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USMLE Step 1 > HIV > Flashcards

HIV Flashcards

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USMLE® Step 1 flashcards
1
Q

What HIV surface glycoprotein helps dock to CD40?

A

gp120

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2
Q

There are two main tropic types of HIV, what are they? What are the co-receptors associated with each?

A 
X4 = CXCR4 co-receptor when gp120 binds CD40
R5 = CCR5 co-receptor
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3
Q

What are the three structural genes in HIV? What does each encode?

A

env codes for gp120 and gp41
gag codes for the capsid
pol codes for the RT, protease, and integrase

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4
Q

This HIV surface protein is involved with viral fusion and entry into host cells:

A

gp41

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5
Q

T/F: HIV has a diploid genome.

A

T. Has 2 molecules of RNA.

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6
Q

Criteria for the diagnosis of AIDS (3):

A
  1. CD4 count < 200, or
  2. HIV + with AIDS-defining condition, or
  3. CD4 / CD8 ratio < 1.5 (eg <14% of T cells are CD4+
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7
Q

This HIV test has a high sensitivity.

This HIV test has a high specificity.

A

ELISA is highly sensitive (will catch all true positives).

W. blot is highly specific (will remove all the false positives).

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8
Q

When might you choose to get an HIV viral load?

A
  1. For patients in the window period of HIV infection (1-2 months post-exposure)
  2. For newborns born to HIV infected mothers
  3. To monitor treatment response
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9
Q

This HIV glycoprotein is needed to attach to a host CD4+ T cell:

A

gp120

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10
Q

What is dual tropism?

A

Tropism is the preference of some HIV viruses for certain co-receptors when gp120 binds to host cells. This is tropism. Dual tropism is when a virus can bind both.

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11
Q

What happens if a person is homozygous for a mutation in CCR5? Heterozygous?

A

Homozygotes are immune to infection with HIV R5. Heterozygotes may have a slowed course of disease.

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12
Q

What drugs constitute HAART?

A 
You need:
2 NRTIs (= NRTI backbone) +
1 other drug (nNRTI or protease inhibitor or integrase inhibitor
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13
Q

Which class of HIV drugs end in -navir?

A

The protease inhibitors.

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14
Q

There is one NtRTI. What is it? What is special about this drug?

A

Tenofovir. It does not need to be activated by phosphorylation, unlike the NRTIs, which do.

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15
Q

This drug is used for prophylaxis in newborns and in occupational exposures:

A

Zidovudine

AZT = ZDV

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16
Q

Drugs that contain -vudine belong to which class of HIV meds?

A

NRTIs

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17
Q

Drugs that contain -vir- belong to which class of HIV meds?

A

NNRTIs

18
Q

This drug is an integrase inhibitor:

A

Raltegravir

19
Q

Main side effect of protease inhibitors:

A

GI intolerance.

20
Q

This class of HIV meds can cause lactic acidosis:

A

NRTIs

21
Q

These HIV medications tend to cause rash:

A

NNRTIs

22
Q

These two HIV medications cause pancreatitis:

A

Didanosine = ddI (NRTI)

Raltegravir (integrase inhibitor)

23
Q

Can you name the 3 NNRTIs:

A

NeVIRapine
EfaVIRenz
DelaVIRdine

24
Q

Seven Protease inhibitors:

A 
LopiNAVIR
AtazaNAVIR
DaruNAVIR
FosampreNAVIR
SaquiNAVIR
RitoNAVIR
IndiNAVIR
25
Q

This class of HIV meds can inhibit CYP 450:

A

Protease inhibitors

26
Q

This HIV drug class can cause bone marrow suppression:

A

NRTIs, NNRTIs

27
Q

What kind of medication is Raltegravir?

A

Integrase inhibitor

28
Q

This HIV med is famed for causing some pretty gnarly neuropsych side effects:

A

Efavirenz (NNRTI)

29
Q

This HIV medication can cause peripheral neuropathy:

A

Didanosine = ddI (NRTI)

30
Q

What side effect do these two medications, ddI and raltegravir, share in common?

A

Both can cause pancreatitis

31
Q

This HIV medication can be given only to people with R5 viruses:

A

Maravaroc

32
Q

What is the mechanisim of action of Enfuvitide?

A

Enfuvitide binds viral gp41 and prevents viral fusion with host cells.

33
Q

This drug is a very last resort medication for people with drug issues or resistance to all known drugs. Why?

A

Enfuvitide, a gp41-binder, it is available in injectible form only and is $$$ costly.

34
Q

Mechanism of action of Maravaroc:

A

Binds CCR5, prevents HIV’s gp120 from docking with host cells. Works against R5 viruses.

35
Q

Lipodistrophy is a side effect of which class of HIV meds?

A

Protease inhibitors

36
Q

GI intolerance is a side effect of which class of HIV meds?

A

Protease inhibitors

37
Q

This HIV drug can cause a fatal hypersensitivity reaction:

A

Abacavir

Abracadabra! You’re dead!

38
Q

This HIV drug can cause a rise in bilirubin:

A

Atazanavir

39
Q

This class of HIV meds causes rash:

A

NNRTIs

40
Q

This HIV med causes both peripheral neuropathy and lactic acidosis:

A

ddI = didanosine

USMLE Step 1 (18 decks)

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