DMARDs: anti-TNF screening: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · DMARDs: anti-TNF screening

Sample item

A patient with rheumatoid arthritis in India is about to begin infliximab. Which pre-treatment evaluation is essential?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Screening for latent and active tuberculosis

TNF-alpha is crucial for granuloma maintenance, so blockade can reactivate latent tuberculosis, a major concern in high-burden countries. Screening with history, chest imaging and tuberculin or interferon-gamma release assay precedes therapy.

Option by option

  • A. HLA-B*5701 testing

    HLA-B*5701 testing is for abacavir.

  • B. Baseline slit-lamp examination for corneal deposits

    Corneal deposits are associated with amiodarone and chloroquine.

  • C. Screening for G6PD deficiency

    G6PD testing is relevant to dapsone, primaquine and rasburicase.

  • D. Screening for latent and active tuberculosis (correct)

    Correct. Reactivation of tuberculosis is the key risk of anti-TNF agents.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Screening for latent and active tuberculosis. TNF-alpha is crucial for granuloma maintenance, so blockade can reactivate latent tuberculosis, a major concern in high-burden countries.

Why is "HLA-B*5701 testing" not the answer?

HLA-B*5701 testing is for abacavir.

Why is "Baseline slit-lamp examination for corneal deposits" not the answer?

Corneal deposits are associated with amiodarone and chloroquine.

Why is "Screening for G6PD deficiency" not the answer?

G6PD testing is relevant to dapsone, primaquine and rasburicase.

What concept does this question test?

It tests DMARDs: anti-TNF screening in Pharmacology. Screening with history, chest imaging and tuberculin or interferon-gamma release assay precedes therapy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study DMARDs: anti-TNF screening?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.