March 31 - Micro

Question 1

Protease inhibitors: names, MOA, and ADRs

Answer 1

NAmes: all end in “-navir”
MOA: Prevent cleavage of gag and pol into functional units, preventing viral particle maturation
ADRs: increased lipids and hyperglycmeia, fat redistribution

Question 2

NRTIs: names, ADRs

Answer 2

Names: zidovudine, lamivudine, tenofovir, didanosine
ADRs: mitochondrial toxicity (inhibit DNA pol gamma); peripheral neuroatphy; bone marrow suppression; myopathy; pancreatitis; lactic acidosis

Question 3

NNRTIs: names, MOA, ADRs

Answer 3

Nevirapine, efavirenz, delavirdine
MOA: unlike NRTIs don’t require activation by phosphorylation. Not effective against HIV-2
ADRs: skin rash, metabolied by CYP

Question 4

Echinococcus granulosus

Answer 4

Tape worm that causes hyatid cysts. Associated with sheep and dog exposure. Often involves liver, causing encapsulated calcified cysts. Risk of anaphylaxis when treated surgically

Question 5

Helminth treatment

Answer 5

Intestinal roundworms: bendazoles or pyrantel pamoate

Flukes and tapeworms: praziquantel expect for echinococcus

Question 6

Typhoid fever presentation

Answer 6

Week 1: rising fever, bacteremia, bradycardia
Week 2: abdominal pain, rose spots on trunk and abdomen
Week 3: HSM, intestinal bleeding and perforation due to ulceration of Peyer’s patches

Question 7

Syphilis lesions in different stages

Answer 7

Primary: chancre (painless ulcer)
Secondary: chondyloma lata (large grey warts in genital region)
Tertiary: gummas (painless gray granulomatous lesions that can be cutaneous or visceral)

Question 8

Flucytosine

Answer 8

Inhibits fungal DNA replication and RNA synthesis

Question 9

Integrase inhibitors: names, ADR

Answer 9

Names: end in “-gravir”
ADR: myopathy

Question 10

Enfuvirtide

Answer 10

fusion inhibitor. Binds envelope protein gp41 inhibiting HIV fusion with target cell membrane

Question 11

Maraviroc

Answer 11

CCR5 antagonist. Inhibits HIV entry by blocking interaction betwee gp120 and CCR5

Question 12

drugs with anaerobic coverate

Answer 12

pip-taz, metronidazole, carbapenems, clindamycin

Question 13

Vitamine to supplement in measles

Answer 13

vitamin A

Question 14

LPS

Answer 14

Toxin released when gram neg cell wall destroyed. Consists of O antigen (used for typing), core polysaccharide, and lipid A (toxic component)

Lipid A activates macrophages and granulocytes leading to synthesis of inflammatory mediators and endogenous pyrogens