Rheumatology: tocilizumab and inflammatory markers: practice question

A General Medicine 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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General Medicine · Rheumatology: tocilizumab and inflammatory markers

Sample item

A 70-year-old woman with giant cell arteritis on tocilizumab presents with fever and cough. Her CRP is normal, though chest radiograph shows lobar consolidation. What explains the normal CRP?

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

The answer and the reasoning

C. IL-6 blockade suppresses hepatic CRP production

Interleukin-6 drives hepatic synthesis of CRP. Tocilizumab blocks the IL-6 receptor, so CRP stays low even during serious infection. Clinical assessment must replace reliance on CRP in these patients.

Option by option

  • A. Tocilizumab destroys neutrophils

    Neutropenia can occur but does not explain a normal CRP.

  • B. Giant cell arteritis lowers acute phase proteins

    Active giant cell arteritis raises acute phase proteins.

  • C. IL-6 blockade suppresses hepatic CRP production (correct)

    Correct. The drug removes the stimulus for CRP production, masking infection.

  • D. Consolidation does not cause systemic inflammation

    Bacterial consolidation normally causes marked systemic inflammation.

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 General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, IL-6 blockade suppresses hepatic CRP production. Interleukin-6 drives hepatic synthesis of CRP.

Why is "Tocilizumab destroys neutrophils" not the answer?

Neutropenia can occur but does not explain a normal CRP.

Why is "Giant cell arteritis lowers acute phase proteins" not the answer?

Active giant cell arteritis raises acute phase proteins.

Why is "Consolidation does not cause systemic inflammation" not the answer?

Bacterial consolidation normally causes marked systemic inflammation.

What concept does this question test?

It tests Rheumatology: tocilizumab and inflammatory markers in General Medicine. Tocilizumab blocks the IL-6 receptor, so CRP stays low even during serious infection. Clinical assessment must replace reliance on CRP in these patients.

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 Rheumatology: tocilizumab and inflammatory markers?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.