Before staing Infliximab in a 65-year-old gentleman for Inflammatory bowel disease, following test is done
Anti-TNF drugs (infliximab, adalimumab) are associated with an increased risk of infections, paicularly reactivation of latent tuberculosis and oppounistic fungal infections including disseminated histoplasmosis and coccidioidomycosis. It is recommended that patients have a purified protein derivative (PPD) or a QuantiFERON-TB gold test as well as a chest x-ray before initiation of anti-TNF therapy. Patients over 65 have a higher rate of infections and death on infliximab or adalimumab than those younger than 65 years of age.Ref: Harrison's 19e p1962
Colonoscopy
Mantoux test
ERCP
Liver biopsy
All India exam