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1. Diagnosis of common variable immunodeficiency (CVID) includes the presence of which of the following in addition to an age older than 2 years:

A. Poor vaccine response and serum immune globulin levels 2 standard deviations below the mean for the age B. Mood dysfunction and intermittent hyperglycemia C. Gastrointestinal disease and poor vaccine response D. Serum immune globulin levels 2 standard deviations below the mean for age and mood dysfunction

2. For patients with severe combined immunodeficiency, treatment with intravenous immunoglobulin (IVIG) after hematopoietic stem cell transplant is typically necessary for patients with which of the following characteristics:

A. Febrile neutropenia B. Graft-versus-host disease C. Acute renal failure D. Inadequate B-cell function

3. U.S. Food and Drug Administration (FDA)-approved indications account for approximately how much of the IVIG use in the United States?

A. 5% to 15% B. 20% to 30% C. 40% to 50% D. 70% to 80%

4. Secondary immunodeficiencies include which of the following:

A. Common variable immunodeficiency B. Wiskott-Aldrich syndrome C. Chronic lymphocytic leukemia D. Kawasaki disease

5. Which of the following immune deficiencies is routinely treated with immune globulin:

A. Human Immunodeficiency Virus (HIV) B. Immunoglobulin A (IgA) deficiency C. Common variable immune deficiency D. Neutropenia

6. Which of the following stabilizing agents is most associated with causing acute renal failure (ARF):

A. Glycine B. Sucrose C. Proline D. Saline

7. Which of the following adverse events occurs most commonly after immune globulin infusion:

A. Hepatitis C infection B. Aseptic meningitis C. Headache D. Hyperlipidemia

8. Polyvalent immune globulin preparations used for treatment of primary immunodeficiency disorder (PIDD) are mainly composed of which of the following:

A. IgA B. IgG C. IgM D. IgE

9. When managing a patient with immunodeficiency, IVIG should be dosed according to which of the following:

A. Clinical response and Serum IgG trough levels B. Ideal body weight and serum platelet levels C. Serum IgG levels trough levels and ideal body weight D. Serum platelet levels and clinical response

10. Which of the following impurities are found in immune globulin products:

A. Live viruses B. Cytokines C. Red blood cells D. Mycobacterium

11. Which of the following is an FDA-approved indication for treatment with immune globulin:

A. PIDD B. Graft-versus-host disease C. Idiopathic cardiomyopathy D. Focal segmental glomerulosclerosis

12. Which of the following immune globulin stabilizing agents can show falsely elevated blood glucose reading when tested with glucose dehydrogenase pyrroloquinoline quinone (GDH-PQQ) methodology:

A. Glycine B. Proline C. Maltose D. Glucose

13. Stabilizing agents are added to immune globulin preparations for which of the following reasons?

A. Prevent molecule aggregation B. Increase the half-life C. Reduce thrombotic risk D. Inhibit hemolysis

14. At high doses (1 to 2gm/kg) immune globulin treatments have which of the following desired therapeutic effects?

A. Vasodilatory B. Anticoagulation C. Immunomodulatory D. Prokinetic

15. Which of the following serious reactions can occur when IgA is administered to patients with IgA deficiency and anti-IgA antibodies:

A. Hyperglycemia B. Diarrhea C. Anaphylaxis D. Hypertension

16. Proinflammatory effects of immune globulin include which of the following:

A. Complement activation B. Downregulation of B lymphocytes C. Binding to histamine receptors D. Helper T-cell inhibition

17. Anti-inflammatory effects of immune globulin include which of the following;

A. Activation of superantigens B. Elimination of autoreactive B lymphocytes C. Release of cytokines D. Memory T-cell activation

18. The most common dose range of immune globulin administered monthly for patients with immunodeficiency is best described as which of the following:

A. 0.1 to 2 g/kg B. 0.3 to 0.6 g/kg C. 1 to 2 g/kg D. 4 to 5 g/kg

19. Which of the following stabilizing agents are added to immune globulin products:

A. Interferon B. Hydroxyethyl starch C. Cytokines D. Amino acids

20. Important laboratory monitoring parameters after a high dose sucrose-stabilized immune globulin infusion (e.g., 2 g/kg over 2 days) in a patient with blood type A include which of the following:

A. Hemoglobin and serum creatinine B. Serum calcium and prothrombin time C. Prothrombin time and hemoglobin D. Serum creatinine and calcium