skip to main content

Troponin ICI Myocarditis — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

HardLung CancerTroponin ICI MyocarditisSCE Medical Oncology

A patient receiving ipilimumab–nivolumab develops confusion, temporal-lobe seizures and CSF lymphocytosis. HSV PCR is initially pending; bacterial studies are unrevealing. Severe immune-mediated encephalitis is strongly suspected. After urgent infectious cover and neurology input, which immunosuppressive regimen is guideline-concordant?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Use methylprednisolone 1 g daily for 3–5 days plus IVIG 2 g/kg over 5 days

For severe ICI encephalitis, ASCO guidance supports pulse methylprednisolone 1 g IV daily for three to five days plus IVIG 2 g/kg over five days. Empirical antiviral treatment continues until HSV is excluded. Anticonvulsants treat seizures but not the immune process; infliximab is not the first-line encephalitis regimen and immunotherapy is held.

Reference: ASCO clinical practice guideline: management of immune-related adverse events. https://pmc.ncbi.nlm.nih.gov/articles/PMC6481621/