Primer 15

Question 1

1. Most common cause of DIC
2. Most common heart murmur
3. Most common CA involved in thrombosis
4. Most common cause of death in SLE patients
5. Most common congenital heart anomaly

Answer 1

1. STOP MT 
(sepsis, trauma, obstetric comp., malignancy, transfusion)
2. Mitral valve prolapse 
3. LAD 
4. Renal failure (lupus nephropathy) 
5. VSD

Question 2

List 6 clinical manifestations of addison’s disease + its cause.

Answer 2

Autoimmune attack on adrenals–> Adrenal atrophy–>
LOW aldo, cortisol

1. Skin hyper-pigmentation
2. HypoTN
3. Weakness
4. Malaise
5. Anorexia
6. Weight loss

Question 3

Classic presentation of branchial cleft cyst?

Answer 3

Lateral neck mass anterior to SCM that does NOT move with swallowing

Question 4

What is the common ending of all protease inhibitors?

What is their MOA?

Answer 4

“-avir”
MOA:
Inhibit HIV1 protease + cleavage of HIV mRNA translation products–> STOP REPLICATION

Question 5

4 side effects shared by all protease inhibitors:

Answer 5

1. GI intolerance
2. Inhibit p450 (RITONAVIR)
3. Hyperlipidemia/ Hypertriglyceridemia
4. Lipodystrophy (buffalo hump)

Question 6

Specific side effects of Ritonavir

Answer 6

1. Inhibit p450–> BOOSTER of other antiHIVs

2. pancreatitis

Question 7

Which drugs cause nephropithiasis? What is their class?

Answer 7

1. Indinavir
2. Atazanavir
   * protease inhibitors*

Question 8

“A combination of di erent classes of medication used to attack the HIV at di erent points in its replication/infection cycle in order to control the infection and avoid resistance”

Answer 8

HAART!

Question 9

List 6 important NRTIs.

What is their mechanism?

Answer 9

zidovudine*
didanosine
lamivudine
abacavir
emtricitabine
tenofovir* (nucleoTide) 

COMPETATIVE inhibition of HIT RT–> STOP REPLICATION

Question 10

What do NRTIs require in order to become active?

Answer 10

phosphorylation by thymidine kinase

Question 11

Which drug cases bone marrow suppression?

Answer 11

Zidovudine (NRTI)

Question 12

Which drugs cause pancreatitis?

Answer 12

Didanosine»> Zalacitabine, Stavudine

NRITs

Question 13

Which drugs cause peripheral neuropathy?

Answer 13

Didanosine»> Zalacitabine, Stavudine

NRITs

Question 14

Which drugs cause hepatic steatosis?

Answer 14

Didanosine, Stavudine

NRTIs

Question 15

Which drug causes a life threatening hypersensitivity reaction?

Answer 15

Abacovir

Question 16

Which drug class is infamous for causing a RASH!?

Answer 16

NNRTIs

Question 17

Which drug is contraindicated in preggos?

Which drug is used to TREAT preggos who have not had antiretroviral therapy prior to delivery?

Answer 17

Efavirenz (NNRTI); Zidovudine (NRTI)

Question 18

What are the three most important side effects of Efavirenz?

Answer 18

1. Neuropsychiatric symptoms
   (nightmares, vivid dreams, dizziness, worsening depression)
2. False-positive drug test to cannabinoids
3. Teratogenic

Question 19

List 5 NNRTIs.

What is their MOA?

Answer 19

nevirapine
delavirdine
efavirenz
etravirine
rilpivirine

MOA: NONcompetative inhibition of HIV RT;
do NOT require thymidine kinase to work!

Question 20

Enfruvirtide:
MOA
2 ADRs

Answer 20

Binds GP41–> stops fusion of HIV to host cell

• -> stops infection
  1. Injection side nodules
  2. ^ risk bacterial pneumonia

Question 21

List the two integrase inhibitors:

Answer 21

1. Raitegravir

2. Elvitgravir

Question 22

List 3 ADRS associated with Raitegravir:

Answer 22

1. Nausea
2. Rash
3. Myopathy

Question 23

Maroviroc:
MOA
Stipulations of use?

Answer 23

Bind CCR5–> INHIBIT conformation of GP120

• -> Inhibit binding to host cell
• Patient must have 100% R5 infection in order to be used
• Tropism test must be done prior to initiating therapy

Question 24

Which drugs cause lactic acidosis?

Answer 24

NRTIs