Clinical Management: Immunology Flashcards
7 cards from real CSP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Clinical Management: Immunology flashcards as text
Which screening test is required before initiating adalimumab therapy?
Answer: Latent tuberculosis test (IGRA or TST)
TNF inhibitors carry a boxed warning for serious infections including TB reactivation, so latent TB screening is required before starting.
A patient with psoriasis also has active Crohn's disease. Which drug class should generally be avoided?
Answer: IL-17A inhibitors
IL-17 inhibitors such as secukinumab and ixekizumab have been linked to new onset or worsening of inflammatory bowel disease.
The ORAL Surveillance trial led to expanded boxed warnings for tofacitinib. What did they add?
Answer: MACE, thrombosis, malignancy, and mortality
Compared with TNF inhibitors in older RA patients with cardiovascular risk factors, tofacitinib showed more MACE, thrombosis, malignancy, and death.
Why is certolizumab pegol often preferred for patients with immune-mediated disease during pregnancy?
Answer: It lacks an Fc region, so very little crosses the placenta
Without an Fc portion, certolizumab is not actively transported across the placenta by the neonatal Fc receptor.
Ustekinumab exerts its effect by targeting which structure?
Answer: Shared p40 subunit of IL-12 and IL-23
Ustekinumab binds the p40 subunit shared by IL-12 and IL-23, blocking both cytokines.
Which vaccine is contraindicated for a patient currently receiving a TNF inhibitor?
Answer: Measles, mumps, rubella (MMR)
Live vaccines such as MMR are contraindicated during biologic immunosuppression because of the risk of vaccine-strain infection.
Infliximab is commonly given with methotrexate in rheumatoid arthritis mainly to do what?
Answer: Reduce formation of antidrug antibodies
Infliximab is chimeric, and adding methotrexate lowers immunogenicity, which helps keep the drug effective.