, and Levofloxacin (6 REZ-Lfx).

8A 50-year-old male with pulmonary Mycobacterium abscessus subsp. abscessus infection has an intact erm(41) gene. How does the presence of a functional T28 polymorphism in erm(41) impact macrolide susceptibility and clinical management?

A.It predicts high cure rates with 3 months of oral azithromycin monotherapy

B.It renders the organism fully susceptible to all beta-lactam antibiotics

C.It confers constitutive high-level resistance to amikacin and cefoxitin

D.It confers inducible macrolide resistance, making long-term oral macrolide monotherapy ineffective despite initial in vitro susceptibility

Explanation: An intact erm(41) gene with a T28 sequevar confers inducible macrolide resistance in M. abscessus subsp. abscessus upon exposure to clarithromycin or azithromycin (evident after 14 days of incubation). Consequently, macrolides cannot be relied upon as the sole active oral agent in multi-drug multidirectional therapy.

9A 45-year-old patient on intensive-phase RHZE for pulmonary TB presents with nausea, vomiting, and jaundice. Serum ALT is 480 U/L (upper limit of normal 40 U/L) and total bilirubin is 62 µmol/L. What is the correct initial action regarding anti-TB drugs?

A.Continue Rifampicin and Isoniazid but stop Pyrazinamide only

B.Stop all hepatotoxic anti-TB drugs immediately and initiate non-hepatotoxic background cover if clinically unstable

C.Continue current regimen and add ursodeoxycholic acid

D.Halve the doses of all four first-line drugs and recheck ALT in 48 hours

Explanation: Drug-induced liver injury (DILI) criteria for stopping anti-TB drugs are ALT >= 3x ULN with symptoms (or ALT >= 5x ULN without symptoms) or total bilirubin > 2x ULN. All potential hepatotoxic drugs (Rifampicin, Isoniazid, Pyrazinamide) must be stopped immediately.

10Which short-course TB Preventive Treatment (TPT) regimen consisting of weekly rifapentine and isoniazid for 12 weeks is recommended by WHO and SA guidelines for HIV-infected individuals without active TB?

A.3HP (Rifapentine + Isoniazid weekly for 12 weeks)

B.1HP (Rifapentine + Isoniazid daily for 28 days)

C.6H (Isoniazid daily for 6 months)

D.4R (Rifampicin daily for 4 months)

Explanation: 3HP consists of weekly high-dose Rifapentine plus Isoniazid for 12 weeks (3 months). It offers equivalent efficacy to 6-9 months of INH monotherapy with significantly higher completion rates and lower hepatotoxicity.

About the Cert Pulmonology(SA) Phys Exam

The Sub-specialty Certificate in Pulmonology [Cert Pulmonology(SA) Phys] is the exit credential for specialist physicians completing post-specialisation fellowship training in Pulmonology in South Africa. The examination tests expert clinical knowledge, diagnostic acumen, guidelines implementation, and therapeutic decision-making across all fields of adult respiratory medicine, with special emphasis on diseases of regional relevance such as tuberculosis, occupational dust diseases, and HIV-related pulmonary complications.

Assessment

Two components each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Content spans 5 blueprint domains: Adult Pulmonary Tuberculosis & Mycobacterial Diseases (25%), COPD, Asthma & Airway Diseases (25%), Interstitial Lung Diseases & Occupational Pulmonary Disease (20%), Pulmonary Vascular Diseases & Pulmonary Hypertension (15%), and Lung Cancer, Interventional Pulmonology & Critical Care Pulmonology (15%).

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 Physicians of South Africa (Colleges of Medicine of South Africa))

Cert Pulmonology(SA) Phys Exam Content Outline

25%

Adult Pulmonary Tuberculosis & Mycobacterial Diseases

Drug-susceptible TB, MDR/XDR-TB regimens (BPaL/BPaLM), HIV-TB co-infection, IRIS, NTM infections, diagnostic molecular assays (GeneXpert Ultra, Line Probe Assays), and South African National TB Guidelines.

25%

COPD, Asthma & Airway Diseases

GOLD and GINA guidelines, bronchiectasis, cystic fibrosis, alpha-1 antitrypsin deficiency, biological therapies in severe asthma, pulmonary rehabilitation, non-invasive ventilation in COPD.

20%

Interstitial Lung Diseases & Occupational Pulmonary Disease

Idiopathic Pulmonary Fibrosis (IPF), progressive pulmonary fibrosis, sarcoidosis, hypersensitivity pneumonitis, connective tissue disease-associated ILD, silicosis, asbestosis, and occupational lung disorders.

15%

Pulmonary Vascular Diseases & Pulmonary Hypertension

Pulmonary arterial hypertension (PAH) classification (Group 1-5), right heart catheterization, targeted vasodilator therapies, acute pulmonary embolism, chronic thromboembolic pulmonary hypertension (CTEPH).

15%

Lung Cancer, Interventional Pulmonology & Critical Care Pulmonology

Staging and management of non-small cell and small cell lung cancer, EBUS-TBNA, rigid and flexible bronchoscopy, pleural diseases, ARDS, mechanical ventilation, and respiratory failure.

How to Pass the Cert Pulmonology(SA) Phys 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 blueprint domains: Adult Pulmonary Tuberculosis & Mycobacterial Diseases (25%), COPD, Asthma & Airway Diseases (25%), Interstitial Lung Diseases & Occupational Pulmonary Disease (20%), Pulmonary Vascular Diseases & Pulmonary Hypertension (15%), and Lung Cancer, Interventional Pulmonology & Critical Care Pulmonology (15%).
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) Phys Study Tips from Top Performers

1Master the latest South African National TB Management Guidelines, including 6-month all-oral BPaL/BPaLM regimens for MDR/RR-TB.

2Review GINA 2025/2026 and GOLD 2025/2026 guidelines, focusing on biologic selection criteria (anti-IgE, anti-IL5/5R, anti-IL4R, anti-TSLP) and NIV in acute hypercapnic respiratory failure.

3Study HRCT patterns (UIP, NSIP, OP, HP) and clinical trials for antifibrotic therapies (nintedanib, pirfenidone) in progressive pulmonary fibrosis.

4Understand the 2022 ESC/ERS Pulmonary Hypertension guidelines criteria (mean PAP >20 mmHg, PVR >2 Wood units) and diagnostic pathways for CTEPH.

Frequently Asked Questions

What is the format of the CMSA Cert Pulmonology(SA) Phys 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.

Who is eligible to write the Cert Pulmonology(SA) Phys exam?

Specialist physicians who hold the FCP(SA) or equivalent registrable qualification in Internal Medicine and have completed or are completing 2 years of accredited subspecialty pulmonology training in South Africa.

What is the passing criteria for the examination?

Candidates must achieve an overall pass mark of 50%, with a 50% subminimum in each of the two components (the written component and the oral/OSCE/OSPE/clinical component).