Chemotherapy: checkpoint inhibitors: 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 · Chemotherapy: checkpoint inhibitors

Sample item

A melanoma patient on pembrolizumab develops profuse diarrhoea with colitis, and later thyroid dysfunction. Which is the best explanation and management?

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

The answer and the reasoning

B. Immune-related adverse events from PD-1 blockade, managed with corticosteroids and holding the drug

Pembrolizumab and nivolumab block PD-1, and ipilimumab blocks CTLA-4, releasing T-cell tolerance and causing immune-related colitis, hepatitis, pneumonitis and endocrinopathies. Moderate to severe events are treated with steroids and withholding the drug.

Option by option

  • A. Bacterial overgrowth treated with chemotherapy

    Antibiotic or chemotherapy is not the answer.

  • B. Immune-related adverse events from PD-1 blockade, managed with corticosteroids and holding the drug (correct)

    Correct. Immune-related events are treated with steroids.

  • C. Cytokine release treated with mesna

    Mesna has no role.

  • D. Direct drug cytotoxicity treated by increasing the dose

    The mechanism is immune, not cytotoxic.

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.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Immune-related adverse events from PD-1 blockade, managed with corticosteroids and holding the drug. Pembrolizumab and nivolumab block PD-1, and ipilimumab blocks CTLA-4, releasing T-cell tolerance and causing immune-related colitis, hepatitis, pneumonitis and endocrinopathies.

Why is "Bacterial overgrowth treated with chemotherapy" not the answer?

Antibiotic or chemotherapy is not the answer.

Why is "Cytokine release treated with mesna" not the answer?

Mesna has no role.

Why is "Direct drug cytotoxicity treated by increasing the dose" not the answer?

The mechanism is immune, not cytotoxic.

What concept does this question test?

It tests Chemotherapy: checkpoint inhibitors in Pharmacology. Moderate to severe events are treated with steroids and withholding the drug.

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 Chemotherapy: checkpoint inhibitors?

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.