Immunopharmacology

Question 1

Which of the following drug is used for patients with SLE and RA?
A. Tacrolimus
B. Cyclosporine
C. Hydroxychloroquine
D. Sirolimus

Answer 1

C. Hydroxychloroquine

Question 2

Which drug suppresses intracellular antigen processing and loading of peptides into MHC class II by increasing the pH of lysosomal and endosomal compartments?

Answer 2

Hydroxychloroquine

Question 3

Recombinant humanized IgG1 that binds to soluble and membrane-associated IL-6 receptors to inhibit signaling

Answer 3

Tocilizumab

Question 4

Anti-IgE recombinant humanized monoclonal antibody for allergic asthma in adult and adolescent patients whose symptoms are REFRACTORY TO INHALED CORTICOSTEROIDS

Answer 4

Omalizumab

Question 5

Total serum IgE levels may remain elevated in patients for up to how long after omalizumab administration?

Answer 5

1 year

Question 6

Which of the 2 anticytokine-antibodies below is used for Crohn’s disease and RA?
A. Etanercept
B. Infliximab

Answer 6

B. Infliximab

Question 7

Which of the 2 anticytokine-antibodies can cause reactivation of latent TB?
A. Etanercept
B. Infliximab

Answer 7

B. Infliximab

Question 8

Which of the 2 anticytokine-antibodies below is used for Psoriatic arthritis and RA?
A. Etanercept
B. Infliximab

Answer 8

A. Etanercept

Question 9

Which of the 2 anticytokine-antibodies is a genetically engineered fusion protein that prevent TNF-α from binding to TNFR1 and TNFR2?
A. Etanercept
B. Infliximab

Answer 9

A. Etanercept

Question 10

Which of the 2 anticytokine-antibodies inhibit T-cell and macrophage function?
A. Etanercept
B. Infliximab

Answer 10

B. Infliximab

Question 11

Which of the 2 anticytokine-antibodies is a chimeric monoclonal antibody that cross links with membrane bound TNF-α receptors on cell surface?
A. Etanercept
B. Infliximab

Answer 11

B. Infliximab

Question 12

Which antimetabolite inhibits lymphocyte folate metabolism?

Answer 12

Methotrexate

Question 13

This antimetabolite suppresses BOTH B and T lymphocytes, including mitogen and mixed lymphocyte responses, probably by DE NOVO SYNTHESIS OF PURINES. The active product inhibits inosine monophosphate dehydrogenase, leading to suppression of T- and B-lymphocyte proliferation.

Answer 13

Mycophenolate mofetil

Question 14

What to do if a patient using allopurinol must take azathioprine?

Answer 14

Reduce azathioprine dose to 1/4-1/3 to prevent toxicity

since both are inactivated by xanthine oxidase

Question 15

Cellcept is a selective noncompetitive inhibitor of which enzyme in the de novo pathway of guanine nucleotide synthesis?

Answer 15

Cellcept (Mycophenolate mofetil) inhibits Inosine Monophosphate Dehydrogenase or IMPDH

Question 16

Cellcept is an alternative to cyclosporine or tacrolimus for intolerant patients when it is combined with:

Answer 16

Prednisone

Cellcept is Mycophenolate mofetil

Question 17

This is the first line drug for preventing or reducing chronic allograft vasculopathy in cardiac transplant recipients due to antiproliferative properties

Answer 17

Mycophenolate mofetil (Cellcept)

Question 18

Which drug, isolated from the mold Penicillum glaucus, inhibits lymphocyte guanosine synthesis to counter refractory rejection in solid organ transplant patients?

Answer 18

Mycophenolate mofetil

Question 19

mTOR inhibitors are associated with an increased risk for developing which vascular pathology?

Answer 19

Hepatic Artery thrombosis

Question 20

This is a Proliferation Signal Inhibitor that inhibits JAK enzymes that stimulate hematopoiesis and immune cell function in response to cytokine or growth factor signaling. It is a targeted synthetic small molecule (tsDMARD) that selectively inhibits all members of the Janus kinase family to varying degrees. At therapeutic doses, it exerts its effect mainly by inhibiting JAK3, and to a lesser extent JAK1, hence interrupting the JAK-STAT signaling pathway.

Answer 20

Tofacitinib (Xeljanz)

Question 21

This oral sedative drug, though banned due to teratogenic effects, is now currently used for treatment of Multiple Myeloma at initial diagnosis and for relapsed-refractory disease. Despite its toxicity, it is also now approved by the FDA for limited use as a potent immunoregulatory agent and to treat certain forms of leprosy (erythema nodosum leprosum).

Answer 21

Thalidomide

Question 22

This is the immunomodulatory derivative of Thalidomide (IMiD) that is less toxic, less teratogenic, and effective for myelodysplastic syndrome with chromosome 5q31 deletion

Answer 22

Lenalidomide

Question 23

Which group of immunosuppressants can cause profound myelosuppression, specifically thrombocytopenia?

Answer 23

Proliferation Signal Inhibitors (PSIs):
- Sirolimus
- Everolimus

Question 24

Cell source (cells that release) IFN-γ

Answer 24

CD4 Th1, CD8 and NK cells

Question 25

Which Mabs bind and neutralize TNF-α and are important for ankylosing spondylitis?

Answer 25

TNF-α inhibitors particularly Infliximab and Adalimumab

Question 26

Which fully human, high-affinity, recombinant anti-tumor necrosis factor (TNF) alpha monoclonal antibody blocks the binding of B. anthracis "protective" antigen to its cellular receptor?

Answer 26

Adalimumab

Question 27

Which alkylating cytotoxic agent can cause hemorrhagic cystitis?

Answer 27

Cyclophosphamide

Question 28

Which alkylating cytotoxic agent can cause pancytopenia when given in large doses?

Answer 28

Cyclophosphamide

Question 29

Cytokine that suppresses HIV replication and stimulates T-cell chemotaxis

Answer 29

IL-16

Question 30

Which fully human IgG2 kappa light chain monoclonal antibody binds to EGFR and is used in metastatic colorectal cancer?

Answer 30

Panitumumab

Question 31

Cell source (cells that release) IFN-α

Answer 31

Leukocytes

Question 32

Human-mouse chimeric Mab that targets EGRF and is used in head and neck squamous cell carcinoma and KRAS-negative, EGFR-positive metastatic colorectal cancer

Answer 32

Cetuximab

Question 33

Cytokine that stimulates eosinophil proliferation

Answer 33

IL-5

Question 34

Interleukin that in produced by hematopoietic stem cells

Answer 34

IL-3

Question 35

Mab that binds to CD38, which is over-expressed in myeloma cells

Answer 35

Daratumumab

Question 36

A ganglioside D2-binding Mab approved for pediatric patients with high-risk neuroblastoma in combination with GM-CSF, IL-2 and 13-cis-retinoic acid

Answer 36

Dinutuximab

Question 37

Which of the following is an acute phase protein that activates complement pathway for the opsonization of microbes? A. Macrophage B. Pentraxin C. Collectin

Answer 37

B. Pentraxin (CRP)

Question 38

Cytokine that is also known as the T-cell growth factor

Answer 38

IL-2

Question 39

Cytokine that stimulates neutrophil chemotaxis

Answer 39

IL-8

Question 40

Mab targeting EGFR used for Squamous non-small cell lung CA in combination with gemcitabine and cisplatin

Answer 40

Necitumumab

Question 41

Treatment of relapsed multiple myeloma via antibody-dependent cell-mediated cytotoxicity (ADCC) after binding to SLAMF7 on myeloma cells

Answer 41

Elotuzumab

Question 42

Cell source (cells that releases) IFN-β

Answer 42

Fibroblasts

Question 43

Regulatory cytokine of Th2

Answer 43

IFN-γ

Question 44

Regulatory cytokine of Th1

Answer 44

IL-10

Question 45

Mab that blocks the cleavage of the complement protein C5

Answer 45

Eculizumab

Question 46

A prodrug of an inhibitor of pyrimidine synthesis that is approved only for RA

Answer 46

Leflunomide

Question 47

An active metabolite pyrimidine synthesis inhibitor that is approved for relapsing-remitting multiple sclerosis

Answer 47

Teriflumide

Question 48

Adenosine deaminase inhibitor that is used mainly as antineoplastic agent for lymphoid malignancies

Answer 48

Pentostatin

Question 49

Humanized IgG1 with a kappa chain that binds CD52 and is used for CLL that have failed with fludarabine therapy, and approved in the EU for RR-MS

Answer 49

Alemtuzumab

Question 50

Recombinant bi-specific trifunctional rat-mouse IgG hybrid mab that targets EpCAM and CD3

Answer 50

Catumaxomab

Question 51

Mab indicated for Glioblastoma multiform

Answer 51

Bevacizumab

Question 52

Cytotoxic agent that is useful in idiopathic thrombocytopenic purpura refractory to prednisone

Answer 52

Vincristine

Question 53

Profound AE of Pentostatin

Answer 53

lymphopenia

Question 54

Cytotoxic agent effectively used against acquired factor XIII antibodies and bleeding syndromes

Answer 54

Cyclophosphamide

Question 55

SEs of Muromonab-CD3 that resulted in its withdrawal from the market

Answer 55

Cytokine release syndrome and severe pulmonary edema

Question 56

Percent concentration of Rho (D) Ig solution of human IgG

Answer 56

15%

Question 57

After miscarriage, Rho (D) IgG treatment is recommended at ___ weeks of gestation

Answer 57

26-28 weeks

Question 58

Orphan drug for treating abdominal ascites in ovarian and gastric CA

Answer 58

Catumaxomab

Question 59

Human anti-mouse antibodies (HAMA) is generated in 4% of patients treated with:

Answer 59

Cetuximab

Question 60

Important SEs of Rituximab

Answer 60

Neutropenia and anemia

Question 61

The main adverse effect of Rituximab is countered by giving:

Answer 61

G-CSF for anemia and neutropenia

Question 62

This is a recombinant humanized monoclonal anti-body that targets all forms of VEGF-A. This antibody binds to and prevents VEGF-A from interacting with the target VEGF receptors. It is FDA approved as a first-line treatment for metastatic colorectal cancer in combination with any intravenous fluoropyrimidine-containing regimen and is now also approved in combination with chemotherapy for metastatic NSCLC and breast cancer.

Answer 62

Bevacizumab

Question 63

This is a monoclonal antibody directed against interleukin-13 which is used in the treatment of moderate-to-severe atopic dermatitis in patients requiring systemic therapy.

Answer 63

Tralokinumab