NAPLEX: Infectious Disease III Antifungals and Antivirals and OI

Question 1

Which electrolytes does Amp B affect

Answer 1

Decr K and Mg

Question 2

Which antifungal requires premedication with APAP, NSAID, or benadryl

Answer 2

Amp B (non lipid)

Question 3

Flucytosine is converted to

Answer 3

fluorouracil
(why it has immunosuppressive SE)

Question 4

Which med has a MOA of decr ergosterol synthesis

Answer 4

Azole Antifungals

Question 5

Fluconazole should not be used against which 2 fungi

Answer 5

C krusei
C Galbrata

Question 6

Treatment choice for aspergillosis

Answer 6

Voriconazole

Question 6

Which azole causes heart failure

Answer 6

itraconazole

Question 7

Which azole causes hepatotoxicity and liver transplant

Answer 7

ketocoazole

Question 8

Which azole causes visual changes and phototoxicity and incr scr

Answer 8

Voriconazole

Question 9

Which azole causes qt prolongation and incr LFTs

Answer 9

Fluconazole
(all risk though except Isavuconazonium shorten QT)

Question 10

IV to PO ration for all azoles

Answer 10

1:1

Question 11

Which azole requires renal dosing

Answer 11

Fluconazole

Question 12

Which azole causes shortened QT

Answer 12

Isavuconazonium

Question 13

All azoles are strong Cyp3A4 ______

Answer 13

inhibitors

Question 14

Which 2 azoles require an acidic gut for absorption

Answer 14

Ketoconazole and itraconazole (sporanox brand)

Question 15

Which antifungal inhibit the synthesis of beta 1,3 D-glucan

Answer 15

Echinocandins

Question 16

Which antifungals have a high incidence of histamine mediated symptoms

Answer 16

Echinocandins (micafungin and caspofungin)

Question 17

Terbinafine has a risk of which toxicity

Answer 17

Hepatotoxicity

Question 18

First line for Candida a oropharyngeal infection

Answer 18

Mild: topical clotrimazole or miconazole
Moderate or HIV: fluconazole

Question 19

First line for Candida albicans esophageal infection

Answer 19

Fluconazole

Question 20

First line for candida krusei or galbrata

Answer 20

Echinocandins

Question 21

First line for cyptococcus

Answer 21

5FU _ Amp B

Question 21

First line for all candida bloodstream infections

Answer 21

Echinocandins

Question 22

Neuramidase inhibitors drugs

Answer 22

Oseltamavir, zanamivir (inhaled)

Question 23

Tamiflu:
Frequency and duration for <12
Frequency and duration for >12 y/o

Answer 23

<12: BID, 5 days
>12: QD, 10 days

Question 24

Which antiviral is inhaled and should not be used with COPD, asthma, or other breathing problems

Answer 24

Zanamivir

Question 25

Which antiviral is dosed based off IBW even in obese patients

Answer 25

Acyclovir

Question 26

Shingrix is given at what age

Answer 26

50 or 19 and immuocomp

Question 27

Antiviral therapy should be started within ____ hours of shingles

Answer 27

72 hrs

Question 28

Which 2 meds treat CMV

Answer 28

Gancicovir
Valgancyclovir

Question 29

What dose and duration of steroids counts as “immunocompromised”?

Answer 29

greater or equal to 14 days,
greater or equal to 20mg/day
greater or equal to 2mg/kg/day

Question 30

Criteria for starting PJP prophylaxis

Answer 30

CD4 <200

Question 31

When to discontinue PJP proph

Answer 31

CD4 >200 x3 months

Question 32

First line for PJP proph and allergy

Answer 32

Bactrim
Ax: atovaquone,
Dapsone, or
Dapsone + Pyramethamine + leucovorin

Question 33

When to start Toxoplasmosis Proph

Answer 33

CD4 <100

Question 34

First line for Toxo Proph and Ax

Answer 34

Bactrim
Ax: Atovaquone or
Dapsone + Pyramethamine + leucovorin

NOT Dapsone alone

Question 35

When to start MAC prophylaxis

Answer 35

CD4 <50 and not on ART

Question 36

First line for MAC Proph

Answer 36

Azithromycin 1200mg qwk

Question 37

MAC treatment

Answer 37

Azithro + Ethambutol