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Infectious Disease > EXAM 4 review questions > Flashcards

EXAM 4 review questions Flashcards

1
Q

The three sites of action for current, preferred anti-Hep C agents are:

A

Protease inhibitors

NS5B and A inhibitors

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2
Q

____, is the oral, enhanced bioavailable and less frequently dosed prodrug of ganciclovir.

A

Valganciclovir

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3
Q

True or False?

Flucytosine is converted into 5-fluorouracil in the gastrointestinal tract due to bacteria conversion.

A

True

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4
Q

_______ is the HSV/VZV viral enzyme that performs the initial phosphorylation of acyclovir or penciclovir.

A

Thymidine kinase

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5
Q

_________ is/are the class(es) of antiretrovirals that is considered the most potent (requires the smallest amount of drug present to have the greatest impact on the host’s cell ability to replicate virus).

A. Protease inhibitor
B. Fusion inhibitor / Attachment inhibitor
C. Attachment inhibitor
D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor
E. Integrase inhibitor

A

E. Integrase inhibitor

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6
Q

_________ is/are the class(es) of antiretrovirals that work at the point in the viral life cycle where the virus is converting viral RNA into viral DNA.

A. Protease inhibitor
B. Fusion inhibitor / Attachment inhibitor
C. Attachment inhibitor
D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor
E. Integrase inhibitor

A

D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor

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7
Q

_______ is the antiretroviral that has an adverse event described as subcutaneous nodules secondary to injection site inflammatory response.

A

Enfuvitide

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8
Q

______, when occurring in neonates, requires high-dose acyclovir therapy as the infection in this population can result in death.

A. Herpes simplex virus 1 or 2 (HSV)
B. Varicella zoster virus (VZV)
C. Cytomegalovirus (CMV)
D. Hepatitis B (HepB)
E. Hepatitis C (HepC)
A

A. Herpes simplex virus 1 or 2 (HSV)

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9
Q

________, is the oral, enhanced bioavailable and less frequently dosed prodrug of penciclovir.

A

Famciclovir

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10
Q

Name 1 of 5 agents that work via inhibition of Hep C RNA-dependent RNA polymerase NS5A:

A 
Daclatasvir 
Ledipasvir 
Ombitasvir 
Elbasvir 
Velpatasvir
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11
Q

What class of antifungals inhibit nucleic acid synthesis?

A

Flucytosine

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12
Q

_____ is the nucleoside reverse transcriptase inhibitor (NRTI) that has an adverse event described as anemia related to accumulation of the monophosphate derivative.

A

Zidovudine

Retrovir

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13
Q

Up to 40% of patients receiving this antiviral for CMV can experience N/V/D?

A

Ganciclovir or valganciclovir

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14
Q

Provide the chemical reaction responsible for activating valganciclovir to ganciclovir

A

Deacetylation

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15
Q

Which enzyme is responsible for activating flucytosine?

A

Cytosine deaminase

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16
Q

________ mechanism of action actually involves 3 steps in the Hep B life cycle, making it unique among the Hep B oral agents.

A

Entecavir

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17
Q

______ is used for HIV but at a higher dose than is used for Hep B.

A

Lamivudine

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18
Q

What class of antifungals inhibit glucan synthesis?

A

Echinocandins

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19
Q

_________ is an antiviral, that is converted to its active form by host nucleotide triphosphates (not mediated by viral enzyme), inhibits CMV DNA polymerase, is nephrotoxic, is co-administered with probenicid to lessen toxicity (as probenicid decreases rate of tubular excretion) and extend the dosing interval and is primarily used for the treatment of cytomegalovirus infections.

A. Acyclovir
B. Ganciclovir
C. Cidofovir
D. Foscarnet
E. Oseltamivir
A

C. Cidofovir

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20
Q

_____ is the integrase inhibitor (INSTI) that is only available at a fixed dose combination with cobicistat

A

Elvitegravir

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21
Q

_________ is an anti-hepatitis antiviral that works by inhibiting HBV-polymerase via chain termination, as well as anti-HIV activity (inhibits HIV nucleoside reverse transcriptase), has few/no drug interactions, can be administered once daily with or without food, and has a benign adverse effect profile.

A. Lamivudine
B. Entecavir
C. Adefovir
D. PEG-interferon (alpha-2a or alpha-2b)
E. Ribavirin
A

A. Lamivudine

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22
Q

Which ‘-azole’ antifungal is associated with high rates of gastrointestinal adverse events?

A

Itraconazole

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23
Q

_________ is an antiviral, that does not require conversion to active form (either using viral or host enzymes), inhibits HSV, VZV and CMV DNA polymerase, can be used to treat resistant HSV and VZV, can accumulate in bone matrix and chelates calcium and magnesium resulting in hypocalcemia.

A. Acyclovir
B. Ganciclovir
C. Cidofovir
D. Foscarnet
E. Oseltamivir
A

D. Foscarnet

24
Q

_______ is the antiretroviral that has an adverse event described as hypersensitivity more likely to occur in persons who are HLA*B5701 positive.

A

Abacavir

25
Q

______, is used as an HSV antiviral when the virus has developed resistance to the drugs of choice.

A. acyclovir
B. ganciclovir
C. cidofovir
D. foscarnet
E. penciclovir
A

D. foscarnet

26
Q

_________ is/are the class(es) of antiretrovirals which has a mechanism of action that occurs prior to the virus entering the cell.

A. Protease inhibitor
B. Fusion inhibitor / Attachment inhibitor
C. Attachment inhibitor
D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor
E. Integrase inhibitor

A

B. Fusion inhibitor / Attachment inhibitor

27
Q

This antiviral is cleared via both glomerular filtration but also glomerular filtration and can cause renal toxicity as well as being directly toxic to mucocutaneous tissue at the site of elimination.

A

Foscarnet

28
Q

What class of antifungals inhibit ergosterol resulting in a hydrophilic pore and may also bind to human cholesterol?

A

Polyenes

29
Q

_______ is the antiretroviral that blocks gp120 binding to the chemokine co-receptor, CCR5.

A

Maraviroc

30
Q

Name 1 of 3 echinocandins

A

Caspofungin (Cancidas®)
Anidulafungin (Eraxis®)
Micafungin (Mycamine®)

31
Q

Cytosine deaminase is responsible for activation of what antifungal?

A

Flucytosine

32
Q

_______ is the protease inhibitor that is only available as a fixed dose combination with ritonavir.

A

Lopinavir/r

33
Q

_______ is an antiretroviral used exclusively for Hep B and can cause renal and bone toxicities

A

Adefovir dipivoxil

34
Q

In a person who is chronically infected with Hep B, what are the results of the HBV laboratory tests?

A

Only HBsAg + Anti-HBc = positive

35
Q

Hemolytic anemia is associated with this Hep C antiretroviral that is typically administered orally.

A

Ribavirin

36
Q

Which class of antifungals has the mechanism of action of inhibition of ß-(1,3) D-glucan synthase?

A

Echinocandins

37
Q

Reduction of N/V/D of 5-FC (flucytosine) can be accomplished by ______

A

Reducing the rate of administration

38
Q

__________ is pregnancy category X and 2 forms of birth control are to be used when this medication is being taken by a woman of child-bearing potential.

A

Ribavirn

39
Q

Name 1 of 3 agents that inhibit Hep C replication via binding to the hepatitis C protease enzyme:

A

Grazoprevir
Paritaprevir
Simeprevir

40
Q

________ mechanism of action is that it inhibits RNA polymerase activity and inhibits the initiation and elongation of RNA fragments resulting in inhibition of viral protein synthesis

A

Ribavirin

41
Q

_______ is the nucleoside reverse transcriptase inhibitor (NRTI) that has an adverse event described as hypopigmentation of the soles of the feet or palms of the hands.

A

Emtricitabine

42
Q

True or False?

Amphotericin B should not be administered within the same Y-site iv as solutions providing electrolytes such as potassium, magnesium and calcium.

A

True

43
Q

What class of antifungals bind to lanosterol 14a-demethylase inhibiting the production of ergosterol?

A

Azoles

44
Q

This antiviral is administered with probenecid to reduce the tubular secretion rate thus reducing the risk for renal toxicity:

A

Cidofovir

45
Q

_______ works as a host cytokine and has antiviral, antiproliferative and immunomodulatory effects. It is used for Hep B, Hep C and has been tried in numerous other viral conditions when no known therapeutic agent is known to work.

A

Interferon alpha 2 b (a is for Hep B)

46
Q

A 4-gram cumulative dose of the deoxycholate formulation of amphotericin is set due to the likelihood for irreversible __________ toxicity.

A

Renal

47
Q

Provide the enzyme that is responsible for activating valganciclovir to ganciclovir

A

Aldehyde oxidase

48
Q

______, is described in the slides as a nearly perfect antiviral drug in that it is specific to its target (HSV). It also has poor activity against CMV. It is a guanine derivative that undergoes initial phosphorylation by the virus and then is subsequently dephosphorylated by the host cell enzyme.

A. acyclovir
B. ganciclovir
C. cidofovir
D. foscarnet
E. penciclovir
A

A. acyclovir

49
Q

_______, is the CMV viral enzyme that performs the initial phosphorylation of ganciclovir.

A

CMV UL97 kinase
UL97 kinase
UL97 kinase phosphotransferase |

50
Q

_________ is/are the class(es) of antiretroviral that is considered the most effective (has the greatest impact on the amount of mature virus being produced by an infected cell).

A. Protease inhibitor
B. Fusion inhibitor / Attachment inhibitor
C. Attachment inhibitor
D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor
E. Integrase inhibitor

A

A. Protease inhibitor

51
Q

____, is the oral, enhanced bioavailable and less frequently dosed prodrug of acyclovir.

A

Valacyclovir

52
Q

Adequate hydration along with slow infusion rates reduces the renal tubule precipitation of what antiviral?

A

Acyclovir

53
Q

_________ is/are the class(es) of antiretrovirals which has/have a mechanism of action that occurs after the host cell has begun making copies of the virus.

A. Protease inhibitor
B. Fusion inhibitor / Attachment inhibitor
C. Attachment inhibitor
D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor
E. Integrase inhibitor

A

A. Protease inhibitor

54
Q

Name 1 of 2 agents that inhibit Hep C replication via inhibition of the HCV RNA-dependent RNA polymerase NS5B:

A

Sofosobuvir

Dasabuvir

55
Q

_________ is an anti-hepatitis antiviral that works by inhibiting multiple steps within HBV-polymerase activity, has no effect on HIV life cycle, must be dosed orally and with food, but has a similar side-effect profile compared to lamivudine.

A. Adefovir
B. Entecavir
C. Tenofovir
D. PEG-interferon (alpha-2a or alpha-2b)
E. Ribavirin
A

B. Entecavir

56
Q

_________ is an anti-hepatitis antiviral that works by inhibiting various steps within hepatitis B and C life cycle including translation, transcription, protein processing and maturation, impact major histocompatibility complex, can mediate tissue damage, must be dosed subcutaneously, is combined with polyethylene glycol to allow for extended dosing interval, and a side effect profile including depression, influenza-like illness, and psychiatric symptoms.

A. Adefovir
B. Entecavir
C. Tenofovir
D. PEG-interferon (alpha-2a or alpha-2b)
E. Ribavirin
A

D. PEG-interferon (alpha-2a or alpha-2b)

Infectious Disease (32 decks)

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