Practice Exam - Practice Exam 1. Which of the following is a pr...

(IgNS) Ig Certified Pharmacist (IgCP) Credential Practice Exam

• Which of the following is a primary indication for immunoglobulin (Ig)

replacement therapy?

• Rheumatoid arthritis
• Systemic lupus erythematosus
• Primary immunodeficiency (PID) [ANSWER]
• Asthma

Rationale: Primary immunodeficiency is a classic indication for Ig replacement therapy due to inadequate endogenous antibody production. RA and SLE may receive immunosuppressive therapy, but not routine Ig replacement.

2. IVIG products are derived from:

• Recombinant monoclonal antibody synthesis
• Pooled human plasma from thousands of donors
• Single-donor human blood samples
• Synthetic immunoglobulin peptides

Correct Answer: B [ANSWER]

Rationale: IVIG is manufactured from pooled human plasma collected from thousands of donors, ensuring broad-spectrum antibodies.

• Which route of administration is associated with a lower risk of systemic

adverse reactions?

• Intramuscular
• Intravenous (IV)
• Subcutaneous (SCIG) [ANSWER]
• Oral 1 / 4

Rationale: SCIG provides more stable serum levels and is associated with fewer systemic side effects compared to IV administration.

4. A serious but rare adverse effect of IVIG therapy is:

• Headache
• Thromboembolic event [ANSWER]
• Mild fever
• Chills

Rationale: IVIG can increase blood viscosity, leading to rare but serious thromboembolic events like stroke or myocardial infarction.

• Which of the following lab values should be monitored during long-term Ig

therapy?

• Hemoglobin A1c
• Serum IgG trough levels [ANSWER]
• Total bilirubin
• Serum sodium

Rationale: IgG trough levels help assess the adequacy of dosing and effectiveness of Ig therapy, especially in PID.

• Which component is most likely to vary among different Ig products?
• The IgG subclass distribution
• Presence of preservatives or stabilizers
• Manufacturing source plasma
• Storage temperature

Correct Answer: B [ANSWER]

Rationale: Stabilizers like sucrose, glycine, or proline vary among products and can influence tolerability and safety (e.g., renal risk).

• Which of the following is an FDA-approved indication for IVIG? 2 / 4

• Psoriasis
• Cystic fibrosis
• Chronic inflammatory demyelinating polyneuropathy (CIDP) [ANSWER]
• Hypertension

Rationale: CIDP is an approved indication for IVIG therapy. It responds to immunomodulatory treatment.

• In SCIG therapy, which of the following is TRUE regarding administration?
• It requires premedication with corticosteroids.
• It can be self-administered at home. [ANSWER]
• It is administered in large boluses once a month.
• It has faster systemic absorption than IVIG.

Rationale: SCIG is designed for patient self-administration at home and provides a more consistent serum level with fewer systemic reactions.

• What stabilizer in some IVIG products is associated with increased renal risk?
• Glycine
• Sucrose [ANSWER]
• Maltose
• Albumin

Rationale: Sucrose has been implicated in osmotic nephrosis leading to acute renal failure, especially in at-risk populations.

• Which product characteristic is important when switching Ig products for a

patient?

• Cost of the drug
• Storage location in pharmacy
• Osmolality and pH [ANSWER]
• Container size

Rationale: Osmolality and pH may affect tolerability and safety; differences can lead to adverse effects if not considered.

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11. The initial IVIG dose for immune thrombocytopenia (ITP) is typically:

• 100 mg/kg daily for 3 days
• 200 mg/kg once monthly
• 1 g/kg daily for 1–2 days [ANSWER]
• 400 mg/kg weekly for 4 weeks

Rationale: The typical ITP dose is 1 g/kg/day for 1–2 days to rapidly increase platelet counts.

• Which pre-existing condition requires special caution before starting IVIG?
• Migraine
• Renal impairment [ANSWER]
• Iron-deficiency anemia
• Hypothyroidism

Rationale: Patients with renal impairment, especially those receiving sucrose-containing IVIG, are at higher risk for acute renal failure.

• Which of the following is NOT typically a component of patient education for

Ig therapy?

• Product storage
• Hand hygiene before infusion
• How to interpret CBC results [ANSWER]
• Recognizing signs of anaphylaxis

Rationale: CBC interpretation is outside the scope of standard patient education. Education focuses on safety, administration, and reaction recognition.

• Why should live vaccines be avoided in patients receiving Ig therapy?
• Ig inactivates vaccine adjuvants
• Passive antibodies interfere with live vaccine efficacy [ANSWER]
• Ig causes enhanced immune response
• Vaccines are metabolized by Ig

Rationale: Passive antibodies in Ig can neutralize live vaccine antigens, rendering the vaccine ineffective.

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