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DNB Respiratory Medicine Previous Year Questions

These are the DNB Respiratory Medicine (Respiratory Medicine (Pulmonology)) theory questions asked by NBEMS in the December 2025 and June 2025 exams, listed paper by paper as they appeared. The Prep DNB app has all 23 DNB sessions from June 2014 to December 2025 plus 6 DipNB papers — 1,091 questions in total — with repeat-question tracking, examiner keywords and MCQs.

Jump to: December 2025 · June 2025 · Important topics · Older papers

DNB Respiratory Medicine December 2025 Question Paper

Paper 1

  1. a) Anatomy of mediastinum. [5] b) Cobbs angle. [5]
  2. a) Lymphatic drainage of lungs. [5] b) Pleural manometry. [5]
  3. a) Airway resistance. [5] b) Collateral ventilation. [5]
  4. a) Histologic classification of lung cancer. [5] b) Structure and causes of granuloma formation. [2+3]
  5. a) Stages of lung development. [5] b) Assessment of diaphragm dysfunction. [5]
  6. Describe structure, physiological functions and applied aspect of pulmonary surfactant in clinical conditions. [3+3+4]
  7. a) Classification of drugs for drug resistant tuberculosis under NTEP. [5] b) Antifungal drugs in respiratory disorders. [5]
  8. a) Steps of ZN staining for detecting acid-fast bacilli on smear microscopy. [5] b) Biochemical tests for diagnostic evaluation of pleural effusion. [5]
  9. a) Lung compliance. [5] b) Henderson-Hasselbalch equation. [5]
  10. a) Sampling methods in clinical research. [5] b) Ethical issues related to scientific publication. [5]

Paper 2

  1. a) Transudative pleural effusion. [5] b) Management options for symptomatic malignant pleural effusion. [5]
  2. a) Causes of diffuse alveolar haemorrhages. [5] b) Secondary pulmonary alveolar proteinosis. [5]
  3. a) Approach to a case with acute chest pain. [5] b) Approach to a case with non-resolving pneumonia. [5]
  4. a) Re-expansion pulmonary oedema. [5] b) Classification of COPD. [5]
  5. a) Respiratory bronchiolitis-ILD. [5] b) Pulmonary arterio-venous malformation. [5]
  6. a) Impulse oscillometry. [5] b) Stereotactic body radiotherapy (SBRT)'. [5]
  7. a) Lipoid pneumonia. [5] b) Radiation pneumonitis. [5]
  8. a) Complications of lung transplantation. [5] b) Postoperative pulmonary complications. [5]
  9. a) Acute silicosis. [5] b) End of life care. [5]
  10. Describe factors associated with poor asthma control and their management. [5+5]

Paper 3

  1. a) Approach to a patient developing severe cutaneous reaction after starting antitubercular therapy for drug sensitive pulmonary tuberculosis. [5] b) Management of pulmonary tuberculosis in patient having chronic kidney disease. [5]
  2. a) Tuberculids. [5] b) Diagnosis and management of Potts spine. [5]
  3. a) Management of TB in a treatment naive HIV positive case. [5] b) Role of pulmonary rehabilitation in post tuberculosis sequelae. [5]
  4. a) Broncho-pleural fistula. [5] b) Complications of bronchiectasis. [5]
  5. a) Contraindications to tuberculosis preventive therapy. [5] b) Pretreatment evaluation for starting treatment for drug resistant tuberculosis. [5]
  6. a) Approach to a case with pulmonary infiltrates with eosinophilia. [5] b) Management of EGPA. [5]
  7. a) Management strategies for refractory hypoxemia in ARDS. [5] b) Difficult airway. [5]
  8. a) Stages and functions of sleep. [5] b) Pathogenesis of obstructive sleep apnoea. [5]
  9. a) Loop gain. [5] b) Obesity related pulmonary disorders apart from OSA. [5]
  10. Scoring methods to quantify the severity of respiratory critical illness. Write briefly on critical illness neuropathy. [5+5]

Paper 4

  1. Describe various techniques of bronchoscopic lung volume reduction with their relative merits and demerits. [10]
  2. a) Oxygen toxicity. [5] b) Applications of exhaled breath nitric oxide in respiratory conditions. [5]
  3. Enlist the driver mutations responsible for tumour progression in non-small cell lung cancer. Mention limitation and toxicity of tyrosine kinase inhibitors in the management of non-small cell lung cancer. [4+3+3]
  4. a) Describe diagnosis and management of progressive pulmonary fibrosis. [3+2] b) Evaluation of a non-smoker, 40-year-old male patient with UIP pattern ILD. [5]
  5. a) Cystic fibrosis modulator therapies. [5] b) Elaborate associations between lung microbiome in healthy and disease states. [5]
  6. a) Indications, technique and complications of mediastinoscopy. [2+2+2] b) Comparison of various stents for management of airway obstruction. [4]
  7. a) Navigation bronchoscopy in the context of lung cancer screening. [5] b) Autofluorescence technique in diagnostic pulmonary procedures. [5]
  8. a) Echocardiographic findings in acute pulmonary thromboembolism. [5] b) Utility of ultrasound in non-pleural chest diseases. [5]
  9. a) Immune related adverse events secondary to immune checkpoint inhibitors. [5] b) HRCT patterns of CTD ILD. [5]
  10. a) Evidence and principles of extracorporeal carbon dioxide removal. [5] b) Newer pharmacological advances in the management of severe COPD. [5]

DNB Respiratory Medicine June 2025 Question Paper

Paper 1

  1. a) Bronchopulmonary segments of human lung. [5] b) Role of intercostal muscles. [5]
  2. a) Development of the airways and blood vessels. [5] b) Airway wall structure at the three principal levels. [5]
  3. a) Pneumocytes. [5] b) Alveolar macrophages. [5]
  4. a) Ultrastructure of a cilium with diagram. [5] b) Mucociliary escalator. [5]
  5. a) Bronchial mucus. [5] b) Standard deviation. [5]
  6. Describe the causes of Ventilation-Perfusion (VA/Q) mismatch and its effects. [10]
  7. a) Alveolar air equation. [5] b) Measurement of residual volume (RV)'. [5]
  8. a) Measurement of physiological shunt. [5] b) Causes of hypoxaemia. [5]
  9. a) Factors affecting diffusion of gases from alveolus to pulmonary circulation. [5] b) Diffusing capacity for carbon monoxide (DLCO). [5]
  10. a) Cross-sectional study. [5] b) Case-control study. [5]

Paper 2

  1. a) Respiratory causes of breathlessness. [5] b) Clubbing and hypertrophic osteoarthropathy. [5]
  2. a) Pulmonary and extra pulmonary manifestations of cystic interstitial lung diseases. [5] b) High resolution CT (HRCT) chest findings in cystic interstitial lung diseases. [5]
  3. a) Solitary lung lesion. [5] b) Non-surgical treatments of mycetoma lung. [5]
  4. a) Systemic manifestations of COPD. [5] b) Clinical significance of hyperinflation in COPD. [5]
  5. a) Pneumococcal vaccination. [5] b) Treatment of high altitude pulmonary edema. [5]
  6. a) Approach to the initial treatment of pulmonary sarcoidosis in adults. [5] b) Antifibrotics in treatment of IPF. [5]
  7. a) Causes of unilateral elevation of the hemidiaphragm. [5] b) Complications of hemothorax. [5]
  8. a) Algorithm for the initiation of pharmacological management of COPD. [5] b) Adverse effects of inhaled corticosteroids in COPD. [5]
  9. a) Hypersensitivity pneumonitis. [5] b) Why inhaled corticosteroids are recommended to be commenced from the time of diagnosis of bronchial asthma? [5]
  10. a) Differential diagnosis of lung abscess. [5] b) Empiric antibiotic selection in adults outpatient of community-acquired pneumonia. [5]

Paper 3

  1. a) Diagnosis of adult pleural tuberculosis. [5] b) Integrated diagnostic and treatment algorithm for drug resistant tuberculosis. [5]
  2. a) Differential diagnosis of lymphadenopathy. [5] b) Paradoxical reaction. [5]
  3. a) Criteria of diagnosis of NTM lung disease. [5] b) Treatment of pulmonary NTM disease. [5]
  4. a) Eligible population and strategy for tuberculosis preventive therapy (TPT)'. [5] b) Expanded population and strategy for tuberculosis preventive therapy (TPT). [5]
  5. a) Ni-Kshay Poshan Yojana (NPY). [5] b) Ni-Kshay Mitra. [5]
  6. a) Evaluation and management of the nonventilated, hospitalized adult patient with acute hypoxemia. [5] b) Noninvasive ventilation in adults with acute respiratory failure: Benefits and contraindications. [5]
  7. a) Acute exacerbation of idiopathic pulmonary fibrosis (AEIPF)'. [5] b) Differential diagnosis of acute Respiratory Distress Syndrome. [5]
  8. a) Clinical manifestations of Obstructive Sleep Apnea (OSA) and its differential diagnosis. [5] b) Diagnostic criteria for Obstructive Sleep Apnea (OSA). [5]
  9. a) Obesity hypo-ventilation syndrome. [5] b) Risk factors for Obstructive Sleep Apnea. [5]
  10. a) Treatment of OSA. [5] b) Central sleep apnea syndrome. [5]

Paper 4

  1. a) Relative contraindications and complications of pleural aspiration. [5] b) Indications of intercostal drain insertion and drain size. [5]
  2. a) Management of surgical (subcutaneous) emphysema following chest drain insertion. [5] b) Assessment of a non-functioning chest drain. [5]
  3. a) Cy-Tb skin test. [5] b) Loop-mediated isothermal amplification (TB-LAMP)'. [5]
  4. a) Ultrasonography in pleural effusion. [5] b) Ultrasonography in pneumothorax. [5]
  5. a) Characteristic patterns of disordered respiratory function. [5] b) Upper airways obstruction. [5]
  6. a) Next Generation Sequencing (NGS) technologies in tuberculosis. [5] b) BPaL/BPaLM regimen. [5]
  7. a) Classify primary acid-base disorders and describe their secondary responses. [5] b) Steps to identify the primary acid-base disorder. [5]
  8. a) Laboratory diagnosis of pneumocystis pneumonia. [5] b) The anion gap. [5]
  9. a) PRISm (preserved ratio but impaired spirometry)'. [5] b) Combined pulmonary fibrosis and emphysema. [5]
  10. a) Leveraging lung cancer imaging for COPD screening. [5] b) Significance of blood eosinophil in COPD management. [5]

High-Yield DNB Respiratory Medicine Topics

A selection of 30 of the 45 important topics curated in the app from repeated DNB Respiratory Medicine questions.

Pulmonary physiology and testing — foundation

  • Ventilation-perfusion matching, dead space, shunt; compliance and resistance
  • Flow-volume loops and spirometry interpretation (obstructive vs restrictive vs mixed)
  • DLCO: measurement, factors affecting, clinical significance

Obstructive airway disease — highest yield

  • COPD: GOLD classification, assessment (mMRC, CAT), pharmacotherapy (LAMA/LABA/ICS), eosinophil-guided therapy
  • COPD exacerbation: assessment, bronchodilators, steroids, antibiotics, NIV indications
  • COPD complications: cor pulmonale, pulmonary hypertension, osteoporosis, PRISm phenotype

Interstitial lung disease

  • ILD classification (ATS/ERS); HRCT patterns (UIP, NSIP, OP, HP)
  • IPF: UIP pattern on HRCT, antifibrotics (pirfenidone, nintedanib), AE-IPF
  • Sarcoidosis: Scadding stages, extrapulmonary features, treatment (steroids, methotrexate)

Tuberculosis — very high yield in India

  • Pulmonary TB: diagnosis (smear, GeneXpert, culture, LPA), NTEP/Nikshay
  • MDR/XDR-TB: definitions, BPaL/BPaLM regimen, bedaquiline, delamanid, shorter MDR regimens
  • Extrapulmonary TB: pleural, miliary, TB meningitis, lymph node, skeletal, abdominal

Pulmonary infections and immunocompromised host

  • Community-acquired pneumonia: CURB-65/PSI, pathogens, empirical antibiotics
  • HAP/VAP: risk factors, prevention bundle, diagnosis and treatment
  • Fungal infections: invasive aspergillosis, PCP, mucormycosis (COVID-associated)

Pleural disease

  • Pleural effusion: Light's criteria, transudate vs exudate, causes, thoracentesis
  • Empyema: staging (A-D), management (antibiotics, drainage, intrapleural fibrinolytics)
  • Pneumothorax: primary/spontaneous, tension PTX, management (needle, chest drain, VATS)

Pulmonary vascular disease

  • Pulmonary embolism: Wells score, CTPA, risk stratification, anticoagulation, thrombolysis
  • Pulmonary hypertension: WHO groups, clinical features, right heart catheterization, specific therapy
  • Cor pulmonale: pathophysiology and management

Lung cancer and occupational/environmental

  • Lung cancer: TNM 8th edition, SCLC vs NSCLC, staging workup, treatment by stage
  • Solitary pulmonary nodule: evaluation algorithm (Brock model, PET)
  • Occupational lung disease: silicosis, asbestosis, COPD; ILD from drugs (amiodarone, nitrofurantoin)

Critical care respiratory medicine

  • ARDS: Berlin definition, lung-protective ventilation, proning, ECMO indications
  • Mechanical ventilation: modes (ACV, SIMV, PSV, APRV), weaning, auto-PEEP
  • NIV: BiPAP in COPD and ACPE; HFNC indications

Miscellaneous

  • Bronchiectasis: aetiology, HRCT, management (airway clearance, antibiotics)
  • Cystic fibrosis (if applicable); alpha-1 antitrypsin deficiency
  • Interventional pulmonology: rigid bronchoscopy, airway stenting, thoracoscopy (VATS)

Older DNB Respiratory Medicine Question Papers & DipNB Papers

The remaining 27 papers are available in the Prep DNB app, organized paper-wise with repeat-question tracking.

Get all 29 papers in the app

Previous Year Questions for Other DNB Subjects