100% CORRECT ANS >> S
1. What is the primary mechanism of action of intravenous
immunoglobulin (IVIG)? A) Direct cytotoxicity B) Complement activation C)
Passive immunization and immunomodulation D) Enzyme inhibition
ANS >> : C) Passive immunization and immunomodulation IVIG provides
passive immunity through antibodies and has immunomodulatory effects
including anti-inflammatory actions.
2. Which immunoglobulin class represents the majority of antibodies in
IVIG preparations? A) IgA B) IgG C) IgM D) IgE
ANS >> : B) IgG IVIG contains primarily IgG antibodies (>95%), with small
amounts of other immunoglobulin classes.
3. What is the half-life of IgG in healthy individuals? A) 7-10 days B) 14-21
days C) 21-28 days D) 28-35 days
ANS >> : C) 21-28 days The half-life of IgG is approximately 3-4 weeks in
healthy individuals.
4. Which IgG subclass has the longest half-life? A) IgG1 B) IgG2 C) IgG3 D)
IgG4
ANS >> : A) IgG1 IgG1 and IgG2 have the longest half-lives (~21 days), while
IgG3 has the shortest (~7 days).
5. What is the recommended storage temperature for most IVIG products?
A) -20°C to -10°C B) 2°C to 8°C C) 15°C to 25°C D) 25°C to 30°C
ANS >> : B) 2°C to 8°C Most IVIG products should be stored refrigerated at
2°C to 8°C.
6. Which of the following is NOT a contraindication to IVIG therapy? A)
IgA deficiency with anti-IgA antibodies B) Severe thrombocytopenia C)
Previous anaphylactic reaction to IVIG D) Hyperviscosity syndrome
,ANS >> : B) Severe thrombocytopenia Thrombocytopenia may actually be an
indication for IVIG in certain conditions like ITP.
7. What is the typical protein concentration of standard IVIG
preparations? A) 2.5% B) 5% C) 10% D) 20%
ANS >> : C) 10% Standard IVIG preparations typically contain 10% protein
(100 mg/mL).
8. Which viral inactivation method is commonly used in IVIG
manufacturing? A) Heat treatment only B) Solvent/detergent treatment only
C) Multiple methods including heat, solvent/detergent, and filtration D) UV
irradiation only
ANS >> : C) Multiple methods including heat, solvent/detergent, and
filtration Multiple viral inactivation/removal methods are used to ensure safety.
9. What is the primary source of plasma for IVIG production? A)
Individual donors B) Pooled plasma from thousands of donors C) Synthetic
production D) Animal plasma
ANS >> : B) Pooled plasma from thousands of donors IVIG is manufactured
from pooled plasma from thousands of screened donors.
10. Which test is used to measure functional antibody levels? A) Total IgG
level B) IgG subclass levels C) Specific antibody titers D) All of the above
ANS >> : D) All of the above Functional assessment includes total IgG,
subclasses, and specific antibody responses.
11. What is the minimum IgA content that may cause reactions in IgA-
deficient patients? A) <1 mcg/mL B) 1-10 mcg/mL C) >50 mcg/mL D) >100
mcg/mL
ANS >> : C) >50 mcg/mL IVIG products with >50 mcg/mL IgA may cause
reactions in IgA-deficient patients with anti-IgA antibodies.
12. Which complement component is most commonly measured to assess
complement consumption? A) C1q B) C3 C) C4 D) C5
ANS >> : B) C3 C3 levels are commonly measured as they reflect both classical
and alternative pathway activation.
13. What is the recommended infusion rate for IVIG initiation? A) 0.5
mg/kg/min B) 1-2 mg/kg/min C) 5-10 mg/kg/min D) 15-20 mg/kg/min
, ANS >> : A) 0.5 mg/kg/min Initial infusion should start slowly at 0.5
mg/kg/min and increase gradually if tolerated.
14. Which immunoglobulin preparation has the highest osmolality? A)
Liquid IVIG with sucrose B) Liquid IVIG with glycine C) Lyophilized IVIG D)
Subcutaneous immunoglobulin
ANS >> : A) Liquid IVIG with sucrose Sucrose-containing IVIG products
typically have higher osmolality.
15. What is the typical pH range for IVIG products? A) 4.0-5.0 B) 6.0-7.0
C) 7.0-8.0 D) 8.0-9.0
ANS >> : A) 4.0-5.0 Most IVIG products have an acidic pH of 4.0-5.0 to
maintain stability.
16. Which factor determines the dosing frequency of IVIG? A) Patient
weight only B) Underlying condition only C) IgG half-life and trough levels D)
Infusion site
ANS >> : C) IgG half-life and trough levels Dosing frequency is based on
maintaining adequate trough IgG levels.
17. What is the mechanism of FcRn (neonatal Fc receptor)? A) Antibody
production B) IgG recycling and half-life extension C) Complement activation
D) Antigen presentation
ANS >> : B) IgG recycling and half-life extension FcRn protects IgG from
degradation and extends its half-life.
18. Which laboratory parameter should be monitored before IVIG
infusion? A) Complete blood count B) Renal function C) Liver function D) All
of the above
ANS >> : D) All of the above Comprehensive monitoring includes CBC, renal
function, and liver function.
19. What is the recommended action if a patient develops fever during
IVIG infusion? A) Continue infusion at same rate B) Increase infusion rate C)
Stop infusion and give antipyretics D) Switch to different product immediately
ANS >> : C) Stop infusion and give antipyretics Fever during infusion
requires stopping and treating symptomatically.
1. What is the primary mechanism of action of intravenous
immunoglobulin (IVIG)? A) Direct cytotoxicity B) Complement activation C)
Passive immunization and immunomodulation D) Enzyme inhibition
ANS >> : C) Passive immunization and immunomodulation IVIG provides
passive immunity through antibodies and has immunomodulatory effects
including anti-inflammatory actions.
2. Which immunoglobulin class represents the majority of antibodies in
IVIG preparations? A) IgA B) IgG C) IgM D) IgE
ANS >> : B) IgG IVIG contains primarily IgG antibodies (>95%), with small
amounts of other immunoglobulin classes.
3. What is the half-life of IgG in healthy individuals? A) 7-10 days B) 14-21
days C) 21-28 days D) 28-35 days
ANS >> : C) 21-28 days The half-life of IgG is approximately 3-4 weeks in
healthy individuals.
4. Which IgG subclass has the longest half-life? A) IgG1 B) IgG2 C) IgG3 D)
IgG4
ANS >> : A) IgG1 IgG1 and IgG2 have the longest half-lives (~21 days), while
IgG3 has the shortest (~7 days).
5. What is the recommended storage temperature for most IVIG products?
A) -20°C to -10°C B) 2°C to 8°C C) 15°C to 25°C D) 25°C to 30°C
ANS >> : B) 2°C to 8°C Most IVIG products should be stored refrigerated at
2°C to 8°C.
6. Which of the following is NOT a contraindication to IVIG therapy? A)
IgA deficiency with anti-IgA antibodies B) Severe thrombocytopenia C)
Previous anaphylactic reaction to IVIG D) Hyperviscosity syndrome
,ANS >> : B) Severe thrombocytopenia Thrombocytopenia may actually be an
indication for IVIG in certain conditions like ITP.
7. What is the typical protein concentration of standard IVIG
preparations? A) 2.5% B) 5% C) 10% D) 20%
ANS >> : C) 10% Standard IVIG preparations typically contain 10% protein
(100 mg/mL).
8. Which viral inactivation method is commonly used in IVIG
manufacturing? A) Heat treatment only B) Solvent/detergent treatment only
C) Multiple methods including heat, solvent/detergent, and filtration D) UV
irradiation only
ANS >> : C) Multiple methods including heat, solvent/detergent, and
filtration Multiple viral inactivation/removal methods are used to ensure safety.
9. What is the primary source of plasma for IVIG production? A)
Individual donors B) Pooled plasma from thousands of donors C) Synthetic
production D) Animal plasma
ANS >> : B) Pooled plasma from thousands of donors IVIG is manufactured
from pooled plasma from thousands of screened donors.
10. Which test is used to measure functional antibody levels? A) Total IgG
level B) IgG subclass levels C) Specific antibody titers D) All of the above
ANS >> : D) All of the above Functional assessment includes total IgG,
subclasses, and specific antibody responses.
11. What is the minimum IgA content that may cause reactions in IgA-
deficient patients? A) <1 mcg/mL B) 1-10 mcg/mL C) >50 mcg/mL D) >100
mcg/mL
ANS >> : C) >50 mcg/mL IVIG products with >50 mcg/mL IgA may cause
reactions in IgA-deficient patients with anti-IgA antibodies.
12. Which complement component is most commonly measured to assess
complement consumption? A) C1q B) C3 C) C4 D) C5
ANS >> : B) C3 C3 levels are commonly measured as they reflect both classical
and alternative pathway activation.
13. What is the recommended infusion rate for IVIG initiation? A) 0.5
mg/kg/min B) 1-2 mg/kg/min C) 5-10 mg/kg/min D) 15-20 mg/kg/min
, ANS >> : A) 0.5 mg/kg/min Initial infusion should start slowly at 0.5
mg/kg/min and increase gradually if tolerated.
14. Which immunoglobulin preparation has the highest osmolality? A)
Liquid IVIG with sucrose B) Liquid IVIG with glycine C) Lyophilized IVIG D)
Subcutaneous immunoglobulin
ANS >> : A) Liquid IVIG with sucrose Sucrose-containing IVIG products
typically have higher osmolality.
15. What is the typical pH range for IVIG products? A) 4.0-5.0 B) 6.0-7.0
C) 7.0-8.0 D) 8.0-9.0
ANS >> : A) 4.0-5.0 Most IVIG products have an acidic pH of 4.0-5.0 to
maintain stability.
16. Which factor determines the dosing frequency of IVIG? A) Patient
weight only B) Underlying condition only C) IgG half-life and trough levels D)
Infusion site
ANS >> : C) IgG half-life and trough levels Dosing frequency is based on
maintaining adequate trough IgG levels.
17. What is the mechanism of FcRn (neonatal Fc receptor)? A) Antibody
production B) IgG recycling and half-life extension C) Complement activation
D) Antigen presentation
ANS >> : B) IgG recycling and half-life extension FcRn protects IgG from
degradation and extends its half-life.
18. Which laboratory parameter should be monitored before IVIG
infusion? A) Complete blood count B) Renal function C) Liver function D) All
of the above
ANS >> : D) All of the above Comprehensive monitoring includes CBC, renal
function, and liver function.
19. What is the recommended action if a patient develops fever during
IVIG infusion? A) Continue infusion at same rate B) Increase infusion rate C)
Stop infusion and give antipyretics D) Switch to different product immediately
ANS >> : C) Stop infusion and give antipyretics Fever during infusion
requires stopping and treating symptomatically.
