2016 Interventional Immunology Pre-Test Question Title * 1. A 35 year-old female is seen for bloody bowel movements (4/day) and lower abdominal pain. She undergoes colonoscopy and is found to have redness and superficial ulceration from the anorectal junction to the descending colon. The remainder of the colon and the ileum are unremarkable. What is the diagnosis? Ulcerative colitis Crohn’s disease Irritable bowel syndrome Diverticulitis Question Title * 2. A 24 year-old male presents with right lower quadrant abdominal pain and watery stools. On colonoscopy, he is found to have focal ulcerations in the ascending colon and terminal ileum. What is the diagnosis? Ulcerative colitis Crohn’s disease Irritable bowel syndrome Diverticulitis Question Title * 3. C.D. is a 32 year-old male recently diagnosed with ileal Crohn’s disease. He presented with abdominal pain, diarrhea, iron-deficiency anemia, and weight loss and has been characterized as having moderate-severe disease. Which treatment regimen has been associated with the greatest response rate in patients such as C.D.? Mesalamine (5-ASA) Azathioprine (thiopurine) Infliximab (anti-TNF) Infliximab and azathioprine Question Title * 4. Why targeting kinases was not considered a feasible therapeutic approach? There are only few kinases in the genome. There are too many kinases in the genome. Kinases utilize ATP and this is also used in many other biochemical events. The ATP binding pocket of kinases is not easily accessible. Question Title * 5. Which other kinases, besides the JAKs, are currently under investigation for immunosuppressive therapy Among the most actively researched targets Syk and the PI3Kinase pathway appear to be the most promising. Drugs targeting MAP kinases such as p38 are no longer being investigated for the treatment of autoimmune diseases. The B cell receptor pathway and the tyrosine kinase BTK are currently investigated as target for the development of immunosuppressants. Several other kinases, not only tyrosine kinases, are being pursued. All of the above Question Title * 6. Why is targeting RORt has the potential to be efficacious in the treatment of inflammatory diseases? Because this transcription factor is activated by IL-17 Because RORt is critical for the development of Th17 cells Because is downstream of the T cells receptor? Because is critical for the development of Th1 cells Question Title * 7. Which of the following is a limitation of CAR T cells as therapy for cancer? CAR constructs must be HLA-matched CARs require the target antigen to be expressed on the tumor cell surface Target antigen must be expressed at high levels Need for frequent or continuous dosing Question Title * 8. What are some of the factors that have made immunotherapy successful recently? Antibodies that block inhibitory checkpoints Technology improvements to engineer T cells Treatment of patients with advanced disease Exclusion of patients who have low blood counts A and B Question Title * 9. Which of the following scenarios is most likely to result in immediate cytokine release syndrome? 70 year old male with chronic lymphocytic leukemia with bulky lymphadenopathy and no lymphocytosis receiving a CD19-directed CAR T cell 10 year old male with relapsed acute lymphoblastic leukemia with 80% blasts in the marrow receiving a CD19-directed CAR T cell 52 year female with ovarian cancer with extensive metastatic deposits receiving a mesothelin-directed CAR T cell 28 year old female with relapsed acute lymphoblastic leukemia with minimal residual disease. Question Title * 10. Which of the following designs allow use of data from neighboring dose levels 3+3 Continual Reassessment Method Two-stage Futility Question Title * 11. Which one of the following is true about subgroup analysis? It is not subject to type 1 error problems It is not subject to type 2 error problems You can make strong causal statements when not prespecified Is appropriate when pre-specified and there is sufficient power Question Title * 12. When would using a biomarker NOT be appropriate? To obtain an early read on efficacy To select patients likely to respond To get a higher response rate by biomarker compared to the clinical outcome To exclude patients unlikely to respond Done