Exam 4 - HIV Stahelin (ChatGPT made these) Flashcards
What is meant by the genetic barrier to resistance in the context of HIV treatment?
A) The ability of the virus to mutate and become resistant to a single drug
B) The number of mutations required for the virus to become resistant to a drug
C) The effectiveness of a drug in preventing viral replication
D) The ability of the immune system to recognize and destroy the virus
B) The number of mutations required for the virus to become resistant to a drug
Which step in the HIV life cycle is targeted by nucleoside reverse transcriptase inhibitors (NRTIs)?
A) Viral entry into host cells
B) Integration of viral DNA into the host genome
C) Reverse transcription of viral RNA into DNA
D) Assembly and maturation of new virions
C) Reverse transcription of viral RNA into DNA
How are nucleoside reverse transcriptase inhibitors (NRTIs) activated metabolically before they can inhibit the enzyme?
A) They are phosphorylated to their triphosphate form by cellular kinases
B) They are cleaved by viral proteases
C) They are methylated by host enzymes
D) They are acetylated by viral enzymes
A) They are phosphorylated to their triphosphate form by cellular kinases
Which structural feature differentiates nucleoside analogues from normal nucleosides used by reverse transcriptase?
A) Lack of a 3’ hydroxyl group
B) Presence of a 5’ phosphate group
C) Addition of a methyl group at the 2’ position
D) Presence of a double bond in the sugar ring
A) Lack of a 3’ hydroxyl group
What is the role of the HLA-B*5701 polymorphism in the hypersensitivity reaction caused by abacavir?
A) It increases the drug’s efficacy
B) It reduces the drug’s side effects
C) It is associated with a higher risk of hypersensitivity reaction
D) It enhances the drug’s absorption
C) It is associated with a higher risk of hypersensitivity reaction
Which NRTI is known for having a longer half-life due to its unique activation pathway?
A) Abacavir
B) Emtricitabine
C) Tenofovir alafenamide
D) Lamivudine
C) Tenofovir alafenamide
Which class of drugs inhibits the integration of HIV DNA into the host genome?
A) NRTIs
B) NNRTIs
C) Integrase inhibitors
D) Protease inhibitors
C) Integrase inhibitors
Which NNRTI is associated with severe hepatotoxicity and rash, including Stevens-Johnson syndrome?
A) Nevirapine
B) Efavirenz
C) Delavirdine
D) Etravirine
A) Nevirapine
How do non-nucleoside reverse transcriptase inhibitors (NNRTIs) inhibit reverse transcriptase?
A) By competing with nucleotides for binding
B) By binding to a hydrophobic pocket near the catalytic site
C) By phosphorylating the enzyme
D) By cleaving the enzyme
B) By binding to a hydrophobic pocket near the catalytic site
Which structural feature allows HIV integrase inhibitors to inhibit the enzyme?
A) Chelation of divalent metal ions
B) Binding to the active site of reverse transcriptase
C) Inhibition of viral entry
D) Blocking the protease cleavage site
A) Chelation of divalent metal ions
Which protease inhibitor is known for making extensive hydrogen bonds with the protease backbone, reducing the impact of resistance mutations?
A) Atazanavir
B) Darunavir
C) Tipranavir
D) Ritonavir
B) Darunavir
What is the mechanism by which HIV can become resistant to reverse transcriptase inhibitors?
A) Mutations in the protease gene
B) Mutations in the reverse transcriptase gene
C) Increased drug efflux
D) Enhanced drug metabolism
B) Mutations in the reverse transcriptase gene
Which drug is used as a pharmacokinetic booster to increase the serum concentrations of other protease inhibitors?
A) Abacavir
B) Cobicistat
C) Tenofovir
D) Lamivudine
B) Cobicistat
Which adverse effect is commonly associated with the use of protease inhibitors boosting?
A) Nephrotoxicity
B) Neurotoxicity
C) Hyperlipidemia
D) Hepatotoxicity
C) Hyperlipidemia
Which NRTI is known for causing a hypersensitivity reaction in some patients, particularly those with the HLA-B*5701 polymorphism?
A) Tenofovir
B) Emtricitabine
C) Abacavir
D) Lamivudine
C) Abacavir
How does HIV become resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs)?
A) By increasing drug efflux
B) By mutations in the NNRTI binding site on reverse transcriptase
C) By enhancing drug metabolism
D) By altering the viral envelope
B) By mutations in the NNRTI binding site on reverse transcriptase
Which integrase inhibitor is known for having a long plasma half-life and does not require boosting?
A) Elvitegravir
B) Dolutegravir
C) Raltegravir
D) Bictegravir
B) Dolutegravir
What is the primary mechanism by which protease inhibitors block HIV protease activity?
A) By binding to the active site and preventing substrate cleavage
B) By inhibiting viral entry into host cells
C) By blocking reverse transcription
D) By preventing integration of viral DNA into the host genome
A) By binding to the active site and preventing substrate cleavage
Which NRTI is a deoxyguanosine analog?
A) Tenofovir
B) Emtricitabine
C) Lamivudine
D) Abacavir
D) Abacavir
Which enzyme is responsible for the phosphorylation of NRTIs to their active triphosphate form?
A) Viral protease
B) Cellular kinases
C) Viral integrase
D) Cellular phosphatases
B) Cellular kinases
What is the primary mechanism of action for integrase inhibitors?
A) Inhibition of viral entry
B) Inhibition of reverse transcription
C) Inhibition of protease activity
D) Inhibition of integration of viral DNA into the host genome
D) Inhibition of integration of viral DNA into the host genome
Which integrase inhibitor is part of the combination drug Biktarvy?
A) Elvitegravir
B) Dolutegravir
C) Raltegravir
D) Bictegravir
D) Bictegravir
Which protease inhibitor is a non-peptidomimetic? (slide 46)
A) Atazanavir
B) Darunavir
C) Tipranavir
D) Ritonavir
C) Tipranavir
Which NRTI is known for its effectiveness in combination with emtricitabine?
A) Abacavir
B) Lamivudine
C) Stavudine
D) Tenofovir
D) Tenofovir
Which NNRTI has a long half-life and is taken once daily?
A) Nevirapine
B) Efavirenz
C) Delavirdine
D) Etravirine
B) Efavirenz
Which integrase inhibitor does not interact with CYP3A4 and has a higher barrier for resistance?
A) Elvitegravir
B) Raltegravir
C) Bictegravir
D) Dolutegravir
D) Dolutegravir
Which NRTI is a deoxycytidine analog? (2 answers)
A) Tenofovir
B) Emtricitabine
C) Lamivudine
D) Abacavir
B) Emtricitabine
C) Lamivudine
Which protease inhibitor is used in combination with cobicistat to boost its concentration?
A) Atazanavir
B) Darunavir
C) Tipranavir
D) Elvitegravir
D) Elvitegravir
Which integrase inhibitor is part of the combination drug Genvoya?
A) Elvitegravir
B) Dolutegravir
C) Raltegravir
D) Bictegravir
A) Elvitegravir
