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Key Facts: Título de Especialista em Alergia e Imunologia Exam

Set by edital

ASBAI publishes the paper structure, cut score and fee in a numbered edital for each edition; no standing figures are published

Edital ASBAI — Prova de Título de Especialista em Alergia e Imunologia

60% Passing Score

Minimum Required Score in Both Phases

Regulamento Oficial ASBAI / AMB

2 Phases

Prova Teórica + Prova Teórico-Prática

Associação Brasileira de Alergia e Imunologia

RQE Registro

Specialist Qualification Registry (CRM / CFM)

Conselho Federal de Medicina

ASBAI / AMB

Examining Body & Specialty Society

https://asbai.org.br

IUIS & GINA

Underlying Clinical & Immunological Guidelines

International Union of Immunological Societies / GINA

The Título de Especialista em Alergia e Imunologia is Brazil's official medical board certification examination administered annually by ASBAI and AMB, conferring the specialist credential required for CRM/CFM RQE registration. The examination consists of theoretical and practical phases evaluating basic immunology, respiratory allergies, food and drug hypersensitivity, anaphylaxis, hereditary angioedema, inborn errors of immunity, and biologics. This question bank provides an English-language study adaptation comprising 100 comprehensive clinical MCQs.

Sample Título de Especialista em Alergia e Imunologia Practice Questions

Try these sample questions to test your Título de Especialista em Alergia e Imunologia 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 classical Gell and Coombs classification of hypersensitivity reactions, which mechanism defines a Type I (immediate) hypersensitivity response?

A.Cross-linking of allergen-specific IgE bound to high-affinity FcεRI receptors on mast cells and basophils, triggering immediate degranulation and mediator release.

B.Complement-mediated lysis and antibody-dependent cellular cytotoxicity (ADCC) directed by IgG or IgM against cell-surface antigens.

C.Deposition of soluble circulating antigen-antibody immune complexes in vascular beds, activating complement and recruiting neutrophils.

D.Sensitized CD4+ and CD8+ T-cell activation and cytokine release mediating delayed-type tissue damage 48 to 72 hours after antigen exposure.

Explanation: Type I (immediate) hypersensitivity is mediated by specific IgE antibodies bound to high-affinity FcεRI receptors on mast cells and basophils. Upon allergen re-exposure, bivalent or multivalent allergens cross-link adjacent IgE molecules, triggering rapid intracellular signaling, calcium influx, and immediate release of preformed mediators (e.g., histamine, tryptase) followed by de novo synthesis of lipid mediators (e.g., leukotrienes, prostaglandin D2).

2Which key cytokine produced by T follicular helper (Tfh) and Th2 cells provides the essential primary signal for immunoglobulin class switch recombination to IgE in human B lymphocytes?

A.Interferon-gamma (IFN-γ)

B.Interleukin-4 (IL-4)

C.Interleukin-10 (IL-10)

D.Interleukin-12 (IL-12)

Explanation: Interleukin-4 (IL-4), along with Interleukin-13 (IL-13), engages the IL-4 receptor alpha (IL-4Rα) chain on B cells, activating the STAT6 transcription factor. In the presence of co-stimulatory CD40-CD40L engagement, this signaling pathway induces activation-induced cytidine deaminase (AID) and directs heavy-chain immunoglobulin class switch recombination to IgE.

3Which trio of epithelial-derived cytokines, collectively known as 'alarmins', is released by damaged mucosal barrier cells to initiate and amplify innate Type 2 allergic inflammation?

A.IL-1β, IL-6, and TNF-α

B.TSLP (Thymic Stromal Lymphopoietin), IL-33, and IL-25

C.IFN-α, IFN-β, and IL-12

D.TGF-β, IL-10, and IL-35

Explanation: Thymic Stromal Lymphopoietin (TSLP), IL-33 (an IL-1 family member released upon cellular necrosis/stress), and IL-25 (IL-17E) are the classical epithelial alarmins. Upon mucosal injury by allergens, viruses, or pollutants, they act on dendritic cells and group 2 innate lymphoid cells (ILC2s) to stimulate robust downstream production of IL-5, IL-13, and IL-4, driving T2-high eosinophilic inflammation.

4Which of the following mast cell mediators is preformed, stored in secretory granules, and serves as the most specific serum biomarker for mast cell activation during systemic anaphylaxis?

A.Leukotriene C4 (LTC4)

B.Prostaglandin D2 (PGD2)

C.Beta-tryptase (Mature Tryptase)

D.Platelet-Activating Factor (PAF)

Explanation: Tryptase is a neutral serine protease stored in the secretory granules of human mast cells in its mature active form. Unlike lipid mediators (LTC4, PGD2, PAF) that require de novo enzymatic synthesis following activation, mature beta-tryptase is preformed and exocytosed immediately upon degranulation, making total/mature serum tryptase the gold-standard biomarker for confirming systemic mast cell activation.

5In the complement cascade, which multi-protein assembly forms the Membrane Attack Complex (MAC) responsible for targeted osmotic cell lysis?

A.C4b2a

B.C3bBb

C.C5b-C6-C7-C8-poly-C9

D.C1q-C1r-C1s

Explanation: Cleavage of C5 by C5 convertase yields C5b, which sequentially binds complement factors C6, C7, and C8. This C5b-8 complex anchors into the lipid bilayer and induces polymerization of 10 to 16 molecules of C9, forming the transmembrane pore known as the Membrane Attack Complex (MAC / C5b-9) that causes osmotic cell lysis.

6Under the modified Gell and Coombs classification for Type IV (delayed-type) hypersensitivity, which subtype is characterized by Th2 cytokine production (IL-4, IL-5, IL-13) and tissue eosinophilia, as observed in maculopapular drug exanthems with eosinophilia?

A.Type IVa (monocyte/macrophage activation via IFN-γ)

B.Type IVb (eosinophil recruitment via IL-5 and Th2 cytokines)

C.Type IVc (cytotoxic CD8+ T-cell tissue destruction via perforin/granzyme B)

D.Type IVd (neutrophil recruitment via CXCL8 and IL-17)

Explanation: Type IVb hypersensitivity is mediated by antigen-specific Th2 cells secreting IL-4, IL-13, and especially IL-5, which recruits and activates eosinophils. This pathway underlies maculopapular drug eruptions with eosinophilia, chronic eosinophilic airway inflammation, and certain forms of DRESS syndrome.

7Which surface receptor complex is universally expressed on mature, antigen-inexperienced naïve B lymphocytes prior to class switch recombination?

A.Monomeric IgA and secretory component

B.Cell-surface monomeric IgM and IgD

C.Dimeric IgG1 and IgG4

D.Membrane-bound IgE

Explanation: Mature naïve B cells that exit the bone marrow and populate secondary lymphoid organs co-express both membrane-bound monomeric IgM (mIgM) and IgD (mIgD) through alternative RNA splicing of the primary heavy-chain transcript (VDJ-Cμ-Cδ). They retain this dual expression until antigen stimulation and T-cell help trigger class switch recombination.

8Which master transcription factor is indispensable for the differentiation and regulatory suppressive function of CD4+CD25+ regulatory T cells (Tregs)?

A.T-bet (T-box expressed in T cells)

B.GATA-3 (GATA binding protein 3)

C.RORγt (Retinoic acid receptor-related orphan receptor gamma t)

D.FOXP3 (Forkhead box P3)

Explanation: FOXP3 (Forkhead box P3) is the lineage-defining master transcription factor for regulatory T cells (Tregs). Mutations in the FOXP3 gene result in loss of functional Tregs and cause the severe autoimmune/allergic polyendocrinopathy syndrome known as IPEX (Immunodysregulation Polyendocrinopathy Enteropathy X-linked).

9Which high-affinity receptor subunit on human mast cells and basophils contains the Immunoreceptor Tyrosine-based Activation Motifs (ITAMs) responsible for initiating intracellular phosphorylation cascades upon IgE cross-linking?

A.Alpha (α) chain

B.Beta (β) chain and Gamma (γ) chain homodimer

C.CD3 zeta (ζ) chain

D.CD19 coreceptor chain

Explanation: The high-affinity IgE receptor (FcεRI) is a tetrameric complex (αβγ2) on mast cells and basophils. The extracellular α chain binds the Fc region of IgE with high affinity, whereas the transmembrane β chain and intracellular γ-chain homodimer contain ITAMs that become phosphorylated by Lyn kinase, recruiting Syk kinase to initiate degranulation and arachidonic acid metabolism.

10Human Leukocyte Antigen (HLA) Class I molecules present endogenous peptide antigens to which subset of T lymphocytes?

A.CD4+ T helper cells

B.CD8+ Cytotoxic T cells

C.CD4+CD25+ Regulatory T cells

D.Group 2 Innate Lymphoid Cells (ILC2s)

Explanation: HLA Class I molecules (HLA-A, HLA-B, HLA-C) are expressed on all nucleated cells and present endogenous, proteasome-derived peptide antigens (8–10 amino acids in length) to CD8+ cytotoxic T lymphocytes. CD8 acts as a co-receptor by binding the non-polymorphic α3 domain of the HLA Class I heavy chain.

About the Título de Especialista em Alergia e Imunologia Exam

The Título de Especialista em Alergia e Imunologia (TEAI) is the official medical board certification examination in Allergy and Clinical Immunology in Brazil, jointly administered by the Associação Brasileira de Alergia e Imunologia (ASBAI) and the Associação Médica Brasileira (AMB) under the regulatory framework of the Conselho Federal de Medicina (CFM). This rigorous annual examination grants qualifying physicians the official specialist credential required to register their Registro de Qualificação de Especialista (RQE) in Allergy and Immunology with Regional Medical Councils (CRMs). The examination is structured in two progressive phases: Phase 1 (Prova Teórica) consists of objective multiple-choice questions assessing foundational immunology, cytokine networks, hypersensitivity mechanisms, cellular pathophysiology, and clinical allergology; Phase 2 (Prova Teórico-Prática) assesses clinical vignettes, laboratory interpretation (total/specific IgE, component-resolved diagnostics / CRD, flow cytometry, complement titers), functional testing (spirometry, skin prick tests, patch tests, controlled challenge protocols), and advanced therapeutic planning (subcutaneous and sublingual allergen immunotherapy, desensitization protocols, and biologics including omalizumab, mepolizumab, benralizumab, dupilumab, and tezepelumab). This question bank provides an English-language MCQ study adaptation designed for comprehensive preparation across all core competencies and specialized clinical scenarios tested in the ASBAI/AMB examination.

Assessment

Examination run by the Associação Brasileira de Alergia e Imunologia (ASBAI) with the AMB under an annual edital. In the 2026 cycle the prova teórico-prática was sat on 16/08/2026 at the CESIR centre. ASBAI additionally awards points towards the título for completion of its EaD module programme, which candidates should factor into their preparation.

Time Limit

Set by each annual edital

Passing Score

Set by each edition's edital

Exam Fee

Set annually by the society's edital and varies with society/AMB membership status; consult the current edital before budgeting (Associação Brasileira de Alergia e Imunologia (ASBAI) — Associação Médica Brasileira (AMB))

Título de Especialista em Alergia e Imunologia Exam Content Outline

15%

Imunologia Básica, Mecanismos Celulares e Hipersensibilidade

Encompasses fundamental innate and adaptive immune mechanisms, toll-like receptors (TLRs), NOD-like receptors (NLRs), Th1/Th2/Th17/Treg/Tfh cellular differentiation and signature cytokines (IL-4, IL-5, IL-13, IFN-γ, IL-17, IL-10, TGF-β), B-cell maturation, activation-induced cytidine deaminase (AID), CD40/CD40L interactions, mast cell and basophil activation via FcεRI, preformed and newly synthesized mediator kinetics (histamine, tryptase, leukotrienes C4/D4/E4, PGD2), the complement cascade and regulatory proteins (C1-INH, CD55, CD59, Factor H), HLA genetics and antigen presentation, and Gell & Coombs hypersensitivity classifications (Types I, II, III, IVa-d).

15%

Asma, Rinite Alérgica e Doenças das Vias Aéreas Superiores e Inferiores

Covers clinical diagnosis, staging, and therapeutic management of upper and lower airway allergic diseases according to ARIA, GINA, SBPT, and ASBAI consensus guidelines. Topics include intermittent and persistent allergic rhinitis, non-allergic rhinitis phenotypes (vasomotor, NARES, drug-induced), chronic rhinosinusitis with and without nasal polyposis (CRSwNP / CRSsNP), Aspirin-Exacerbated Respiratory Disease (AERD / Samter's triad), pulmonary function testing (spirometry, post-bronchodilator reversibility criteria of >12% and >200 mL, methacholine challenge PC20), fractional exhaled nitric oxide (FeNO), asthma endotyping (T2-high eosinophilic/allergic vs T2-low neutrophilic/paucigranulocytic), and Step 5 severe asthma biologic selection.

15%

Alergia Alimentar, Reações Adversas a Drogas e Hipersensibilidade Ocupacional

Analyzes IgE-mediated food allergies (cow's milk protein allergy Bos d 4/5/8, egg Gal d 1/2, peanut Ara h 1/2/3/8/9, tree nuts, fish parvalbumin, shellfish tropomyosin), non-IgE-mediated gastrointestinal food allergies (Food Protein-Induced Enterocolitis Syndrome / FPIES, Food Protein-Induced Allergic Proctocolitis / FPIP, Eosinophilic Esophagitis / EoE), food-dependent exercise-induced anaphylaxis (FDEIA / Tri a 19), immediate and delayed drug hypersensitivity reactions, beta-lactam allergy testing and cross-reactivity, NSAID hypersensitivity phenotypes (NERD, NECD, NIUA, SNIUAA, SNIDR), Severe Cutaneous Adverse Reactions (SJS/TEN, DRESS, AGEP), radiocontrast media reactions, and drug desensitization protocols.

15%

Anafilaxia, Angioedema Hereditário e Adquirido e Hipersensibilidade a Venenos

Focuses on acute resuscitation protocols and diagnostic criteria for anaphylaxis (WAO 2020 guidelines, immediate intramuscular epinephrine in the anterolateral thigh, fluid management, refractory anaphylaxis protocols, serum tryptase kinetics), Hymenoptera venom allergy (honeybee Apis mellifera, yellow jacket Vespula, paper wasp Polistes, fire ant Solenopsis invicta), venom skin testing and venom immunotherapy (VIT), differential diagnosis of angioedema (histaminergic vs bradykininergic), Hereditary Angioedema (HAE Types I and II, HAE with normal C1-INH / FXII/PLG mutations), Acquired Angioedema (AAE with B-cell disorders / low C1q), ACE-inhibitor-induced angioedema, and targeted on-demand/prophylactic therapies (icatibant, pdC1-INH, lanadelumab, berotralstat).

15%

Dermatite Atópica, Urticária e Dermatoses Alérgicas

Explores atopic dermatitis pathophysiology (skin barrier disruption, filaggrin FLG mutations, Th2/Th22 skewing, TSLP, IL-4/IL-13, IL-31 pruritus signaling, Staphylococcus aureus colonization and enterotoxin superantigens), diagnostic criteria (Hanifin & Rajka), severity indices (SCORAD, EASI), topical calcineurin inhibitors, crisaborole, phototherapy, systemic targeted biologics (dupilumab, tralokinumab) and JAK inhibitors (upadacitinib, abrocitinib), infectious complications (eczema herpeticum), Chronic Spontaneous Urticaria (CSU) pathogenesis (Type I auto-allergic vs Type IIb autoimmune with anti-FcεRIα/anti-IgE autoantibodies), Chronic Inducible Urticaria (CIndU), and EAACI/GA2LEN/ASBAI step-wise second-generation antihistamine up-dosing, omalizumab, and cyclosporine A algorithms.

15%

Erros Inatos da Imunidade (Imunodeficiências Primárias) e Desregulação Imunológica

Assesses primary immunodeficiencies according to the International Union of Immunological Societies (IUIS) classification. Key topics include Severe Combined Immunodeficiency (SCID: X-linked IL2RG, ADA, RAG1/RAG2, Artemis) and neonatal TREC screening; Combined Immunodeficiencies with syndromic features (Wiskott-Aldrich syndrome, Ataxia-Telangiectasia, 22q11.2 DiGeorge syndrome, Hyper-IgE / Job syndrome STAT3 vs DOCK8); Predominantly Antibody Deficiencies (X-linked agammaglobulinemia / Bruton BTK, Common Variable Immunodeficiency / CVID, Selective IgA Deficiency, Hyper-IgM syndromes); Phagocyte Defects (Chronic Granulomatous Disease / CGD with DHR-123 assay, Leukocyte Adhesion Deficiency LAD-1 / CD18, Chédiak-Higashi syndrome); and Immune Dysregulation Syndromes (IPEX / FOXP3, ALPS / FAS, Hemophagocytic Lymphohistiocytosis / HLH).

10%

Métodos Diagnósticos em Alergia, Imunoterapia Alérgeno-Específica e Imunobiológicos

Evaluates in vivo testing modalities (skin prick tests, intradermal tests, patch tests, double-blind placebo-controlled food challenges), in vitro diagnostics (specific IgE, Component-Resolved Diagnostics / CRD microarray, basophil activation tests / BAT), Allergen Immunotherapy (SCIT and SLIT cellular and molecular mechanisms, Treg induction, IL-10, IgG4 blocking antibodies, indications, contraindications, and systemic reaction management), and targeted biologic therapies (Omalizumab, Mepolizumab, Reslizumab, Benralizumab, Dupilumab, Tezepelumab, Tralokinumab) regarding mechanism of action, receptor targets, eligibility criteria, and clinical monitoring.

How to Pass the Título de Especialista em Alergia e Imunologia Exam

What You Need to Know

Passing score: Set by each edition's edital
Assessment: Examination run by the Associação Brasileira de Alergia e Imunologia (ASBAI) with the AMB under an annual edital. In the 2026 cycle the prova teórico-prática was sat on 16/08/2026 at the CESIR centre. ASBAI additionally awards points towards the título for completion of its EaD module programme, which candidates should factor into their preparation.
Time limit: Set by each annual edital
Exam fee: Set annually by the society's edital and varies with society/AMB membership status; consult the current edital before budgeting

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

Título de Especialista em Alergia e Imunologia Study Tips from Top Performers

1Master Basic Immunology & Cellular Signaling: Ensure thorough familiarity with Th2 cytokine cascades (IL-4, IL-5, IL-13), epithelial alarmins (TSLP, IL-33, IL-25), FcεRI cross-linking biochemistry, and the complement regulatory cascade (C1-INH, factor H, CD55, CD59).

2Memorize Component-Resolved Diagnostics (CRD) Patterns: Differentiate genuine sensitization from cross-reactivity in foods (e.g., Ara h 2 vs Ara h 8, Cor a 1 vs Cor a 9/14) and aeroallergens (Der p 1/2 vs Der p 10 tropomyosin; Phl p 1/5 vs profilins).

3Learn Anaphylaxis & Angioedema Diagnostic Criteria: Memorize the WAO 2020 anaphylaxis criteria, correct intramuscular epinephrine dosing (0.01 mg/kg, max 0.5 mg in adults), baseline vs acute tryptase formulas, and C1-INH / C4 / C1q patterns across HAE Types I, II, and AAE.

4Understand Inborn Errors of Immunity (IEI) Diagnostic Pathways: Focus on SCID flow cytometry phenotypes (T-B+NK-, T-B-NK-, T-B+NK+), TREC analysis, DHR-123 for CGD, CD18 for LAD-1, BTK for XLA, and characteristic syndromic features in WAS, A-T, and Hyper-IgE.

5Master Severe Asthma & Atopic Dermatitis Biologics: Know exact molecular targets, FDA/ANVISA indications, biomarker cutoffs (eosinophils, IgE, FeNO), and dosing schedules for Omalizumab, Mepolizumab, Benralizumab, Dupilumab, and Tezepelumab.

Frequently Asked Questions

What is the Título de Especialista em Alergia e Imunologia (TEAI)?

It is the official board certification examination in Allergy and Clinical Immunology in Brazil, administered annually by the Associação Brasileira de Alergia e Imunologia (ASBAI) in partnership with the Associação Médica Brasileira (AMB) and recognized by the Conselho Federal de Medicina (CFM). Passing this exam confers the specialist title necessary to obtain the Registro de Qualificação de Especialista (RQE) from regional CRMs.

What is the format and structure of the ASBAI/AMB examination?

The examination consists of two main phases: Phase 1 (Prova Teórica), an objective multiple-choice examination evaluating theoretical immunology, hypersensitivity mechanisms, clinical allergic disorders, and diagnostic algorithms; and Phase 2 (Prova Teórico-Prática), featuring clinical vignettes, laboratory and diagnostic test interpretation (e.g., skin tests, CRD, complement assays, spirometry), and therapeutic case management (e.g., allergen immunotherapy, biologics).

What score is required to pass the examination?

Candidates must achieve a minimum passing score of 60% in both the theoretical (Prova Teórica) and practical (Prova Teórico-Prática) phases, along with meeting the curricular evaluation requirements established in the official annual Edital.

What are the prerequisites to sit for the ASBAI specialist examination?

Candidates must hold an active medical license (CRM) in Brazil and provide documented proof of completing a MEC/CNRM-accredited Medical Residency in Allergy and Immunology or fulfill the alternative training requirement of documented continuous clinical practice and professional activity in Allergy and Immunology for at least 6 years (double the residency duration), as specified in the official Edital.

What is the legal importance of the RQE in Brazil?

The Registro de Qualificação de Especialista (RQE) is the only legal credential that permits a physician in Brazil to publicly advertise and identify themselves as a specialist (Alergista e Imunologista) in compliance with CFM Resolution nº 1.974/2011 and Brazilian medical advertising legislation (Resolução CFM nº 2.336/2023).

Is this question bank an official ASBAI or AMB publication?

No. This question bank is an independent English-language MCQ study adaptation developed to help allergists, immunologists, residents, and candidates master the theoretical foundations, clinical guidelines, and diagnostic nuances required for the ASBAI/AMB Specialist Title Examination.