MEDICOLOGY

Tuesday, August 2, 2022

Antiviral Drugs MCQs. 82

01. 30-year-old male patient with human immuno- deficiency virus infection is being treated with a HAART (highly active antiretroviral therapy) regimen. Four weeks after initiating therapy, he presents to the emergency department complaining of fever, rash, and gastrointestinal upset. Which one of the following drugs is most likely the cause of his symptoms?
A. Zidovudine
B. Nelfinavir
C. Abacavir
D. Efavirenz
E. Darunavir

Answer: C. Abacavir

02. Which one of the following drugs has hypersensitivity reaction characterised by fever, rash, & GI upset?
A. Zidovudine
B. Nelfinavir
C. Abacavir
D. Efavirenz
E. Darunavir

Answer: C. Abacavir

03. Which of the following statements about NRTIs is wrong?
A. Treat HIV
B. Inhibit HIV reverse transcriptase 
C. Analog of native ribosides
D. Lack a 3-hydroxyl group 
E. None of these 

Answer: E. None of these 
Ribosides( nucleotides or nucleosides containing ribose)

04. Which of the following statements about NRTIs is wrong after entery into the cell?
A. Phosphorylated to triphosphate by cellular enzyme 
B. Triphosphate analog incorporated into viral DNA by RT
C. No bond between nucleoside triphosphate & growing DNA 
D. 3-5-phosphodiester bond not form due to lack of hydroxyl 
E. DNA chain elongation is increased 

Answer: E. DNA chain elongation is increased 
DNA chain elongation is terminated because there is not 3-hydroxyl group is present so no 3-5-phosphodiester bond is fromed between incoming nucleoside triphosphate and the growing DNA chain. 

05. Which of the following statements about Tenofovir is wrong?
A. Available as Tenofovir disoproxil fumerate (TDF)
B. Available as Tenofovir alafenamide (TAF)
C. Convert to Tenofovir diphosphate by lymphoid enzyme 
D. Tenofovir diphosphate is active from
E. TAF has less activity than TDF at lower doses 

Answer: E. TAF has less activity than TDF at lower doses 
TAF achieve improved anti HIV activity at lower doses than TDF that results in five to seven fold increase in intracellular diphosphate in the lymphoid cell and lower circulating plasma tenofovir levels. 
ADRs: Renal insufficiency and loss of bone mineral density 

06. Which of the following statements about NRTIs is wrong?
A. Dose adjustment in renal insufficiency 
B. Renally excreted 
C. Abacavir metabolised by alcohol dehydrogenase 
D. Abacavir metabolised by glucuronyl transferase
E. Zidovudine is only available as Skin formulation

Answer: E. Zidovudine is only available as Skin formulation
Zidovudine is available as oral and IV formulation while alla other NRTIS are available as oral. 
Dose adjustment for NRTIS is required in renal insufficiency except Abacavir which is metabolised by alcohol dehydrogenase and glucoronly transferase.


07.  A 75-year-old man with chronic obstructive pulmonary disease is diagnosed with suspected influenza based on his complaints of flu-like symptoms that began 24 hours ago. Which of the following agents is most appropriate to initiate for the treatment of influenza?
A. Ribavirin.
B. Oseltamivir. 
C. Zanamivir.
D. Rimantadine. 
E. Amantadine.

Answer: B. Oseltamivir

08. Which of the following drugs is prohibited in influenza if a person is diagnosed with chronic obstructive pulmonary disease?
A. Ribavirin.
B. Oseltamivir. 
C. Zanamivir.
D. Rimantadine. 
E. Amantadine.

Answer: C. Zanamavir 
Two drugs are frequently used for influenza Oseltamivir (oral) and Zanamavir, Zanamavir is administered via inhalation and is not recommended for patients with COPD.


09. A 24-year-old female is diagnosed with genital herpes simplex virus infection. Which of the following agents is indicated for use in this diagnosis?
A. Valacyclovir
B. Cidofovir
C. Ganciclovir
D. Zanamivir
E. Lamivudine

Answer: A. Valacyclovir 
Famcyclovir, Pencyclovir, Acyclovir all are indicated for HSV. Cidofovir and Gancyclovir are indicated for Cyclomegalo virus retinitis. Zanamavir is used to treat influenza.

10. One of the Following drugs is used to treat influenza  virus infection commonly?
A. Valacyclovir
B. Cidofovir
C. Ganciclovir
D. Zanamivir
E. Lamivudine

Answer: D. Zanamavir  
Famcyclovir, Pencyclovir, Acyclovir all are indicated for HSV. Cidofovir and Gancyclovir are indicated for Cyclomegalo virus retinitis. Zanamavir is used to treat influenza.

11. One of the Following drugs is used to treat Cyclomegalovirus retinitis?
A. Valacyclovir
B. Cidofovir
C. Ganciclovir
D. Zanamivir
E. A & B
F. B & C

Answer: F. B & C 
Famcyclovir, Pencyclovir, Acyclovir all are indicated for HSV. Cidofovir and Gancyclovir are indicated for Cyclomegalo virus retinitis. Zanamavir is used to treat influenza.

12. What is the mechanism of action of Acyclovir?
A. Premature DNA chain Termination 
B. Inhibit viral neuraminidase
C. Inferences with viral messenger RNA 
D. Inhibit reverse transcriptase 
E. Block M2 protein ion channel 

Answer: A. Premature DNA chain Termination 

13. Transient irritation of the eye and palpebral (eyelid) edema is the adverse effect of following?
A. Trifluridine
B. Penciclovir
C. Gancyclovir
D. Lamivudine
E. Zanamavir 

Answer: A. Trifluridine
It's an antiviral drug having short life necessitiates to apply frequently used in the treatment of HSV-1 and HSV-2 and vaccina virus. Restricted to topical ophthalmic preparation. Toxic for systemic use.
 
14. Following statements about Penciclovir and Famciclovir is wrong?
A. Famciclovir is prodrug of Penciclovir
B. Penciclovir has longer intracellular half-life than Acyclovir 
C. Penciclovir applied Topically 
D. Famciclovir not active orally 
E. None of these 

Answer: Famciclovir not active orally 
Famciclovir is effective orally while Penciclovir applied topically. 

15. A female patient who is being treated for chronic hepatitis B develops nephrotoxicity while on treatment. Which is the most likely medication she is taking for HBV treatment?
A. Entecavir
B. Telbivudine
C. Lamivudine
D. Adefovir

Answer: D. Adefovir 

16. Nephrotoxicity is the most common adverse effect of following drugs in the treatment of HBV?
A. Entecavir
B. Telbivudine
C. Lamivudine
D. Adefovir

Answer: D. Adefovir (Terminate chain elongation and prevents replication of HBV)
Uncommon in Lamivudine and Entecavir. Ribavirin is used for the treatment of hepatitis C infection.

17. Which class of direct acting antivirals for hepatitis C works by inhibiting formation of the membranous web that provides a platform for viral replication?
A. A. NS3/NS4A protease inhibitors 
B. NS5B polymerase inhibitor 
C. NS5A replication complex inhibitor 
D. Interferons

Answer: C. NS5A replication complex inhibitor