hivfin Flashcards
SATA
Which of the following processes are involved in the antifungal action of flucytosine?
a) Inhibition of ergosterol biosynthesis
b) Inhibition of cytosine deaminase
c) Action of fungal enzyme for drug permeation
d) inhibition of DNA synthesis
e) Inhibition of fungal RNA synthesis
dukh
c) Action of fungal enzyme for drug permeation
d) inhibition of DNA synthesis
e) Inhibition of fungal RNA synthesis
Famciclovir:
a) Blocks formation of preintegration complex (PiC), transfer of HIV cDNA to host DNA &repair of gaps formed during strand transfer
b) Adenosine nucleoside triphosphate analog, the active metabolite interferes with viral RNA-dependent RNA polymerase
c) Prodrug of penciclovir - nucleoside analog DNA polymerase inhibitor used for the treatment of recurrent cold sores and genital herpes in healthy & HIV patients, and to manage herpes zoster.
d) Noncompetitively inhibits reverse transcriptase Foscarnet
e) Competitively inhibit reverse transcriptase causing chain termination after incorporation
into viral DNA. To be active they need to be phosphorylated intracellularly
dukh
c) Prodrug of penciclovir - nucleoside analog DNA polymerase inhibitor used for the treatment of recurrent cold sores and genital herpes in healthy & HIV patients, and to manage herpes zoster.
Side effects of ribavirin include:
a) Hypersensitivity, rashes, hepatotoxicity, fever, stevens-johnson syndrome
b) Pancreatitis, altered taste, paresthesias
c) Anemia, marrow suppression, teratogenic
d) NVD, elevated LFT’s/hepatotoxicity, dyscrasias
e) Hypersensitivity, dizziness, hepatic, psychiatric (delusions/hallucinations)
dukh
c) Anemia, marrow suppression, teratogenic
TP is a 53 yo female with diabetes who is admitted to the general medical ward for community-acquired pneumonia. The patient has an allergy to penicillin and cefazoline (bronchospasm) but has no other known allergies and no other significant past medical history. Which of the following would be the most appropriate empiric intravenous treatment of this patient’s pneumonia in the hospital?
a) Ceftriaxone plus azithromycin
b) Levofloxacin
c) Doxycycline
d) ampicillin/sulbactam plus azithromycin
therapeutics
a) Ceftriaxone plus azithromycin
Flucytosine
a) Forms membrane pores binding to ergosterol
b) Inhibit squalene epoxidase
c) Inhibit lanosterol 14 alpha demethylase
d) Inhibits RNA & DNA synthesis
e) Inhibit 1,2 beta glucan synthase
dukh
d) Inhibits RNA & DNA synthesis
SATA
MP is a 23 year old male recently diagnosed with HIV who has never been on antiretrovirals. His
current viral load is 176,864 copies/ml and CD cell count is 38 cells/mm3 (confirmed with a
repeat lab test). Three months ago when he was first diagnosed, his viral load was 108,654 and
his CD4 cell count was 106 cells/mm3. He has a genotype that demonstrates no antiretroviral
resistance and has no abnormal physical exam or lab findings (an HLAB-5701 lab test has not
been collected). He has no complaints and states that he feels well. He does not drink alcohol,
smoke or use illicit drugs. Other than his recent HIV diagnosis (risk factor MSM) he reports no
other significant PMH, NDKA (no known drug allergies) and is on no medications. He presents to
your clinic today stating that he is willing to do whatever is recommended with regard to his
antiretroviral treatment (ART) because he wants to manage his HIV appropriately. He is ready to
commit to initiating any treatment if this is appropriate .
Which of the following statements is true regarding opportunistic infection prophylaxis for MP at this time?
a) He does not require opportunistic infection prophylaxis at this time
b) He should be initiated on azithromycin, 1200mg po weekly, for the prevention of MAC
c) He should be initiated on Trimethoprim-Sulfamethoxazole, 1DS tab po daily, for prevention of PCP and toxoplasma infection
d) He should be initiated on Acyclovir for the prevention of herpes simplex
conry- therapeutics
b) He should be initiated on azithromycin, 1200mg po weekly, for the prevention of MAC
c) He should be initiated on Trimethoprim-Sulfamethoxazole, 1DS tab po daily, for prevention of PCP and toxoplasma infection
PG is a 26 year old female in her first trimester of pregnancy who develops ‘walking pneumonia’.
She has a penicillin allergy (angioedema) and is otherwise healthy. Which of the following oral
therapies would be most appropriate to treat her on an outpatient basis? (note: local resistance rate to all agents listed is <10%)
a) Doxycycline
b) Azithromycin
c) Levofloxacin
d) Amoxicillin
etzel- therapeutics
b) Azithromycin
Chloroquine
a) Inhibit electron transport chain and folate synthesis Atovaquone
b) Inhibit formation of hemozoin from heme, free heme lyses membranes
c) Inhibits nucleic acid, phospholipid and protein synthesis
d) Inhibit merozoite invasion, binds to a heme forming a complex toxic to the parasite
b) Inhibit formation of hemozoin from heme, free heme lyses membranes
JT is a 45yo, 70kg prison guard, who is diagnosed with active pulmonary tuberculosis and is placed on a 4 drug regimen of INH 300mg po daily, Rifampin 600 po mg daily, Ethambutol 1600mg daily and Pyrazinamide 1500mg po daily. After one month of therapy the patient complains of “blurred vision” and difficulty distinguishing colors. This adverse effect is most likely attributed to which of the following?
a) Pyrazinamide
b) Ethambutol
c) Rifampin
d) Isoniazid
b) Ethambutol
14) Isoniazid
a) Inhibits alanine racemase and d-ala-d-ala ligase
b) Inhibit messenger RNA synthesis
c) Inhibit mycobacterial growth, binding preferentially to mycobacterial DNA
d) Inhibits mycolic acid synthesis
e) Prodrug leading to inhibition of mycolic acid synthesis
d) Inhibits mycolic acid synthesis
Cycloserine
a) Inhibits mycolic acid synthesis
b) Inhibits mycobacterial growth, binding preferentially to mycobacterial DNA
c) Inhibit messenger RNA synthesis
d) Inhibits alanine racemase and d-ala-d-ala ligase
e) Prodrug leading to inhibition of mycolic acid synthesis
d) Inhibits alanine racemase and d-ala-d-ala ligase
Which of the following statements regarding the antiviral drug foscarnet is correct?
- Is a pyrophosphate analog
- Needs phosphorylation by viral thymidine kinase
- Inhibits viral DNA polymerase
- Gets deposited in the bones
a) Only 2,3,4 are correct
b) All of the statements are correct (1,2,3,4)
c) Only 1,3,4 are correct
d) Only 1,2,4 are correct
e) Only 1,2,3 are correct
c) Only 1,3,4 are correct
Divalent metal ions have a pharmacodynamic drug interaction with the following drug
a) Abacavir
b) Cobicistat
c) Amphotericin
d) Ritonavir
e) Dolutegravir
e) Dolutegravir
A pharmacist should counsel HIV-infected patients to take which of the following antiretrovirals on an empty stomach when they are being initiated on therapy?
a) Atripla (efavirenz/tenofovir disoproxil fumarate/emtricitabine)
b) Triumeq (dolutegravir/abacavir/lamivudine)
c) Stribild (elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate)
d) Genvoya (elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide)
a) Atripla (efavirenz/tenofovir disoproxil fumarate/emtricitabine)
Side effects of Saquinavir (Invirase), Lopinavir, Ritonavir (Norvir), Fosamprenavir, Indinavir (Crixivan), Atazanavir, Nelfinavir (Viracept), Tipranavir, Amprenavir include:
a) Hypersensitivity, rashes, hepatotoxicity, fever, Stevens-Johnson syndrome
b) Anemia, marrow suppression, teratogenic
c) Pancreatitis, altered taste, paresthesias
d) Hypersensitivity, dizziness, hepatic, psychiatric (delusions/hallucinations)
e) NVD, elevated LFT’s, hepatotoxicity, dyscrasias
c) Pancreatitis, altered taste, paresthesias
TB is the 4th leading cause of infectious disease deaths worldwide. Primary infection occurs in the lungs where a chronic inflammatory lesion, a granuloma, walls of the tubercle bacillus and prevents spread. However, the live but dormant TB can become
reactivated and spread to become cavitary tuberculosis and spread systemically to produce military TB. During this reactivation, the patient can be highly infectious to others.
Which of the following can increase the risk of TB reactivation? (Choose all that apply)
a) AIDS
b) Malnutrition
c) Age
d) Immunosuppressive therapy
e) Cancer
a) AIDS
b) Malnutrition
c) Age
d) Immunosuppressive therapy
e) Cancer
Amphotericin
a) Inhibits DNA & RNA synthesis
b) Forms membrane pores binding to ergosterol
c) Inhibit 1,2 beta glucan synthase
d) Inhibit lanosterol 14 alpha demethylase
e) Inhibit squalene epoxidase
b) Forms membrane pores binding to ergosterol
chlamydia is the most common sexually transmitted infectious disease. Which of the following may occur with a chlamydia infection? Choose all that apply.
a) Infection may be asymptomatic
b) Infection may lead to pelvic inflammatory disease
c) Infection may lead to ectopic pregnancy
d) Infection may ascend to the upper genital tract
e) Infection may lead to infertility
a) Infection may be asymptomatic
b) Infection may lead to pelvic inflammatory disease
c) Infection may lead to ectopic pregnancy
d) Infection may ascend to the upper genital tract
e) Infection may lead to infertility
A patient is diagnosed with an initial C.difficile infection. His Scr is 2.3mg/dL and WBC is 21,000 cells/mL. He is otherwise clinically stable. Which of the following is correct?
a) The patient has severe C.diff and should be treated with vancomycin 125 mg POq6h
b) The patient has severe C.diff and should be treated with a vancomycin pulsed-tapered regimen Only for recurrence
c) The patient has non-severe C.diff and should be treated with a vancomycin pulsed-tapered regimen
d) The patient has non-severe C.diff and should be treated with vancomycin 125 mg PO q6h
a) The patient has severe C.diff and should be treated with vancomycin 125 mg POq6h
Which of the following respiratory pathogens is spread through aerosolized droplets?
Choose all that apply.
a) TB
b) Legionella pneumophila
c) HIV
d) Streptococcus Pyogenes
e) SARS-CoV2 (COVID-19)
a) TB
b) Legionella pneumophila
d) Streptococcus Pyogenes
e) SARS-CoV2 (COVID-19)
Which of the following antiretroviral regimens should prompt a pharmacist to question/contact the prescriber due to an inappropriate combination of antiretrovirals for an antiretroviral-naive patient?
a) Tivicay (Dolutegravir) + Descovy (tenofovir alafenamide/emtricitabine)
b) Tivicay (Dolutegravir) + Truvada (tenofovir disoproxil fumarate/emtricitabine)
c) Crixivan (Indinavir) + low dose Norvir (Ritonavir) + Emtriva (Emtricitabine) + Epivir (Lamivudine)
d) Isentress (Raltegravir) + Descovy (tenofovir alafenamide/emtricitabine)
c) Crixivan (Indinavir) + low dose Norvir (Ritonavir) + Emtriva (Emtricitabine) + Epivir (Lamivudine)
CV is a 57 year old male grade-school teacher with diabetes and poorly controlled asthma. He develops fever, chills, coughing, myalgia, and fatigue for one-day duration. CV is diagnosed with influenza. At this time, which of the following agents would be considered he best option for the outpatient (ambulatory) management of his influenza?
a) Inhaled oseltamivir
b) Not therapy is indicated at this time
c) Oral oseltamivir
d) Intravenous Paramivir
c) Oral oseltamivir
Pentamidine
a) Inhibit merozoite invasion, binds to heme forming a complex toxic to the parasite
b) Inhibit formation of hemozoin from heme, free heme lyses membranes
c) Inhibit electron transport chain and folate synthesis
d) inhibits nucleic acid, phospholipid and protein synthesis
d) inhibits nucleic acid, phospholipid and protein synthesis
MP is a 23 year old male recently diagnosed with HIV who has never been on antiretrovirals. His current viral load is 176,864 copies/ml and CD cell count is 38 cells/mm3 (confirmed with a repeat lab test). Three months ago when he was first diagnosed, his viral load was 108,654 and his CD4 cell count was 106 cells/mm3. He has a genotype that demonstrates no antiretroviral resistance and has no abnormal physical exam or lab findings (an HLAB-5701 lab test has not been collected). He has no complaints and states that he feels well. He does not drink alcohol, smoke or use illicit drugs. Other than his recent HIV diagnosis (risk factor MSM) he reports no other significant PMH, NDKA (no known drug allergies) and is on no medications. He presents to your clinic today stating that he is willing to do whatever is recommended with regard to his antiretroviral treatment (ART) because he wants to manage his HIV appropriately. He is ready to commit to initiating any treatment if this is appropriate.
Which of the following antiretroviral combinations is the most appropriate and recommended regimen for MP at this time based on current HIV treatment guidelines?
a) Odefsey (Rilpivirine/tenofovir alafenamide/emtricitabine)
b) Complera (Rilpivirine/tenofovir disoproxil fumarate/emtricitabine)
c) Triumeq (dolutegravir/abacavir/lamivudine)
d) Tivicay (Dolutegravir) + Descovy (tenofovir alafenamide/emtricitabine)
d) Tivicay (Dolutegravir) + Descovy (tenofovir alafenamide/emtricitabine)
Atovaquone
a) Inhibits nucleic acid, phospholipid and protein synthesis
b) Inhibit merozoite invasion, binds to heme forming a complex toxic to the parasite
c) Inhibit formation of hemozoin from heme, from heme lyses membranes
d) Inhibit electron transport chain and folate synthesis
d) Inhibit electron transport chain and folate synthesis
LJ is a 23 year old male presenting to clinic for his routine STD screen. His last screen, 6 months ago, was negative for all STDs. In the past 6 months, LJ reports having multiple male and female sex partners and inconsistent condom use. He states that he has a painless ulcer on his penis X (can’t read) number of weeks ago but feels fine otherwise. Results from his current screen come back as follows: Chlamydia (+), Gonorrhea (+), Syphilis (+), HIV (-). Which of the following is the most appropriate treatment recommendation for LJ?
a) Azithromycin 1g PO x 1 dose + benzathine penicillin 2.4MU x 3 doses
b) Ceftriaxone 1g IM x 1 dose + azithromycin 1g PO x 1 dose
c) Cefixime 400 mg PO x 1 dose + benzathine penicillin 2.4 MU x 1 dose
d) Ceftriaxone 1g IM x 1 dose + azithromycin 1g PO x 1 dose + benzathine penicillin 2.4 MU x 1 dose
e) Ceftriaxone 1g IM x 1 dose + azithromycin 1g PO x 1 dose + benzathine penicillin 2.4 MU x 3 doses
d) Ceftriaxone 1g IM x 1 dose + azithromycin 1g PO x 1 dose + benzathine penicillin 2.4 MU x 1 dose
Which of the following statements is true regarding the use of PrEP?
a) PrEP is indicated for HIV negative patients with a recent exposure to HIV and is administered for 28 days after the exposure.
b) PrEP consists of a antiretroviral treatment regimen that consists of three antiretrovirals from at least two different pharmacological classes.
c) PrEP should be taken on a daily basis by the patient to maximize it’s efficacy and the patient should have repeat HIV testing every three months while taking PrEP
d) all
c) PrEP should be taken on a daily basis by the patient to maximize it’s efficacy and the patient should have repeat HIV testing every three months while taking PrEP
LL is a 23 year old sexually active female reporting dysuria, urinary frequency, and abnormal vaginal discharge. Upon testing, she is diagnosed with Gonorrhea. Her pregnancy test is negative and she has no known drug allergies. Which of the following recommendations is most appropriate for LL?
a) Initiate ceftriaxone 250mg IM in a single dose plus azithromycin 1g PO in a single dose
b) Initiate azithromycin 1g PO in a single dose
c) Initiate cefixime 400mg PO in a single dose plus azithromycin 1g PO in a single dose
d) Initiate gentamicin 240mg IM in a single dose
a) Initiate ceftriaxone 250mg IM in a single dose plus azithromycin 1g PO in a single dose
Which of the following statements regarding NRTI’s is true?
a) Most NRTI’s are hepatically eliminated thus require dosage adjustment for hepatic insufficiency
b) Most NRTI’s are renally eliminated thus require dosage adjustment for renal insufficiency
c) The NRTI’s have poor bioavailability thus should be administered with food
d) No dosage adjustment is needed for renal or hepatic insufficiency
b) Most NRTI’s are renally eliminated thus require dosage adjustment for renal insufficiency
Which of the following is the most likely infectious agent in diaper rash?
a) Toxoplasma gondii
b) Coccidioides immitis
c) Candida albicans
d) Aspergillus fumigatus
e) Cryptococcus neoformans
c) Candida albicans
Aspiration pneumonia is generally polymicrobial and is caused by Streptococcus pneumonia and oral anaerobes. Which of the following oral medications are best suited to treat community acquired aspiration pneumonia?
a) Ciprofloxacin
b) Vancomycin
c) Amoxicillin/clavulanic acid
d) Daptomycin
c) Amoxicillin/clavulanic acid
Which of the following infections in a pregnant women can infect her child in utero and produce a range of similar birth defects and lesions, including microcephaly and cerebral calcifications,
known as TORCH complex? Choose all that apply.
a) Herpes virus
b) Cytomegalovirus
c) Toxoplasmosis
d) Zika virus
e) Rubella
a) Herpes virus
b) Cytomegalovirus
c) Toxoplasmosis
d) Zika virus
e) Rubella
Which of the following antifungal drugs belongs to echinocandins and inhibits glucan synthesis?
a) Griseofulvin
b) Terbinafine
c) Flucytosine
d) Micafungin
e) Nystatin
d) Micafungin
Side effects of oseltamivir (Tamiflu), zanamivir (Relenza) include:
a) Anemia, marrow suppression, teratogenic
b) NVD, elevated LFT’s/hepatotoxicity, dyscrasias
c) Hypersensitivity, rashes, hepatotoxicity, fever, stevens-johnson syndrome
d) Pancreatitis, altered taste, paresthesias
e) Hypersensitivity, dizziness, hepatic, psychiatric (delusions/hallucinations)
e) Hypersensitivity, dizziness, hepatic, psychiatric (delusions/hallucinations)
Ribavirin
a) Guanosine nucleoside used to treat some forms of Hepatitis C. Inhibits replication of DNA & RNA viruses. Inhibits inosine monophosphate dehydrogenase, reducing GTP
b) Blocks HIV protein gp120 from interacting with receptor, prevents entry
c) Inhibits viral DNA polymerase, RNA polymerase and Reverse Transcriptase
d) Neuraminidase inhibitor
a) Guanosine nucleoside used to treat some forms of Hepatitis C. Inhibits replication of DNA & RNA viruses. Inhibits inosine monophosphate dehydrogenase, reducing GTP
Foscarnet
a) Guanosine nucleoside used to treat some forms of Hepatitis C. Inhibits replication of DNA & RNA viruses. Inhibits inosine monophosphate dehydrogenase, reducing GTP
b) Blocks HIV protein gp120 from interacting with receptor, prevents entry
c) Inhibits viral DNA polymerase, RNA polymerase and Reverse Transcriptase
d) Neuraminidase inhibitor
c) Inhibits viral DNA polymerase, RNA polymerase and Reverse Transcriptase
Which of the following patients should NOT be initiated on HIV antiretroviral therapy based upon the information provided at the present time?
a) 32 year old patient recently diagnosed HIV positive whose CD4 count is 50 cells/mm3 and whose viral load (HIV-RNA) is 192,000 copies/ml.
b) 29 year old patient recently diagnosed HIV positive whose CD4 count is 480 cells/mm3 and whose viral load (HIV-RNA) is 3,423 copies/ml.
c) 25 year old patient recently diagnosed HIV positive whose CD4 count is 350 cells/mm3 and whose viral load (HIV-RNA) is 124,000 copies/ml who states they are completely unwilling to start or adhere to therapy at this time
d) 22 year old patient recently diagnosed HIV positive.
c) 25 year old patient recently diagnosed HIV positive whose CD4 count is 350 cells/mm3 and whose viral load (HIV-RNA) is 124,000 copies/ml who states they are completely unwilling to start or adhere to therapy at this time
terbinafine, naftifine
a) Forms membrane pores binding to ergosterol
b) Inhibit squalene epoxidase
c) Inhibit 1,2 beta glucan synthase
d) Inhibits RNA & DNA synthesis
e) Inhibit lanosterol 14 alpha demethylase
b) Inhibit squalene epoxidase
A 41 year old female patient wants to learn about the different vaccines, she is currently taking immunosuppressive therapy for her kidney transplant. Which of the following is likely to be contraindicated in such patient?
a) Inactivated vaccine
b) Live attenuated vaccine
c) Toxoid
d) Conjugate Vaccine
b) Live attenuated vaccine
MP is a 23 year old male recently diagnosed with HIV who has never been on antiretrovirals. His current viral load is 176,864 copies/ml and CD cell count is 38 cells/mm3 (confirmed with a
repeat lab test). Three months ago when he was first diagnosed, his viral load was 108,654 and his CD4 cell count was 106 cells/mm3. He has a genotype that demonstrates no antiretroviral
resistance and has no abnormal physical exam or lab findings (an HLAB-5701 lab test has not been collected). He has no complaints and states that he feels well. He does not drink alcohol,
smoke or use illicit drugs. Other than his recent HIV diagnosis (risk factor MSM) he reports no other significant PMH, NDKA (no known drug allergies) and is on no medications. He presents to
your clinic today stating that he is willing to do whatever is recommended with regard to his antiretroviral treatment (ART) because he wants to manage his HIV appropriately. He is ready to
commit to initiating any treatment if this is appropriate.
Which of the following represents the most appropriate assessment of MP
a) Antiretroviral naive, HIV positive male with current opportunistic infection who is ready P’s current state of to initiate ART
b) Antiretroviral naive, HIV positive male with unstable and uncontrolled HIV infection that has progressed to AIDS and who is ready to initiate ART
c) Antiretroviral experienced, HIV positive male with unstable and uncontrolled HIV infection that has progressed to AIDS and who is ready to initiate ART
d) Antiretroviral naive, HIV positive male with stable and controlled HIV infection that has not yet progressed to AIDS and who is ready to initiate ART
b) Antiretroviral naive, HIV positive male with unstable and uncontrolled HIV infection that has progressed to AIDS and who is ready to initiate ART