(IgNS) Ig Certified Pharmacist (IgCP) Credential
Practice Exam
1. Which of the following is a primary indication for immunoglobulin (Ig)
replacement therapy?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Primary immunodeficiency (PID) [ANSWER]
D. 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:
A. Recombinant monoclonal antibody synthesis
B. Pooled human plasma from thousands of donors
C. Single-donor human blood samples
D. Synthetic immunoglobulin peptides
Correct Answer: B [ANSWER]
Rationale: IVIG is manufactured from pooled human plasma collected from thousands of
donors, ensuring broad-spectrum antibodies.
3. Which route of administration is associated with a lower risk of systemic
adverse reactions?
A. Intramuscular
B. Intravenous (IV)
C. Subcutaneous (SCIG) [ANSWER]
D. Oral
,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:
A. Headache
B. Thromboembolic event [ANSWER]
C. Mild fever
D. Chills
Rationale: IVIG can increase blood viscosity, leading to rare but serious thromboembolic events
like stroke or myocardial infarction.
5. Which of the following lab values should be monitored during long-term Ig
therapy?
A. Hemoglobin A1c
B. Serum IgG trough levels [ANSWER]
C. Total bilirubin
D. Serum sodium
Rationale: IgG trough levels help assess the adequacy of dosing and effectiveness of Ig therapy,
especially in PID.
6. Which component is most likely to vary among different Ig products?
A. The IgG subclass distribution
B. Presence of preservatives or stabilizers
C. Manufacturing source plasma
D. 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).
7. Which of the following is an FDA-approved indication for IVIG?
,A. Psoriasis
B. Cystic fibrosis
C. Chronic inflammatory demyelinating polyneuropathy (CIDP) [ANSWER]
D. Hypertension
Rationale: CIDP is an approved indication for IVIG therapy. It responds to immunomodulatory
treatment.
8. In SCIG therapy, which of the following is TRUE regarding administration?
A. It requires premedication with corticosteroids.
B. It can be self-administered at home. [ANSWER]
C. It is administered in large boluses once a month.
D. 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.
9. What stabilizer in some IVIG products is associated with increased renal risk?
A. Glycine
B. Sucrose [ANSWER]
C. Maltose
D. Albumin
Rationale: Sucrose has been implicated in osmotic nephrosis leading to acute renal failure,
especially in at-risk populations.
10. Which product characteristic is important when switching Ig products for a
patient?
A. Cost of the drug
B. Storage location in pharmacy
C. Osmolality and pH [ANSWER]
D. Container size
Rationale: Osmolality and pH may affect tolerability and safety; differences can lead to adverse
effects if not considered.
, 11. The initial IVIG dose for immune thrombocytopenia (ITP) is typically:
A. 100 mg/kg daily for 3 days
B. 200 mg/kg once monthly
C. 1 g/kg daily for 1–2 days [ANSWER]
D. 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.
12. Which pre-existing condition requires special caution before starting IVIG?
A. Migraine
B. Renal impairment [ANSWER]
C. Iron-deficiency anemia
D. Hypothyroidism
Rationale: Patients with renal impairment, especially those receiving sucrose-containing IVIG,
are at higher risk for acute renal failure.
13. Which of the following is NOT typically a component of patient education for
Ig therapy?
A. Product storage
B. Hand hygiene before infusion
C. How to interpret CBC results [ANSWER]
D. Recognizing signs of anaphylaxis
Rationale: CBC interpretation is outside the scope of standard patient education. Education
focuses on safety, administration, and reaction recognition.
14. Why should live vaccines be avoided in patients receiving Ig therapy?
A. Ig inactivates vaccine adjuvants
B. Passive antibodies interfere with live vaccine efficacy [ANSWER]
C. Ig causes enhanced immune response
D. Vaccines are metabolized by Ig
Rationale: Passive antibodies in Ig can neutralize live vaccine antigens, rendering the vaccine
ineffective.
Practice Exam
1. Which of the following is a primary indication for immunoglobulin (Ig)
replacement therapy?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Primary immunodeficiency (PID) [ANSWER]
D. 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:
A. Recombinant monoclonal antibody synthesis
B. Pooled human plasma from thousands of donors
C. Single-donor human blood samples
D. Synthetic immunoglobulin peptides
Correct Answer: B [ANSWER]
Rationale: IVIG is manufactured from pooled human plasma collected from thousands of
donors, ensuring broad-spectrum antibodies.
3. Which route of administration is associated with a lower risk of systemic
adverse reactions?
A. Intramuscular
B. Intravenous (IV)
C. Subcutaneous (SCIG) [ANSWER]
D. Oral
,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:
A. Headache
B. Thromboembolic event [ANSWER]
C. Mild fever
D. Chills
Rationale: IVIG can increase blood viscosity, leading to rare but serious thromboembolic events
like stroke or myocardial infarction.
5. Which of the following lab values should be monitored during long-term Ig
therapy?
A. Hemoglobin A1c
B. Serum IgG trough levels [ANSWER]
C. Total bilirubin
D. Serum sodium
Rationale: IgG trough levels help assess the adequacy of dosing and effectiveness of Ig therapy,
especially in PID.
6. Which component is most likely to vary among different Ig products?
A. The IgG subclass distribution
B. Presence of preservatives or stabilizers
C. Manufacturing source plasma
D. 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).
7. Which of the following is an FDA-approved indication for IVIG?
,A. Psoriasis
B. Cystic fibrosis
C. Chronic inflammatory demyelinating polyneuropathy (CIDP) [ANSWER]
D. Hypertension
Rationale: CIDP is an approved indication for IVIG therapy. It responds to immunomodulatory
treatment.
8. In SCIG therapy, which of the following is TRUE regarding administration?
A. It requires premedication with corticosteroids.
B. It can be self-administered at home. [ANSWER]
C. It is administered in large boluses once a month.
D. 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.
9. What stabilizer in some IVIG products is associated with increased renal risk?
A. Glycine
B. Sucrose [ANSWER]
C. Maltose
D. Albumin
Rationale: Sucrose has been implicated in osmotic nephrosis leading to acute renal failure,
especially in at-risk populations.
10. Which product characteristic is important when switching Ig products for a
patient?
A. Cost of the drug
B. Storage location in pharmacy
C. Osmolality and pH [ANSWER]
D. Container size
Rationale: Osmolality and pH may affect tolerability and safety; differences can lead to adverse
effects if not considered.
, 11. The initial IVIG dose for immune thrombocytopenia (ITP) is typically:
A. 100 mg/kg daily for 3 days
B. 200 mg/kg once monthly
C. 1 g/kg daily for 1–2 days [ANSWER]
D. 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.
12. Which pre-existing condition requires special caution before starting IVIG?
A. Migraine
B. Renal impairment [ANSWER]
C. Iron-deficiency anemia
D. Hypothyroidism
Rationale: Patients with renal impairment, especially those receiving sucrose-containing IVIG,
are at higher risk for acute renal failure.
13. Which of the following is NOT typically a component of patient education for
Ig therapy?
A. Product storage
B. Hand hygiene before infusion
C. How to interpret CBC results [ANSWER]
D. Recognizing signs of anaphylaxis
Rationale: CBC interpretation is outside the scope of standard patient education. Education
focuses on safety, administration, and reaction recognition.
14. Why should live vaccines be avoided in patients receiving Ig therapy?
A. Ig inactivates vaccine adjuvants
B. Passive antibodies interfere with live vaccine efficacy [ANSWER]
C. Ig causes enhanced immune response
D. Vaccines are metabolized by Ig
Rationale: Passive antibodies in Ig can neutralize live vaccine antigens, rendering the vaccine
ineffective.
