NAECB NAECB Immunotherapy & Allergen Management 1 — Questions and Answers
Question 1: Allergen immunotherapy (AIT) works primarily by:
- Blocking beta-2 receptors
- Inducing immune tolerance through repeated allergen exposure (Correct answer)
- Suppressing cortisol production
- Eliminating IgE from circulation permanently
Correct answer: Inducing immune tolerance through repeated allergen exposure
AIT induces immunological tolerance by shifting the immune response from Th2-dominant allergic inflammation toward a regulatory, tolerant phenotype.
Question 2: The build-up phase of subcutaneous allergen immunotherapy (SCIT) typically involves:
- Weekly injections with increasing allergen doses (Correct answer)
- Monthly injections at a fixed dose
- Daily oral drops at maximum dose
- Single high-dose injection quarterly
Correct answer: Weekly injections with increasing allergen doses
During the build-up phase, weekly injections with progressively increasing allergen concentrations are given until the target maintenance dose is reached.
Question 3: What is the recommended observation period after each subcutaneous immunotherapy injection in a US clinic?
- 5 minutes
- 15 minutes
- 20–30 minutes (Correct answer)
- 60 minutes
Correct answer: 20–30 minutes
Patients must be observed for 20–30 minutes after SCIT injections because most systemic reactions occur within this window.
Question 4: Sublingual immunotherapy (SLIT) tablets approved in the US are indicated for which conditions?
- Cat and dog dander allergy only
- Mold and cockroach allergy only
- Grass pollen, dust mite, and ragweed allergies (Correct answer)
- Food allergies exclusively
Correct answer: Grass pollen, dust mite, and ragweed allergies
FDA-approved SLIT tablets in the US target grass pollen, house dust mite, and short ragweed allergens for allergic rhinitis and asthma.
Question 5: Which of the following is an absolute contraindication to initiating allergen immunotherapy?
- Mild persistent asthma with controlled symptoms
- Severe or uncontrolled asthma (FEV1 < 70% predicted) (Correct answer)
- History of seasonal allergic rhinitis
- Positive skin prick test to grass pollen
Correct answer: Severe or uncontrolled asthma (FEV1 < 70% predicted)
Severe or uncontrolled asthma with FEV1 below 70% predicted is an absolute contraindication because systemic reactions carry higher risk of fatal bronchospasm.
Question 6: How long should maintenance allergen immunotherapy typically be continued to achieve lasting clinical benefit?
- 6 months
- 1 year
- 3–5 years (Correct answer)
- Lifelong
Correct answer: 3–5 years
Maintenance immunotherapy is recommended for 3–5 years to achieve durable tolerance that persists after discontinuation.
NAECB NAECB Immunotherapy & Allergen Management 1
Allergen immunotherapy (AIT) works primarily by: