Ig Certified Pharmacist (IgCP) Credential Practice Exam
1. What is the primary indication for intravenous immunoglobulin (IVIG) in
immunodeficient patients?
A) To treat active infections
B) To provide passive immunity by replacing deficient antibodies
C) To stimulate endogenous antibody production
D) To reduce inflammatory responses
ANSWER: B) To provide passive immunity by replacing deficient antibodies
EXPLANATION: IVIG provides passive immunity by supplying functional antibodies to
patients with primary or secondary immunodeficiencies who cannot produce adequate
antibodies themselves.
2. Which immunoglobulin subclass is most abundant in normal human serum?
A) IgG1
B) IgG2
C) IgG3
D) IgG4
ANSWER: A) IgG1
EXPLANATION: IgG1 constitutes approximately 60-65% of total IgG in normal human
serum and has the longest half-life among IgG subclasses.
3. What is the typical elimination half-life of intravenous immunoglobulin?
A) 3-5 days
B) 7-10 days
C) 14-21 days
D) 28-35 days
ANSWER: C) 14-21 days
EXPLANATION: IVIG has an average half-life of approximately 3-4 weeks, though this
can vary based on patient factors and product characteristics.
4. Which adverse reaction is most commonly associated with IVIG infusion?
A) Anaphylaxis
B) Hemolytic anemia
C) Headache
D) Renal failure
,ANSWER: C) Headache
EXPLANATION: Headache is the most frequently reported adverse reaction, occurring in
up to 50% of patients, often related to infusion rate or product characteristics.
5. What is the mechanism of action of IVIG in autoimmune conditions like ITP?
A) Direct cytotoxic effect on autoantibodies
B) Blockade of Fc receptors on macrophages
C) Stimulation of platelet production
D) Inhibition of complement activation
ANSWER: B) Blockade of Fc receptors on macrophages
EXPLANATION: In ITP, IVIG works primarily through Fc receptor blockade, preventing
macrophage destruction of antibody-coated platelets.
6. Which laboratory parameter should be monitored to detect hemolysis following
IVIG administration?
A) Serum creatinine
B) Hemoglobin and haptoglobin
C) Liver function tests
D) C-reactive protein
ANSWER: B) Hemoglobin and haptoglobin
EXPLANATION: Hemoglobin decrease and haptoglobin consumption indicate IVIG-
related hemolysis, particularly important with blood group A or AB patients.
7. What is the recommended premedication regimen to reduce IVIG infusion
reactions?
A) Diphenhydramine and acetaminophen
B) Corticosteroids alone
C) Only slowing the infusion rate
D) No premedication needed
ANSWER: A) Diphenhydramine and acetaminophen
EXPLANATION: Premedication with acetaminophen and diphenhydramine is standard to
prevent or mitigate infusion-related reactions.
8. Which patient population is at highest risk for IVIG-induced aseptic meningitis?
A) Elderly patients
B) Patients with migraines
C) Those receiving high-dose therapy
D) Pediatric patients
, ANSWER: B) Patients with migraines
EXPLANATION: Patients with a history of migraines have increased susceptibility to IVIG-
induced aseptic meningitis, particularly with rapid infusion.
9. What is the primary difference between IVIG and subcutaneous immunoglobulin
(SCIG)?
A) SCIG contains only IgG1
B) IVIG has higher antibody titers
C) Administration route and pharmacokinetics
D) SCIG is not effective for primary immunodeficiencies
ANSWER: C) Administration route and pharmacokinetics
EXPLANATION: The fundamental difference is administration route, with SCIG providing
more stable IgG levels and fewer systemic adverse effects.
10. Which virus is routinely tested for in IG products due to historical transmission
concerns?
A) HIV
B) Hepatitis C
C) Cytomegalovirus
D) Parvovirus B19
ANSWER: B) Hepatitis C
EXPLANATION: Hepatitis C transmission via IG products occurred historically, leading to
rigorous screening and viral inactivation processes.
11. What is the target trough IgG level for patients with primary immunodeficiencies?
A) >400 mg/dL
B) >500 mg/dL
C) >600 mg/dL
D) >800 mg/dL
ANSWER: B) >500 mg/dL
EXPLANATION: Maintaining trough IgG levels above 500 mg/dL is associated with
reduced infection frequency in primary immunodeficiencies.
12. Which enzyme is used in some IG products to reduce IgG aggregates?
A) Plasmin
B) Pepsin
C) Neuraminidase
D) None, aggregates are always present
1. What is the primary indication for intravenous immunoglobulin (IVIG) in
immunodeficient patients?
A) To treat active infections
B) To provide passive immunity by replacing deficient antibodies
C) To stimulate endogenous antibody production
D) To reduce inflammatory responses
ANSWER: B) To provide passive immunity by replacing deficient antibodies
EXPLANATION: IVIG provides passive immunity by supplying functional antibodies to
patients with primary or secondary immunodeficiencies who cannot produce adequate
antibodies themselves.
2. Which immunoglobulin subclass is most abundant in normal human serum?
A) IgG1
B) IgG2
C) IgG3
D) IgG4
ANSWER: A) IgG1
EXPLANATION: IgG1 constitutes approximately 60-65% of total IgG in normal human
serum and has the longest half-life among IgG subclasses.
3. What is the typical elimination half-life of intravenous immunoglobulin?
A) 3-5 days
B) 7-10 days
C) 14-21 days
D) 28-35 days
ANSWER: C) 14-21 days
EXPLANATION: IVIG has an average half-life of approximately 3-4 weeks, though this
can vary based on patient factors and product characteristics.
4. Which adverse reaction is most commonly associated with IVIG infusion?
A) Anaphylaxis
B) Hemolytic anemia
C) Headache
D) Renal failure
,ANSWER: C) Headache
EXPLANATION: Headache is the most frequently reported adverse reaction, occurring in
up to 50% of patients, often related to infusion rate or product characteristics.
5. What is the mechanism of action of IVIG in autoimmune conditions like ITP?
A) Direct cytotoxic effect on autoantibodies
B) Blockade of Fc receptors on macrophages
C) Stimulation of platelet production
D) Inhibition of complement activation
ANSWER: B) Blockade of Fc receptors on macrophages
EXPLANATION: In ITP, IVIG works primarily through Fc receptor blockade, preventing
macrophage destruction of antibody-coated platelets.
6. Which laboratory parameter should be monitored to detect hemolysis following
IVIG administration?
A) Serum creatinine
B) Hemoglobin and haptoglobin
C) Liver function tests
D) C-reactive protein
ANSWER: B) Hemoglobin and haptoglobin
EXPLANATION: Hemoglobin decrease and haptoglobin consumption indicate IVIG-
related hemolysis, particularly important with blood group A or AB patients.
7. What is the recommended premedication regimen to reduce IVIG infusion
reactions?
A) Diphenhydramine and acetaminophen
B) Corticosteroids alone
C) Only slowing the infusion rate
D) No premedication needed
ANSWER: A) Diphenhydramine and acetaminophen
EXPLANATION: Premedication with acetaminophen and diphenhydramine is standard to
prevent or mitigate infusion-related reactions.
8. Which patient population is at highest risk for IVIG-induced aseptic meningitis?
A) Elderly patients
B) Patients with migraines
C) Those receiving high-dose therapy
D) Pediatric patients
, ANSWER: B) Patients with migraines
EXPLANATION: Patients with a history of migraines have increased susceptibility to IVIG-
induced aseptic meningitis, particularly with rapid infusion.
9. What is the primary difference between IVIG and subcutaneous immunoglobulin
(SCIG)?
A) SCIG contains only IgG1
B) IVIG has higher antibody titers
C) Administration route and pharmacokinetics
D) SCIG is not effective for primary immunodeficiencies
ANSWER: C) Administration route and pharmacokinetics
EXPLANATION: The fundamental difference is administration route, with SCIG providing
more stable IgG levels and fewer systemic adverse effects.
10. Which virus is routinely tested for in IG products due to historical transmission
concerns?
A) HIV
B) Hepatitis C
C) Cytomegalovirus
D) Parvovirus B19
ANSWER: B) Hepatitis C
EXPLANATION: Hepatitis C transmission via IG products occurred historically, leading to
rigorous screening and viral inactivation processes.
11. What is the target trough IgG level for patients with primary immunodeficiencies?
A) >400 mg/dL
B) >500 mg/dL
C) >600 mg/dL
D) >800 mg/dL
ANSWER: B) >500 mg/dL
EXPLANATION: Maintaining trough IgG levels above 500 mg/dL is associated with
reduced infection frequency in primary immunodeficiencies.
12. Which enzyme is used in some IG products to reduce IgG aggregates?
A) Plasmin
B) Pepsin
C) Neuraminidase
D) None, aggregates are always present
