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100+ Free FRCPath Immunology Practice Questions

Pass your FRCPath Part 1 Immunology / Allergy and Clinical Immunology Certificate Examination and Part 2 Immunology exam on the first try — instant access, no signup required.

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Fever, urticarial rash, hearing loss and an NLRP3 variant suggest what?

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2026 Statistics

Key Facts: FRCPath Immunology Exam

2

Part 1 written papers

RCPath Immunology examination page

3 hours

Length of each Part 1 written paper

RCPath Immunology examination page

6

Part 2 practical stations

RCPath Immunology sample station materials

GBP 749

2026 ACICE and Part 1 fee

RCPath fees for examinations 2026

RCPath states that the 2021 Immunology curricula created two pathways: Allergy and Clinical Immunology (ACI) and Allergy, Clinical and Laboratory Immunology (ACLI). ACI candidates take the Allergy and Clinical Immunology Certificate Examination (ACICE) and do not take Part 2, while ACLI candidates take Part 1 Immunology and progress to Part 2 Immunology. Part 1 comprises two 3-hour short-answer written papers reflecting the Allergy and Immunology curriculum. Part 2 includes a practical examination with six 1-hour stations such as autoimmunity, quality, immunochemistry, data analysis, flow cytometry and clinical vignettes, plus a 60-minute oral examination. The 2026 RCPath fee schedule lists ACICE and Part 1 Immunology at GBP 749, Part 2 Practical at GBP 827 and Part 2 Oral at GBP 749.

Sample FRCPath Immunology Practice Questions

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

1Acute tryptase is 24 micrograms/L after hypotension, with baseline 8 micrograms/L. What does this support?
A.Mast-cell mediated anaphylaxis
B.Non-specific lipid transfer protein allergy
C.Omega-5 gliadin wheat-dependent exercise-induced anaphylaxis
D.Perioperative anaphylaxis work-up with acute and baseline tryptase plus specialist testing
Explanation: The rise exceeds the baseline x1.2 + 2 rule, supporting mast-cell activation during anaphylaxis.
2Delayed urticaria and hypotension occur four hours after eating red meat. Which allergy is most likely?
A.Omega-5 gliadin wheat-dependent exercise-induced anaphylaxis
B.Alpha-gal allergy
C.Perioperative anaphylaxis work-up with acute and baseline tryptase plus specialist testing
D.Chronic spontaneous urticaria
Explanation: Alpha-gal reactions are classically delayed after mammalian meat ingestion.
3Oral itching to raw apple with cooked apple tolerated and birch pollen rhinitis suggests what?
A.Perioperative anaphylaxis work-up with acute and baseline tryptase plus specialist testing
B.Chronic spontaneous urticaria
C.PR-10 pollen-food syndrome
D.NSAID-exacerbated respiratory disease
Explanation: Birch-related PR-10 proteins are heat labile and usually cause local oral symptoms.
4Systemic reactions to peach and tomato, including cooked forms, most strongly suggest what?
A.Chronic spontaneous urticaria
B.NSAID-exacerbated respiratory disease
C.Venom immunotherapy
D.Non-specific lipid transfer protein allergy
Explanation: LTPs are heat-stable and can cause systemic reactions to plant foods.
5Anaphylaxis occurs only when wheat ingestion is followed by exercise. What is the likely mechanism?
A.Omega-5 gliadin wheat-dependent exercise-induced anaphylaxis
B.NSAID-exacerbated respiratory disease
C.Venom immunotherapy
D.Risk-stratified delabelling and supervised challenge when appropriate
Explanation: Omega-5 gliadin allergy can require exercise or other cofactors to trigger anaphylaxis.
6Hypotension occurs during anaesthesia and resolves. What follow-up is most appropriate?
A.Venom immunotherapy
B.Perioperative anaphylaxis work-up with acute and baseline tryptase plus specialist testing
C.Risk-stratified delabelling and supervised challenge when appropriate
D.Mast-cell mediated anaphylaxis
Explanation: Perioperative anaphylaxis requires tryptase interpretation and later specialist evaluation of likely triggers.
7Daily wheals continue for ten weeks without a consistent external trigger. What diagnosis best fits?
A.Risk-stratified delabelling and supervised challenge when appropriate
B.Mast-cell mediated anaphylaxis
C.Chronic spontaneous urticaria
D.Alpha-gal allergy
Explanation: Urticaria lasting more than six weeks without a reproducible trigger is chronic spontaneous urticaria.
8Asthma, nasal polyps and bronchospasm after ibuprofen suggest what?
A.Mast-cell mediated anaphylaxis
B.Alpha-gal allergy
C.PR-10 pollen-food syndrome
D.NSAID-exacerbated respiratory disease
Explanation: COX-1 NSAID intolerance can worsen asthma and nasal polyposis.
9A patient has systemic reactions to wasp stings and positive venom-specific IgE. What disease-modifying treatment is indicated?
A.Venom immunotherapy
B.Alpha-gal allergy
C.PR-10 pollen-food syndrome
D.Non-specific lipid transfer protein allergy
Explanation: Venom immunotherapy substantially reduces future systemic sting reaction risk.
10A remote childhood penicillin rash without severe features is reported. What is the best immunology approach?
A.PR-10 pollen-food syndrome
B.Risk-stratified delabelling and supervised challenge when appropriate
C.Non-specific lipid transfer protein allergy
D.Omega-5 gliadin wheat-dependent exercise-induced anaphylaxis
Explanation: Low-risk penicillin labels should be assessed because unnecessary avoidance causes harm.

About the FRCPath Immunology Exam

FRCPath Immunology is the RCPath specialty examination pathway for Allergy and Clinical Immunology and Allergy, Clinical and Laboratory Immunology training routes. It assesses allergy, clinical immunology, immunodeficiency, autoimmunity, complement, immunochemistry, flow cytometry, laboratory quality, service development and clinical liaison.

Assessment

The 2021 curricula created ACI and ACLI routes. ACI candidates take ACICE and do not take Part 2; ACLI candidates take Part 1 Immunology and proceed to Part 2 Immunology. Part 2 has practical station and oral components.

Time Limit

Part 1: two 3-hour written papers. Part 2 practical: six 1-hour stations. Part 2 oral: 60 minutes split into two 30-minute examiner-pair sections.

Passing Score

Marked under RCPath Immunology specialty regulations and examiner marking schemes; candidates must meet the standard for the relevant Part 1, ACICE, practical and oral components.

Exam Fee

2026 RCPath fees: ACICE GBP 749; Immunology Part 1 GBP 749; Part 2 Practical GBP 827; Part 2 Oral GBP 749. (Royal College of Pathologists)

FRCPath Immunology Exam Content Outline

Core clinical coverage

Allergy and Anaphylaxis

Tryptase interpretation, food allergy components, perioperative anaphylaxis, venom allergy, urticaria, NSAID-exacerbated disease and biologics.

Core clinical and laboratory coverage

Primary and Secondary Immunodeficiency

CVID, XLA, SCID, CGD, hyper-IgM, complement deficiency, secondary antibody deficiency, vaccine responses and infection prevention.

Core laboratory coverage

Autoimmunity and Complement

ANA, ENA, ANCA, anti-GBM, myositis and liver antibodies, HAE, acquired C1-INH deficiency, aHUS, CAPS, FMF and HLH.

Part 2 practical emphasis

Immunochemistry and Cellular Immunology

SPEP, immunofixation, cryoglobulins, tryptase, lymphocyte subsets, DHR, memory B cells, TREC screening and PID genomics.

Part 2 quality emphasis

Laboratory Quality, Statistics and Governance

QC, EQA, Westgard rules, assay interference, method comparison, verification, demand management, critical communication and CAPA.

Part 2 oral/practical emphasis

Clinical Liaison and Integrated Scenarios

Test selection, interpretive reporting, multidisciplinary advice, practical station reasoning, casebook evidence and service development.

How to Pass the FRCPath Immunology Exam

What You Need to Know

  • Passing score: Marked under RCPath Immunology specialty regulations and examiner marking schemes; candidates must meet the standard for the relevant Part 1, ACICE, practical and oral components.
  • Assessment: The 2021 curricula created ACI and ACLI routes. ACI candidates take ACICE and do not take Part 2; ACLI candidates take Part 1 Immunology and proceed to Part 2 Immunology. Part 2 has practical station and oral components.
  • Time limit: Part 1: two 3-hour written papers. Part 2 practical: six 1-hour stations. Part 2 oral: 60 minutes split into two 30-minute examiner-pair sections.
  • Exam fee: 2026 RCPath fees: ACICE GBP 749; Immunology Part 1 GBP 749; Part 2 Practical GBP 827; Part 2 Oral GBP 749.

Keys to Passing

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

FRCPath Immunology Study Tips from Top Performers

1Study allergy, immunodeficiency, autoimmunity and complement as clinical-laboratory problems rather than isolated facts.
2Practise interpreting immunochemistry, flow cytometry and QC data aloud for Part 2 station and oral preparation.
3Use route-specific RCPath guidance: ACI candidates focus on ACICE, while ACLI candidates must plan for Part 2 Immunology.
4Track false-positive and interference-prone tests such as ANA, IgE, tryptase and immunoassays with pretest probability.
5For oral practice, structure answers around clinical problem, immunological mechanism, test selection, safety action and communication.

Frequently Asked Questions

Is uk-mrcpath-immunology the official exam name?

No. The source ID uses MRCPath wording, but RCPath uses FRCPath Immunology, with Part 1 Immunology and ACICE routes after the 2021 curricula.

What is the Part 1 format?

RCPath states that Immunology Part 1 comprises two three-hour written papers made up of short-answer questions. It is not listed as a fixed-count MCQ paper.

What is ACICE?

ACICE is the Allergy and Clinical Immunology Certificate Examination. RCPath states that ACI-pathway candidates take ACICE and do not take Part 2, while ACLI candidates take Part 1 Immunology and Part 2 Immunology.

What is the Part 2 format?

Part 2 Immunology includes practical stations, such as autoimmunity, quality, immunochemistry, data analysis, flow cytometry and clinical vignettes, plus a 60-minute oral examination.

Does this bank reproduce the official exam format?

No. The official examination uses short-answer, practical and oral formats. This site-wide bank provides 100 four-option practice questions adapted to the official content areas for revision.