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PEBC > Virology > Flashcards

Virology Flashcards

1
Q

at what age can you use valacyclovir

A

12

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2
Q

how long to recover from HSV 1 primary vs recurrent infxn

A

primary = 1-3 wks
recurrent = 7-10d

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3
Q

how long to recover from primary vs secondary genital herpes

A

primary = 2-4wks
recurrent = 8-10dh

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4
Q

when shoudl you consider suppressive tx fro HSV2

A

if getting 6 or more recurrent episodes/ yr

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5
Q

for those with genital HSV in pregnancy, what should be done

A

if active outbreak or prodrome during delivery = c section

otherwise, start suppressive tx at 36wks with acyclovir or valacyclovir

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6
Q

what are the options for PrEP?

A

daily tenofovir DF or AF + emtricitabine or PRN 2 tabs 2-24hr before and 1 tab daily until 48 hrs fater

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7
Q

what are the options for nPEP

A

tenofovir DF/ emtricitabine + raltegravir or dolutegravir

tenofovir DF or AF/ emtricitabine + darunavir/ ritonavir

x28d

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8
Q

when might you get symptoms of HIV infection after exposure

A

2-6wks post exposure

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9
Q

which ARVs cause dyslipidemia

A

TAF, EFV (efavirenz), boosted PIs

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10
Q

which tenofovir causes more renal tubular dysfxn and bone mineral density loss

A

TDF

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11
Q

which NRTI causes hypersensitivity rxns

A

abacavir

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12
Q

name the NRTIs

A

LATTEZ
lamivudine, abacavir, tenofovir DF, AF, emtricitabine, ziidovudine

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13
Q

what do the INSTIs end with

A

-gravir

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14
Q

what do the PIs end with

A

-avir

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15
Q

which ARV increases metformin concentrations

A

bictegravir

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16
Q

which ARV class should be taken apart from cations

A

INSTIs

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17
Q

cobicistat inhibits which CYP enzyme

A

3A4

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18
Q

cobicistat is used to boost (3 drugs)

A

atazanavir, darunavir, elvitegravir

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19
Q

name the 4 initial recommended ARV regimens to start

A

TAF/FTC + BIC
ABC/3TF + DTG
TDF or TAF + FTC or 3TC + DTG
3TC + DTG (only if viral load <100k)

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20
Q

which ARV should be avoided until HLA is known

A

abacavir (HLA-B701)

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21
Q

which ARV should be taken with food

A

generally PIs, elvitegravir, dolutegravir

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22
Q

which NNRTI is preferred for use except in pregnancy

A

efavirenz

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23
Q

if pts CrCl <60, which AVR should be avoided?, which can be used if >30 or on dialysis

A

avoid TDF
can use TAF

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24
Q

which tenofovir is assocaited w/ renal tubular dysfxn

A

TDF

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25
Q

which ARTs should be avoided in psych illness

A

efavirenz and CVD: ABC, DRV, LPV/rilpivirine

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26
Q

which ARTs should be avoided in dyslipidemia

A

boosted PI, efavirenz, elvitegravir/ cobicistat

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27
Q

which tenofovir improves lipid levels

A

TDF

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28
Q

which ARTs should be used in hep B coinfection

A

tenofovir AF or DF + emtricitabine or lamivudine (tenofovir inhibits hepatitis)
then dd either PI + enhancer or INSTI or NNRT

29
Q

which parinatal ART should be started in infants born to HIV infected mothers

A

zidovudine

30
Q

which ART class lacks CYP interactions

A

INSTI

31
Q

if CD4<200, what should be started?

A

prophylaxis for PCP with TMP/SMX

32
Q

when should assessment of viral load be done after starting ART

A

2-8wks

33
Q

what is preferred regimen for pts trying to get pregnant with HIV

A

2NRTIs + ritonavir boosted PI or iNSTI, reserve fusion inhibitors for those who failed tx on other 1st line options

34
Q

what is the preferred tx for <200 CD4 or prophylaxis for PCP

A

TMP/SMX

35
Q

T or F: mothers with HIV can breastfeed

A

F- HIV can be transmitted through breastmilk

36
Q

what age is croup most common in

A

6mths-3yrs

37
Q

when should CS start working for croup

A

2-3hrs

38
Q

when should epi start working for croup, how long does it last

A

10 min, lasts 2hrs

39
Q

what croup severities require epi

A

severe only

40
Q

what is 1st line for high risk pt tx for covid

A

paxlovid x5d or remdesivir IV x2d

41
Q

if a patient is to use paxlovid, they must present within ____. If it is remdesivir, they must present within ____

A

5d for paxlovid, 7d for remdesivir

42
Q

what is the eGFR cut off for paxlovid and remdesivir

A

<30
<60 (paxlovid only 1 tab of nirmatrelvir)

43
Q

what is second line tx for mild covid

A

fluvoxamine x15d (w/in 7d) or budesonide x14d

44
Q

which CYP enzyme does ritonavir inhibit

A

CYP3A4 - effect lasts for 2 days after stopping (v strong)

45
Q

what are some common AEs of paxlovid

A

metallic taste, elevated BP, HA, muscle pain, N/V/D
long term hepatotoxicity w/ ritonavir

46
Q

T or F: remdesivir and paaxlovid are not safe in pregnancy

A

F- both are safe

47
Q

when do neuraminidase inhibitors have to be started? what is the usual treatment duration?

A

within 48hrs
treat for 5 days

48
Q

which patients should receive antiviral tx regardless of time since sx onset for influenzaa

A

Pts >1yr of age + chronic condition or immuncomp or other RF

Pts >65yrs in which influenza is strongly suspected

Pts requiring hospitalization

Serious, complicated, or progressive (regardless of pt’s previous health status)

49
Q

what is the 1st choice antiviral for influenza for most pts

A

oseltamivir x5d

50
Q

which neuraminidase inhibitor requires renal dosing adjustment

A

oseltamivir

51
Q

zanamivir may be used in influenza instead of oseltamivir if

A

pt >7yrs without lung issues + failed oseltamivir and no enteral access or has influenza B

52
Q

when is peramivir used in influenza

A

if =>18yrs and can’t inhale and has IV access

53
Q

which antivirals are used for influenza prophylaxis, for how long?

A

Oseltamivir 75mg daily (renal adjustment required) x10d
Zanamivir 10mg daily x10d
Baloxavir = same as tx once

54
Q

influenza vaccination is recommended in those _____ months old

A

> 6mths
6-23mths = cell culture inactivated type, otherwise IIV4-SD
=>65yrs = HD

55
Q

PEP and nPEP should be started within

A

72hrs

56
Q

what is preferred and alt tx for gonorrhea

A

ceftriaxone IM + azithromycin x1 dose (esp if pharyngeal or MSM)
cefixime IM + azithro ok if not MSM or pharyngeal

alt: azithro + gentamicin or ciprofloxacin
gentamicin + doxycycline

57
Q

which STIs is a test of cure recommended

A

gonorrhea, chlamydia, syphilis

58
Q

T or F: sexual partners of gonorrhea and chlamydia do not need to be treated

A

F- both need to be treated even if asymp (all partners w/in 60d)

59
Q

in gonorrhea and chlamydia, pt should abstain from sex for __________

A

7 d after tx started

60
Q

when is a test of cure recommended for chlamydia

A

if adherence concerns, alt tx needed, child abuse, pregnancy

61
Q

what is the preferred tx for chlmydia

A

azithromycin x1dose
docycycline x7d

62
Q

what is the alt tx for chlamydia if pt is pregnant

A

amoxicillin x7d
azithromycin x1dose

63
Q

how long should you abstain from sex after syphilis

A

7d after COMPLETING tx

64
Q

what is the preferred tx for pubic lice

A

permethrin 1%
mixed pyrethrins

65
Q

what is the preferred tx for scabies

A

permethrin 5% cream

66
Q

what is preferred tx for syphilis

A

benzathines penicillin G IM

alt: doxycycline or ceftriaxone

67
Q

what is preferred tx for CNS or ocular syphilis

A

penicillin G IV

68
Q
A

PEBC (9 decks)

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