Pharm Antivirals

25 Questions | By Chachelly | Updated: Mar 21, 2022 | Attempts: 603

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1.

The diagram below depicts a simplified pathway of the viral growth cycle: Which of the steps shown in the pathway is most likely inhibited by amantadine?
- A.
  
  A
- B.
  
  B
- C.
  
  C
- D.
  
  D
- E.
  
  E
- F.
  
  F
- G.
  
  G
- H.
  
  H
- I.
  
  I
2.

A 23-year-old man had recurrent genital herpes which was effectively treated each time by acyclovir. The patient asked his physician why the treatment was not able to prevent recurrence. Which of the following was most likely the answer of the physician?
- A.
  
  Acyclovir has a very short duration of action
- B.
  
  Recurrence is due to a new contact with infected partners
- C.
  
  Antiviral drugs have no effect on the latent state of viral diseases
- D.
  
  Recurrence is due to a hypersensitivity reaction to viral proteins
- E.
  
  Resistant to acyclovir is the rule after one cycle of therapy
3.

A 34-year-old woman reported to her physician a two-day history of genital burning pain that was worse during urination and accompanied by fever and malaise. Physical examination revealed multiple blisters and ulcerative lesions in the vaginal area. A presumptive diagnosis of herpes genitalis was made and an oral drug was prescribed. Which of the following steps of viral growth cycle was most likely inhibited by the prescribed drug?
- A.
  
  Attachment to the host cell
- B.
  
  Uncoating
- C.
  
  Penetration
- D.
  
  Transcription
- E.
  
  MRNA and protein synthesis
- F.
  
  Proteolytic cleavage
4.

A 31-year-old man with AIDS was recently diagnosed with cytomegalovirus pneumonia. The patient’s current medications included zidovudine, didanosine and saquinavir. An IV therapy with ganciclovir was started. Which of the following adverse effects could be most likely predicted from the concurrent administration of ganciclovir and the antiretroviral drugs?
- A.
  
  Anemia and neutropenia
- B.
  
  Retinal detachment
- C.
  
  Cataract
- D.
  
  Sexual dysfunction
- E.
  
  Hyperglycemia
- F.
  
  Lactic acidosis
5.

A 33-year-old woman with AIDS was recently diagnosed with cytomegalovirus retinitis. The ophthalmologist prescribed a drug that must be phosphorylated first by virusspecific enzymes, and then by host’s cell enzymes to become active. Which of the following drugs was most likely given?
- A.
  
  Foscarnet
- B.
  
  Ribavirin
- C.
  
  Ganciclovir
- D.
  
  Acyclovir
- E.
  
  Vidarabine
- F.
  
  Zidovudine
6.

A 43-year-old man with AIDS presented to his physician with a complaint of multiple painful ulcers in tongue and palate. Exfoliative cytology was done which led to the diagnosis of herpes simplex infection, and a therapy with oral acyclovir was initiated. Two weeks later no improvement was seen and the dose of the drug was increased but without success. Which of the following was most likely the cause of failure of acyclovir therapy?
- A.
  
  Mutation of aspartate protease
- B.
  
  Viral transpeptidase deficiency
- C.
  
  Viral thymidine kinase deficiency
- D.
  
  Viral neuraminidase deficiency
- E.
  
  Mutation of reverse transcriptase
7.

A 12-day-old, premature baby boy developed a poor feeding pattern, irritability and respiratory distress. His mother, who suffered several episodes of genital herpes, was admitted to labor with premature ruptures of the membranes. Physical examination of the baby revealed several small vesicular skin lesions located on the scalp and a dendritic keratitis was present on both eyes. Which of the following drugs was most likely included in the therapeutic treatment of this baby?
- A.
  
  Saquinavir
- B.
  
  Acyclovir
- C.
  
  Zidovudine
- D.
  
  Pentamidine
- E.
  
  Fluconazole
- F.
  
  Metronidazole
8.

A 74-year-old diabetic woman was brought to the emergency room with fever (102.7°F), shaking chills, cough, headache and malaise. Physical examination showed profound dyspnea and rales were audible on auscultation on both lungs. Chest x-ray showed bilateral infiltrates and blood gas analysis revealed significant hypoxia. A gram stain of the sputum showed no bacteria. Fluorescent antibodies identified influenza A virus on cells of nasal aspirates. An appropriate therapy was started which included a drug that acts by inhibiting viral uncoating. Which of the following drug was most likely prescribed?
- A.
  
  Foscarnet
- B.
  
  Ganciclovir
- C.
  
  Zidovudine
- D.
  
  Amantadine
- E.
  
  Cidofovir
- F.
  
  Indinavir
9.

A 34-year-man with AIDS was recently diagnosed with cytomegalovirus retinitis and a therapy with gancyclovir was started. Two weeks later the disease was not much improved and the ophthalmologist decided to add another drug that, unlike gancyclovir, can inhibit DNA polymerase directly without requiring activation by phosphorylation. Which of the following drugs was most likely prescribed?
- A.
  
  Acyclovir
- B.
  
  Lopinavir
- C.
  
  Ribavirin
- D.
  
  Foscarnet
- E.
  
  Trifluridine
- F.
  
  Nevirapine
10.

A 75-year-old patient was brought to the emergency room from a nursing home with chief complains of fever (102.8° F), cough, headache, malaise, anorexia and photophobia. Conventional antibiotic therapy was ineffective and three days later influenza virus was isolated from the sputum. Over the next week, three other nursing home patients developed similar symptoms. Vaccination and chemoprophylaxis were planned for all nursing home residents and staff. Which of the following drugs was most likely administered as a prophylactic measure?
- A.
  
  Acyclovir
- B.
  
  Foscarnet
- C.
  
  Ribavirin
- D.
  
  Ganciclovir
- E.
  
  Oseltamivir
- F.
  
  Zidovudine
11.

A 24-year old man visited his physician complaining of painful ulcers on his penis. Upon examination multiple rounded translucent vesicles were seen on the penis gland, intermixed with superficial, circular ulcers which were very painful to the touch. Regionallimphoadenopathy was also present. A preliminary diagnosis was made. Which of the following drugs was most likely prescribed for the treatment of the patient’s disorder?
- A.
  
  Penicillin G
- B.
  
  Doxycycline
- C.
  
  Metronidazole
- D.
  
  Acyclovir
- E.
  
  Ketoconazole
12.

A 5 year-old girl was admitted to the emergency room because of fever (102 F°) and disorientation in time and space. Soon after the admission the patient had a seizure. Ceftriaxone and dexamethasone were initiated but the next day the patient became lethargic and lapsed into a coma. Examination of the cerebrospinal fluid was normal and a CT scan of the brain revealed a decrease density in a small area of the right parietal lobe. Acyclovir IV was started and after 5 days of therapy the patient was alert, responsive and actively moving. The patient was most likely suffering from which of the following diseases?
- A.
  
  Neisseria meningitis
- B.
  
  Toxoplasma encephalitis
- C.
  
  Cryptococcal meningitis
- D.
  
  Cytomegalovirus encephalitis
- E.
  
  Herpes encephalitis
13.

A 23-year-old, heroin addicted man presented to the hospital complaining of severe fatigue and scleral icterus. Physical examination showed hepatomegaly and mild ascites. Significant laboratory findings were: total bilirubin 4.4 ng/mL, ALT 380 U/L, AST 320 U/L. Serologic tests were positive for hepatitis C virus infection. Which of the following pairs of drugs would be appropriate for this patient?
- A.
  
  Interferon-alpha and foscarnet
- B.
  
  Ribavirin and saquinavir
- C.
  
  Interferon-alpha and ribavirin
- D.
  
  Saquinavir and foscarnet
- E.
  
  Zidovudine and ganciclovir
- F.
  
  Ganciclovir and foscarnet
14.

A 71-year-old man was brought to the emergency room because of fever (103.2° F), chills, dyspnea, and generalized aches in the back and legs. Social history of the patient was significant for an outbreak of flu in the community. A clinical diagnosis of influenza was made and a treatment with oseltamivir was started. Which of the following actions most likely mediated the therapeutic effect of the drug in the patient?
- A.
  
  Prevention of virus release from infected cells
- B.
  
  Blockade of fusion of the virus with the host cell
- C.
  
  Inhibition of viral transcription
- D.
  
  Inhibition of viral proteolytic cleavage
- E.
  
  Inhibition of viral protein synthesis
15.

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.
  
  Transpeptidase
- B.
  
  DNA-polymerase
- C.
  
  Aspartate protease
- D.
  
  Reverse transcriptase
- E.
  
  Neuraminidase
- F.
  
  Integrase
16.

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.
  
  Hepatic cirrhosis
- B.
  
  Renal failure
- C.
  
  Hemolytic anemia
- D.
  
  Neutropenia
- E.
  
  Agranulocytosis
- F.
  
  Pancreatitis
17.

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.
  
  Raltegravir
- B.
  
  Lopinavir
- C.
  
  Amantadine
- D.
  
  Lamivudine
- E.
  
  Palivizumab
- F.
  
  Trastuzumab
18.

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.
  
  DNA-polymerase
- B.
  
  Phosphotransferase
- C.
  
  RNA-polymerase
- D.
  
  HIV Protease
- E.
  
  Thymidine-kinase
- F.
  
  Neuraminidase
19.

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.
  
  DNA-polymerase
- B.
  
  Phosphotransferase
- C.
  
  RNA-polymerase
- D.
  
  HIV Protease
- E.
  
  Thymidine-kinase
- F.
  
  Neuraminidase
20.

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.
  
  Amantadine
- B.
  
  Ribavirin
- C.
  
  Ganciclovir
- D.
  
  Lopinavir
- E.
  
  Gentamicin
- F.
  
  Doxycycline
21.

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.
  
  Enfuvirtide
- B.
  
  Saquinavir
- C.
  
  Amantadine
- D.
  
  Interferon alpha-2a
- E.
  
  Ganciclovir
- F.
  
  Foscarnet
22.

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.
  
  Lamivudine
- B.
  
  Entecavir
- C.
  
  Interferon alpha-2a
- D.
  
  Tenofovir
- E.
  
  Ribavirin
23.

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.
  
  Foscarnet
- B.
  
  Saquinavir
- C.
  
  Amantadine
- D.
  
  Zidovudine
- E.
  
  Trifluridine
24.

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.
  
  Entecavir
- B.
  
  Lopinavir
- C.
  
  Nevirapine
- D.
  
  Zidovudine
- E.
  
  Trifluridine
- F.
  
  Oseltamivir
25.

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.
  
  Gancyclovir
- B.
  
  Lopinavir
- C.
  
  Raltegravir
- D.
  
  Nevirapine
- E.
  
  Didanosine
- F.
  
  Lamivudine