Dip Allerg(SA)

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Examination for the Diploma in Allergology of the

College of Family Physicians of South Africa

17 March 2015
Paper 2

Long Questions/Cases

(3 hours)

All questions to be answered. Each question to be answered in a separate book (or books if more than one is required
for the one answer)

Discuss insect venom allergy under the following headings

a)
Possible clinical features and classification of severity of reactions.
b)
Risk factors for severe reactions.
c)
Diagnosis.
d)
Management.
e)
Indications and contra-indications for starting immunotherapy.

[25]

Asthma management in children

a)
Describe the wheezy phenotypes in children under the age of 5.
(6)
b)
Discuss how you would assess the degree of control of asthma in young children. (6)
c)
Discuss potential reasons for poor asthma control.
(7)
d)
Discuss the use of leukotriene receptor antagonists in young children, including
indications for which these medications may be effective, indications for which they
are ineffective and potential side effects of the leukotriene receptor antagonists. (6)
[25]

A mother brings her 18-month-old daughter to you with a background history of sickle cell
anaemia. The child has received ceftriaxone for previous febrile illnesses, but on the last
administration, developed an urticarial rash within 10 minutes of starting the infusion. The
infusion was stopped, and an IV antihistamine given. The rash resolved within 1 hour, and
there were no respiratory symptoms
a)
Do you think that there was a possible drug reaction and why?
(3)
b)
What is the approach to a patient with a possible reaction to an antibiotic?
(10)
c)
Which tests are available as part of the workup of this patient?
(5)
d)
Is penicillin a safe alternative antibiotic, and would you do any further tests, or have
any recommendations for the administration of penicillins?
(5)
e)
What 2 alternative antibiotics would you consider for septicaemia in this child as they
are unrelated to cephalosporins?
(2)
[25]
PTO/Page 2 Question 4
-2-

Discuss an approach to non-IgE-mediated enteropathies, including a classification system

and examples of each type, presentation, diagnosis, management and prognosis.
[25]

Dip Allerg(SA)

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Examination for the Diploma in Allergology of the

College of Family Physicians of South Africa
18 March 2015

Paper 3

Short Questions

(3 hours)

All questions to be answered. Each question to be answered in a separate book (or books if more than one is required
for the one answer)

Section A
1

Discuss factors which can augment or affect a food allergic reaction.

a)
b)

3
and

Discuss the 2 main groupings of skin reactions to foods in patients with atopic dermatitis,
briefly discuss how you would diagnose each type.
[10]

Discuss the use of the serum tryptase level, including timing of sampling and possible
conditions for which tryptase levels could assist in the diagnosis.
[10]

Discuss chronic urticaria under the following headings

a)
Definition.
b)
Discuss the physical urticarias.
c)
Differences between chronic spontaneous urticaria and urticarial vasculitis.

Discuss the allergic march.

As part of your answer, please discuss the concept of the
allergy causation.

[10]

(6)
skin barrier defect in
(4)
[10]

Discuss allergy prevention in the offspring terms of

a)
Antenatal strategies.
b)
Post natal strategies.

(2)
(6)
(2)
[10]

(5)
(5)
[10]

Discuss treatment strategies available for allergic rhinitis.

[10]

Discuss the role of component testing in peanut and cows milk allergy.

[10]

PTO/Page 2 Question 9

-29

a)
b)

Briefly describe a classification system for oral antihistamines, giving an example of

each category.
(6)
Describe which antihistamine(s) are suitable for use in an acute allergic reaction and
why.
(4)
[10]

Dip Allerg(SA)
THE COLLEGES OF MEDICINE OF SOUTH AFRICA
Incorporated Association not for gain
Reg No/Nr 1955/000003/08

Examination for the Diploma in Allergology of the

College of Family Physicians of South Africa

18 March 2015
Paper 3

(3 hours)
True/False

Candidate number: __________________________________

Answer all questions in the space provided

Section B
Indicate whether the statements is True or False
1

Blood specific IgE to penicillin determinants is the most sensitive test used as diagnostic
workup for previous IgE mediated penicillin allergy.
( )

Urticaria pigmentosa lesions (cutaneous mastocytosis) usually only appear during

adolescence.
( )

Skin prick tests to sesame are always recommended as first line investigations in patients
with previous anaphylaxis.
( )

Anaphylaxis to egg white is not an absolute contraindication to influenza vaccination.

( )

Skin prick tests are essential in the routine investigation of chronic urticaria.

( )

6
in

The introduction of peanut in an infants diet should be delayed until the age of 12 months
order to help prevent the development of peanut allergy.
( )

Desensitisation for milk allergy is done routinely in clinical practice.

( )

Increasing the humidity in the home can reduce the number of house dust mites.

( )

Leukotriene receptor antagonists are as effective as intranasal corticosteroids for treatment

of allergic rhinitis in adults.
( )

10

Ciclesonide inhaler may be used in children and adults from the age of 6 years.

( )