ABAI study guide
ABAI · Work through your exam, one topic at a time.
The American Board of Allergy and Immunology (ABAI) is a conjoint board of the American Board of Internal Medicine and the American Board of Pediatrics, based in Philadelphia. It certifies physicians in the specialty of allergy and immunology and administers both initial certification examinations and Maintenance of Certification (MOC) examinations. Candidates typically reach ABAI after completing an accredited allergy and immunology fellowship, and they apply through the board's exam application pathway, which publishes exam overviews, application instructions, important dates, and fees. Certification is not a one-time event: ABAI also publishes MOC requirements, reciprocal credit information, and core competencies that diplomates must satisfy to keep their credential current. Topics on this exam: Allergy and Immunology. The ABAI study guide has 2 sections and about 617 words.
01Allergy: Diagnosis and Management
Allergic disease is best understood as an IgE-mediated (or, in some conditions, non-IgE or mixed) hypersensitivity response to otherwise harmless antigens. Candidates must distinguish sensitization (a positive test showing specific IgE, with or without symptoms) from clinical allergy (symptoms reproducibly tied to exposure). Know the mechanisms and limits of each test: skin prick testing detects specific IgE on mast cells and has high sensitivity but variable specificity; serum specific IgE has similar operating characteristics; intradermal testing is reserved for select drug and venom evaluations because of false positives and reaction risk. Total IgE is rarely diagnostic.
323 words, about 2 min02Immunology: Innate and Adaptive Immunity, Immunodeficiency, and Immunomodulation
The immune system is organized into innate (fast, non-specific: barriers, phagocytes, complement, NK cells) and adaptive (slow, specific, memory: T and B lymphocytes) arms. Candidates must understand antigen presentation via MHC class I (to CD8+ cytotoxic T cells) and MHC class II (to CD4+ helper T cells), immunoglobulin isotypes and their functions (IgM first responder, IgG opsonizer and placental transfer, IgA mucosal, IgE allergic/antiparasitic), and complement pathways (classical, lectin, alternative) with their effector consequences. Recognize classic presentations: B-cell/antibody defects (e.g., X-linked agammaglobulinemia, common variable immunodeficiency) present with recurrent sinopulmonary infections by encapsulated bacteria; T-cell defects (e.g., DiGeorge syndrome) present with viral, fungal, and opportunistic infections; phagocyte defects (e.g., chronic granulomatous disease) with catalase-positive organisms; complement defects with encapsulated organisms and, for terminal components, recurrent Neisseria. Severe combined immunodeficiency presents early with failure to thrive and opportunistic infection.
294 words, about 1 min