1.
A 71-year-old woman was admitted to the hospital with a 2-day history of progressive
dyspnea, fever, cough and wheezing. Chest radiograph was normal but a bronchoscopy
showed marked erythema of the trachea and bronchi, with multiple ulcerations. A
bronchial biopsy confirmed the diagnosis of herpetic tracheobronchitis. The patient
received IV acyclovir for 3 days but no improvement was seen. Resistance to acyclovir
was suspected and an alternative drug was given IV. Which of the following drugs was
most likely administered?
A. 
B. 
C. 
D. 
E. 
2.
A 35-year-old man visited an ophthalmologist because of a foreign body sensation,
lacrimation, photophobia and blurred vision in his left eye. Eye examination showed a
conjunctival hyperemia and a branched lesion of corneal epithelium with terminal bulbs,
swollen border and a central ulcer. A presumptive diagnosis was made and a topical
therapy with eye drops was ordered. Which of the following drugs was most likely
prescribed?
A. 
B. 
C. 
D. 
E. 
F. 
3.
A 56-year-old man suffering from viral hepatitis B had started a treatment with
interferon alpha-2a, but nine month later he was still HBeAg positive. The
gastroenterologist decided to stop interferon and start another drug. Which of the
following drugs was most likely prescribed?
A. 
B. 
C. 
D. 
E. 
F. 
4.
A 41-year-old woman with AIDS started a highly active antiretroviral therapy with
lamivudine, abacavir and efavirenz. Which of the following adverse effects could most
likely occur during the therapy?
A. 
B. 
C. 
D. 
E. 
F. 
5.
A 31-year-old HIV positive man was found to have a CD4 lymphocyte count of 122
cell/mm at the last control visit. A 3 HAART (Highly Active Antiretroviral Therapy) was
started which included a drug that does not require phosphorylation to be active. Which
of the following is an antiretroviral drug with this property?
A. 
B. 
C. 
D. 
E. 
F. 
6.
A 34-year-old pregnant woman at term was admitted to the hospital for delivery. The
woman had a long history of AIDS and was following a HAART therapy (ritonavir +
lamivudine + tenofovir). An oral dose of nevirapine was given to the woman at the onset
of labor. Which of the following statements best explains the reason for this
administration?
A. 
To potentiate the ongoing antiretroviral therapy
B. 
To decrease the toxicity of ritonavir in the newborn
C. 
To prevent drug-induced respiratory depression in the newborn
D. 
To prevent HIV transmission in the newborn
E. 
To decrease the toxicity of lamivudine in the newborn
7.
A 61-year-old woman suffering from viral hepatitis B was admitted to the hospital for a
follow up examination. She was found to have >105 HBV DNA copies/mL and ALT of 210
U/L (normal <20). A therapy with entecavir was prescribed. The inhibition of which of the
following viral enzymes most likely mediated the therapeutic effect of the drug in the
patient’s disease?
A. 
B. 
C. 
D. 
E. 
F. 
8.
A 23-year-old woman with AIDS came to the hospital complaining of floating spots in
her vision and difficulty in reading. Funduscopic examination revealed the presence of
alternating areas of hemorrhagic tissue and fluffy, white patches in the proximity of
retinas of both eyes consistent with hemorrhagic retinitis. Which of the following drugs
was most likely prescribed for the treatment of the patient’s ocular disorder?
A. 
B. 
C. 
D. 
E. 
F. 
9.
A 34-year-old man presented to the hospital with jaundice and complaints of
incapacitating fatigue and vague intermittent abdominal pain for the past month. The
patient had a history of IV drug abuse and of alcohol abuse. Hepatitis serologic tests
were positive for HBsAg. Which of the following drugs would be appropriate for this
patient?
A. 
B. 
C. 
D. 
E. 
F. 
10.
A 35-year-old man with AIDS presented to the clinic for a follow up visit. He was
concerned because he noticed a growth on his neck. He has been following a Highly
Active Antiretroviral Therapy (HAART) for 4 months. Physical examination disclosed an
accumulation of fat on his upper back. Pertinent lab results were: total cholesterol 380
mg/dL, triglycerides 420 mg/dL, blood glucose 240 mg/dL. All lab values were within
normal limits before starting the HAART. Which of the following pairs of drugs most likely
caused the signs and the lab values of this patient?
A. 
B. 
C. 
D. 
Zidovudine and lamivudine
E. 
11.
A 35-year-old man with AIDS started a therapy which included a lopinavir/ritonavir
combination. Which of the following statements best explains the main reason of this
combination regimen?
A. 
Lopinavir prevents ritonavir resistance
B. 
Lopinavir inhibits ritonavir metabolism
C. 
Lopinavir enhances ritonavir intestinal absorption
D. 
Ritonavir prevent lopinavir resistance
E. 
Ritonavir inhibits lopinavir metabolism
F. 
Ritonavir enhances lopinavir intestinal absorption
12.
A 38-year-old woman suffering from chronic hepatitis B started a treatment with a
drug that is able to inhibit several steps of hepatitis B virus replication including
uncoating, early transcription, translation, assembly and release. Which of the following
drugs was most likely administered?
A. 
B. 
C. 
D. 
E. 
13.
A 54-year-old man with AIDS was found to have a CD4 lymphocyte count of 110
cell/mm at the last control visit. The patient had an extensive hi 3 story of treatment with a
variety of drug regimens without sustained clinical benefit. He was currently taking
zalcitabine, lamivudine and efavirenz. The physician decided to add to another drug that
acts by blocking the insertion of reversed-transcribed HIV DNA into the chromosomes of
the host cells. Which of the following drugs was most likely prescribed?
A. 
B. 
C. 
D. 
E. 
F. 
14.
A 32-year-old woman visited her physician complaining of some very painful blisters
on her abdomen. Physical examination showed localized blisters on her left abdomen
consistent with a varicella-zoster infection. A drug therapy was started. Which of the
following enzymes was most likely inhibited by the administered drug?
A. 
B. 
C. 
D. 
E. 
F. 
15.
A 72-year-old man was admitted to the hospital with one week history of fever, night
sweats and shortness of breath. Blood exams on admission were notable for hemoglobin
10 g/dL and creatinine 3.2 mg/dL. Physical examination showed decreased lung sounds
bilaterally. A viral culture from bronchoalveolar lavage was positive for HSV and a therapy
with IV acyclovir was started. The patient was at increased risk of developing which of the
following adverse effects as a result of this therapy?
A. 
B. 
C. 
D. 
E. 
F. 
16.
A 5-month-old baby girl born prematurely at 31weeks’ gestation was found to have
bronchopulmonary dysplasia that needed oxygen use. Recently a respiratory syncytial
virus outbreak occurred in the community and the pediatrician decided to order a drug to
prevent the RSV infection. Which of the following drugs was most likely prescribed?
A. 
B. 
C. 
D. 
E. 
F. 
17.
A 31-year-old woman with a two year history of AIDS reported of watery, bloody
diarrhea for approximately two weeks with accompanying abdominal pain. A colon biopsy
revealed cytomegalovirus inclusions in the colonic mucosa. An IV therapy was started.
Which of the following viral enzymes was most likely inhibited by the administered drug?
A. 
B. 
C. 
D. 
E. 
F. 
18.
A 35-year-old HIV positive man presented to the hospital for a follow up visit. His CD4
lymphocyte count was found 350 cells/mm3. An HAART (Highly Active Antiretroviral
Therapy) was initiated. Which of the following triple drug regimen was most likely used?
A. 
Flucytosine + acyclovir + saquinavir
B. 
Didanosine+ ganciclovir +zidovudine
C. 
Vidarabine + foscarnet +didanosine
D. 
Ribavirin + saquinavir + zidovudine
E. 
Zidovudine + didanosine + saquinavir
19.
A 44-year-old man was recently found HIV positive and started a highly active
antiretroviral therapy (HAART) with two nucleoside reverse transcriptase inhibitors (NRTI)
and one protease inhibitor (PI). Which of the following two steps in the HIV growth cycle
were specifically affected by this drug regimen?
A. 
B. 
C. 
Transcription and binding
D. 
Transcription and assembly
E. 
20.
A 34-year-old man recently diagnosed with AIDS was found to have a viral load of
185000/copies mL during a control visit. The patient had been following a highly active
antiretroviral therapy with efavirenz, stavudine, lopinavir saquinavir and raltegravir for five
months. A lab test indicated a mutation in the gene encoding the reverse transcriptase
enzyme. Which of the following pairs of antiretroviral drugs most likely became
ineffective because of the development of resistance?
A. 
B. 
C. 
Raltegravir and stavudine
D. 
E. 
Raltegravir and saquinavir
F.