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Micro Viruses -DIT o Flashcards

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1
Q

EBV Cancer(3)

A 
Nasopharyngeal Carcinoma
Burtkett lymphoma (african)
Hodgkins Lymphoma (Immune comp)
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2
Q

heterophile Ab test

A

EBV monospot

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3
Q

Atypical cells

A

CD8 cells that look like B cells in a EBV infection

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4
Q

Reye Syndrome
Cause
symptoms
findings

A

hepatoenephalopathy, hypoglycemia, vomiting, coma

post viral infection (VZV and influenza B) and given aspirin

Find: ASA metal decrease beta oxidation by reversible inhibition of mitochonchonria enzymes

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5
Q

ASA exception to Reye’s

A

Kawasaki Disease

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6
Q

HCV family

A

RNA flavivirus

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7
Q

HDV family

A

RNA delta virus

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8
Q

HAV family

A

RNA piconavirus

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9
Q

HBV family

A

DNA hepadnavirus

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10
Q

HEV family

A

RNA hepevirus

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11
Q

Viral neonatal encephalitis (3 causes)

A

HSV1
HSV2 - temporal lobes
CMV

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12
Q

TORCH

A

Transplacental infections

Toxoplasma
Other(syphilis)
Ruebella
CMV
Herpes
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13
Q

Cowdry type A inclusion bodies

A

seen in HSV-1

encephalitis clue

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14
Q

Viral recombination

A

exchange of genes between 2 chromosomes by crossing over w/in regions of significant sequence homology

2 closely related viruses co-infect

DNA or RNA w/DNA phase

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15
Q

Viral reassortment

A

segemented genomes only (BOAR: Bunyavirus, orthomyxoviruses, arenaviruses, reoviruses)

viruses co infect and segments are exchanged -> new strands 9high frequency recombination)

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16
Q

Viral complementation

A

2 viruses infect a cell but one virus has a mutated genome resulting in a non functional protein

non mutated virus complements the mutated one allowing it to replicate

problem of replication still remains for the progeny

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17
Q

Viral Phenotypic mixing

A

simultaneous infection go cell w/ 2 viruses

Genome of virus A can be partially coated w/ surface proteins from virus B

Type B determines infectivity

Progeny though are from Virus A

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18
Q

Live attenuated vaccines (6)

A 
Sabian's oral polio
MMR
intranasal influenza
varicella 
yellow fever
Small pox
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19
Q

Killed viral vaccines (4)

A

Rabies
injected influenza
Salk polio
HAV

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20
Q

Recombinent viral vaccines(2)

A

HBV

HPV

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21
Q

Normal DNA viral genome Structure

2 categories of exceptions and examples (1+3)

A

Usually double stranded and linear

Single stranded exception - parvovirus

circular

  • hepadnavirus
  • papillomavirus
  • polyomavirus
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22
Q

Concern w/ egg allergy vaccines (3)

A

influenza
MMR
yellow fever

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23
Q

Circular DNA viruses (3) exceptions to the linear DNA rule

A

hepadnovirus
Papillovirus
polyomavirus

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24
Q

SS DNA virus (1) exception to the DS DNA

A

parvovirus - it is (-) stranded and needs to be transcribed 1st

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25
Naked viruses 4 DNA 4 RNA
DNA - PAPP - Parvoirus - Adenovirus - Polyomavirus - Papillomavirus RNA - CPR Hepe - Calcivirus - picovirus - reovirus - hepevirus can transmit more readily ( no fluids needed)
26
+ strand RNA means?
the genome acts as a mRNA can be be directly translated into viral protein; transcribed copy (-) to replicate + and form a template to be passed on to progeny (-) strand RNA needs to be transcribed to + strand 1st before viral protein can be made
27
DNA viral protein usually replicates where? Exception
in the nucleus Pox virus is an exception, too big
28
RNA viral protein is usually replicated where> 2 exceptions
in the cytoplasm Exception - infuenza virus - retrovirus
29
Except for retroviruses, all other viruses are what
haploid Retrovirus is diploid w/ 2 SS of RNA
30
Infectivity of viral genome directly is usually exceptions (2 w/ DNA; RNA)
most dsDNA - except Pox and HBV + stranded RNA (except - stranded ssRNA) exceptions require polymerases to be packaged w/in
31
Which viruses are not infectious in normal state
They need polymerase to complete infectivity - Pox and HBV - negative strand RNA
32
Latent infection established in the following herpes virus ``` HSV 1 HSV 2 VZV EBV CMV ```
``` HSV 1 - trigeminal ganglia HSV 2 - sacral ganglia VZV - Dorsal root ganglion EBV - B cells CMV - monocytes ```
33
Other infections of note w/ HSV 1 other than cold sores(4)
temporal lobe encephalitis keratoconjunctivitis gingivostomatovirus oral herpes labialis
34
Tanzk stain used to detect what in what viruses?(3)
stains multi-nuceated giant cells For HSV 1, HSV 2, VZV
35
Cowdry inctranuclear bodies found in (3)
HSV 2 HSV2 VZV
36
Give a patient a medication for what appears to be a sore throat but also has some painful posterior LAD and malaise and then develops a maculopapular rash what happened?
gave a person with EBV ampicillin
37
Downey cells
Atypical lymphocytes of T cell origin in a EBV infection
38
What is the most concerning result of a VSV infection in the elderly?
pneumonia
39
Heterophile negative yet still has signs of mononucleosis (5)
``` CMV HIV Acute toxoplasmosis acute viral hepatitis strep throat ```
40
Most common congenital transmission in utero
CMV
41
Complication of CMV in a bone marrow transplant patient
life threatening pneumonia
42
Complications of CMV in an AIDS patient (3)
Retinitis GI ulceration esophagitis
43
HIV + patient being treated for dysphagia by giving antifungals and not getting better be concerned of
esphogitis due to CMV
44
Herpes virus genome description
dsDNA linear enveloped
45
EBV associated malignancies (6)
``` nasopharyngial carcinoma Burkitts lymphoma Hodgkins lymphoma diffuse large cell lymphoma oral hairy cell leukoplakia lymphoproliferative disorders ```
46
Owls eye inclusions seen in organ tissues
CMV infection Reed sternberg seen in the vasculature
47
Roseola is due to ? Presentation
exanthum subetum due to HHV8 presents as high fevers for a couple days followed by diffuse macular rash
48
kid comes in w/ fever of 102 and seizures and later breaks into a macupapular rash a couple days later
HHV6 roseola | completed by febrile seizures
49
Karposi sarcoma is rare (5%) but more common in infects what cells? other organs that can be involved?
men who have sex w/ men infects the spindle cells of vascular and lymphatic endothelial tissue -> highly vascular lesions the lung
50
Rx for karposi sarcoma tumors | 4
HAART Topical - alitretinoin intralesion - vinblastine liposomal anthracyclines - daunorubicin, doxorubicin
51
3 different types of Karposi sarcoma tumors
Classic -slow growing w/out much potential for METS Epidemic - found in HIV/AIDs Immunocompromised - transplant patients
52
Rx that needs viral thymidine kinase to work(3) Treats? (2)
acyclovir valacyclovir famiciclovir Inhibits RSV and VZV
53
Preffered drug for treating herpes zoster
famiciclover
54
Drug used by CMV viral kinase (2)
ganciclovir | valgancicilovir
55
viral dan polymerase inhibitor that does not need activation by viral kinase to work rx(2)
Foscarnet Rx for CMV retinitis and acyclovir resistant HSV Toxicity : nephrotoxicity and anemia
56
What labs are you going to draw aftar starting a patient on ganciclovir?(2)
CBC - causes: neutropenia, leukopenia, thrombocytopenia creatine - causes renal failure
57
Aplastic anemia in a sickle cell patient
parvo B19 virus
58
Child catches a fever and has slapped cheek rash that spreads to body
parvo B 19 virus
59
4 associations/presentations w/ parvo B19
Aplastic crisis in sickle cell patient 5ths disease/erythema infectiosum in kids (slapped cheeks and fever) Rheumatoid like arthritis in adults hydrops fatalis w/ pregnancy Remember parvovirus only ss DNA, linear, no env
60
5ths disease is due to?
Parvo virus B19 (ss DNA, linear) contagious before the characteristic sloped cheeks rash
61
HPV family of virus Description
papillomavirus dsDNA, circular (1/3), no env 1 and 2 - skin 6 and 11 - genital warts 16 and 18 CIN
62
JC virus is associated w/ what presentation Family?
PML - progressive multifocal leukoencephalopathy in HIV Polyomavirus (dsDNA, circular, no env)
63
Polyomovirus presentation features
PML - progressive mulitfocal leukoencelpoathy due to JC virus dsDNA and circular, NO env
64
Poxvirus has 3 presentations? unique feature of family?
Small pox cowpox - vaccinia mulluscum contagiosum - dsDNA, enveloped (only P starting dsDNA that is), linear DNA dependent RNA polymerase w/ and replicates in the cytoplasm; too big
65
mulluscum contagiosum is apart of what family?
pox virus dsDNA, enveloped, linear, rep in cytoplasm*
66
Adenovirus presents as (4)
conjunctivitis pharangitis diarrhea pneumonia non enveloped, dsDNA, linear
67
URI followed by conjunctivitis due to
adenovirus
68
Hepadinovirus causes
HBV dsDNA, enveloped, circular (carries reverse transcriptase which works on the viral RNA product that the host cell machinery makes after infection)
69
most common cause of fatal infantile gastroenteritis is?
rotavirus, a reovirus Remember reoviruses are only dsRNA virus
70
most common cause of gastroenteritis on cruise ships and nursing homes
norwalk virus (Norovirus)
71
2 reovirus presentations description
Coltivirus - tick based self limiting flu rotavirus - diarhea dsRNA virus (only one), non enveloped
72
Coltivirus family? and presentation
reovirus (rotavirus) -dsRNA, non enveloped colorado tick fever - acute self limited flu like disease
73
rotavirus family? and presentation
reovirus (coltivirus) -dsDNA, non enveloped #1 cause of gastroenteritis in the world for kids -> dehydration and death
74
Piconavirus family ((5) description
ssRNA (+), non enveloped ``` PERCH Poliovirus* echovirus* rhinovirus Coxsackie virus* HAV* ``` * = enterovirus and fecal oral transmission
75
Poliovirus family? presentation
picovirus (echovirus, rhinovirus, Coxsackie, HAV) -ssRNA (+) nonenveloped infects the motor neuron of the anterior horn -> flaccid paralisis
76
Viruses causing the common cold(2)
Rhinovirus #1 | Coronavirus
77
Viruses that infect the motor neuron of the anterior horn (2)
West Nile Virus (flavivirus) | poliovirus (picovirus)
78
Echovirus family ? Presentation(3)
Picovirus (polio, Rhinovirus, Coxsackie, HAV) -ssRNA (+) nonenveloped aseptic meningitis (more common in the summer) myocarditis URIs
79
meningitis outbreak in the summer months
echovirus
80
Rhinovirus family? presentation?
Picovirus (polio, echovirus, coxsackie, HAV) -ssRNA (+) nonenveloped common cold; not an enterovirus like the rest of the picoviruses
81
Coxsackie virus family? Presentation (4)
picovirus (polio, echovirus, rhinovirus. HAV) -ssRNA (+) nonenveloped - myocarditis/ pericarditis - aseptic meningitis - herpangioma - hand foot and mouth dieases (body wide rash)
82
4 disease leading to bodyside rash including the hands and feet
Coxsackie virus Nesseira meningitis Syphillis Rocky mtn spotted fever
83
HAV family and presentation
picovirus (polio, echovirus, rhinovirus, coxsackie virus) -ssRNA (+) nonenveloped acute viral hepatitis
84
Calicivirus family has? Description
norovirus - gastroenteritis on cruiseships/ nursing homes - vomiting and diarrhea nonenveloped SS (+)
85
norovirus is apart of which viral family presentation
calicivirus - presents as severe diarrhea and vomiting nonenveloped SS (+)
86
Rotavirus outbreaks are associated w?
winter months daycares and playgroups
87
Arboviruses that cause encephalitis (4)
st louis encephalitis eastern equine encephalitis western equine encephalitis California encephalitis
88
Flavivirus family contains (5) description
``` HCV yellow fever dengue fever St louis encephalopathy West nile ``` ssRNA, enveloped (+) strand
89
HCV is a member of what family? presentation
flavivirus (HCV yellow fever, dengue fever, St louis encephalopathy, West nile) - ssRNA, enveloped (+) strand creates HCV
90
yellow fever is a member of what family presentation (3)
flavivirus (HCV yellow fever, dengue fever, St louis encephalopathy, West nile) - ssRNA, enveloped (+) strand high fever black vomitus and other hemorragic presentations(petechia, epistaxis) jaundice W/in the aides mosquito, high mortality rate >50%
91
presentation of high fever, black vomit and jaundice be concerned of caught by
yellow fever - > 50% mortality bite of infected aides mosquito
92
Dengue fever family? presentation
flavivirus (HCV yellow fever, dengue fever, St louis encephalopathy, West nile) - ssRNA, enveloped (+) strand break bone fever, muslce and joint pain HA retro-orbital pain hemorragic fever is feared complication - test w/ turniquet test, transferred by mosquitos
93
patient presents w/ severe fever, muscle and joint pain and retro orbital pain? what is on site test you can do
dengue fever, mosquitos Tournequte test - excess petechia w/ occlusion w/ a BP cuff between SBP and DBP -> increased capillary wall fragility
94
St louis encephalitis family? caused by?
flavivirus (HCV yellow fever, dengue fever, St louis encephalopathy, West nile) - ssRNA, enveloped (+) strand arbovirus
95
West nile virus family? Presentation - usually ((5) - Complicated (4)
flavivirus (HCV yellow fever, dengue fever, St louis encephalopathy, West nile) - ssRNA, enveloped (+) strand usually only HA, malaise, low back pain, myalgia and anorexia for 3-6 days complicated; meningitis +/- encephalitis w/ muscle weakness, flaccid paralysis, alterations of consciousness
96
Diagnose of acute W Nile virus w?
IgM antibodies in CSF or serum. many have been exposed -> IgG already present usually only HA, malaise, low back pain, myalgia and anorexia for 3-6 days
97
Natural reservoir of W Nile virus Rx?
Birds, humans are incidental hosts supportive
98
retrovirus family contains (2) description
HIV HTLV - t cell leukemia ssRNA virus (+) stranded w/ reverse transcriptase
99
Tolgvirus family contains (3) description
Rubella western equine encphalopathy eastern equine encphalopathy ssRNA virus (+) strand
100
Cause of the german measles and presentation
rubella (tolgavirsu) - 3 days fever postauricalar LAD * arthralgias and fine truncal rash (head -> down) child does not act as ill as the presentation
101
Congenital infection of rubella(3)
cataracts deafness cardiac - PDA and pulmonary stenosis
102
infant w/? cataracts, deafness, and cardiac - PDA and pulmonary stenosis
Rubella infection
103
Coronavirus family contains? Description
coronavirus -. 2nd most common cause of common cold ssRNA (+) strand Only helical capsid of all the ssRNA (+) strands
104
influenza family description? what 2 viral antigens of importance
orthomyxoviruses - enveloped, (-) stranded, ssRNA, SEGMENTED hemagluttinin - promotes viral entry neuraminidase - promotes viral release
105
hemagluttin
influenza viral antigen that promotes viral entry
106
neuraminidase
influenza viral antigen prevents viral relase
107
Cause of influenza pandemics where strands of the flu can infect where they normally couldn't Mechanism
Genetic Shift due to gene resortment w/ segmants undergoing high frequency recombination ex when a pig and human flu virus co-infect a cell and get new
108
Genetic drift
the regular process of random mutation responsible for yearly flu changes
109
Drugs used in the prevention of influenza(2)
Zanamivir | oseltamivir
110
Drugs that block flu viral uncoating but no longer work (2)
amantadine | rimantidine
111
Rx for hep C (2)
Ribavarin and IFN alpha
112
Uses of ribavarin(2)
hep c | RSC
113
Avian influenza presentation and Rx?
H5N1, spread only bird to human URI, GI, fever, pancytopenia, elevated AST/ALT rx: oseltamivir
114
Swine flu presentation and Rx?
H1N1 typical flu and GI symptoms Rx- seltamivir or zanamivir to high risk/severely ill
115
Paramyxoviruses (3) description
PRM(x2) in the name ssRNA enveloped virus (-) stranded Parainfluenza -> croup RSV Measles Mumps
116
barking cough ->respiratory distress in a kid 6 months - 3 yrs Rx?
parainfluenza (parmyxoviruses family) croup, also have inspiratory stridor Rx w/ cool mist, racemic Epi, dexamethasone, oxygen
117
Steeple sign on x ray
croup - parainfluenza
118
brassy cough, wheezing and respiratory distress that may mimic asthma more common in what time of year?
RSV Winter
119
RSV family? Presentation and Rx?
paramyxoviruses (PRM2 - parainfluenza, RSV, Mumps, measles) - ssRNA, enveloped, (-) stranded brassy cough in an infant, wheezing, respiratory digress ~asthma ( bronchiolitis +/- pneumonia) contains Fusion protein (F protein) -> syncita formation
120
Parainfluenza is part of what family?
paramyxoviruses (PRM2 - parainfluenza, RSV, Mumps, measles) - ssRNA, enveloped, (-) stranded causes croup
121
palivizumab
given to preemies during the winter months to prevent RSV protects against F protein in paramycoxivirus
122
Rx for RSV
Albuterol or racemetric epinephrine Supplemental oxygen Ribavarin NOT to be used in children generally, maybe adults especially after a bone marrow transplant
123
measles family? presentation(3)
paramyxoviruses (PRM2 - parainfluenza, RSV, Mumps, measles) - ssRNA, enveloped, (-) stranded 1st. cough, coryza(runny nose), conjunctivitis 2. Koplik spots 3. Descending maculopapular rash starting from the neck
124
measles complications (4)
encephalitis - subacute sclerosing panencephalitis - seizure, ataxia, - can occur 6-7 yrs after initial infection fetal loss premature delivery giant cell pneumonia (syntia w/ F protein of paramyxovirus family)
125
Mumps family presentation? (3)
paramyxoviruses (PRM2 - parainfluenza, RSV, Mumps, measles) - ssRNA, enveloped, (-) stranded Parotitis (uni or bilateral) Orchitis - concern of sterility aseptic meningitis
126
Causes of aseptic meningitis (4)
coxsackie echo enterovirus... mumps
127
Hanta virus family presentation infection w/ exposure to?
part of bunyaviruses - ssRNA, CIRCULAR, helical hemorrhagic fever pneumonia acute respiratory distress progressive pulmonary edema aerosolized rodent urine (Utah, NM, Colorado, Arizona)
128
Rabies virus family? Presentation
rhabdovirus - ssRNA, enveloped, linear, helical bullet shaped virus 1. fever, malaise, HA 2. agitation, strange behavior, photophobia, hydrophobia 3. hallucination,s paralysis, coma and DEATh Long incubation time
129
negri bodies
cytoplasmic inclusions in neurons w/ infected virus as it makes its way retrograde fashion to the CNS bullet shaped
130
HIV virus uses what protein to bind to macrophages and T cells? What are the co-receptors(2)
viral gp120 binds to CD4 surface marker | -> conformational change and binding to co-receptors CCR5 (early - dendrites/macrophages) and CXCR4 (later - CD4 cells)
131
gp120
HIV viral envelope protein for docking w/ co receptor (CCR5- maroviroc or CXCR4) env gene
132
gp41
HIV viral envelope protein for fusion and entry (enfuvfirtide) env gene
133
env gene
HIV gene for gp 120 and gp 41 for docking and fusion respectfully
134
p24
HIV viral protein responsible for the capsid gag gene
135
gag gene
HIV viral gene encoding for capsid protein p24
136
pol gene
HIV viral gene encoding for integrase and reverse transcriptase
137
Homozygous CCR5 mutation means
a patient is immune to HIV infection w/ CCR5 tropism
138
Why are babies false positive for HIV when born from positive mothers? what test is done to differentiate
b/c babies blood may have IgG antibodies which are used to detect the disease w/ an ELISA may be present use PCR to measure viral load to determine if actually infected
139
AIDS is assigned to an HIV patient when (3)
CD4 < 14%
140
Window period in HIV is due to
timeframe from infection to actual development of antibodies made and detectable in the serum 1-3 months
141
Malignancies predisposed in HIV positive pts(3)
Kaposi sarcoma - > HHV8 - increase in blood vessel production ~bascilliary angiomatois (bartenella hensla infection) Non - hodgkin Lymphoma -> associated w/ EBV - primary CNS tume - large B cell lymphoma - EBV associated Squamous cell carcinoma - HPV 16 and 18
142
Oral infections associated w/ HIV (5)
``` HSV - ulcers CMV - lesions Candidia - thrush EBV - oral hairy leukoplakia Esophagitis - candidia ```
143
Pneumocystis jirovecii is a concern in HIV when Rx?
CD4 < 200 TMP:SMX
144
Histoplasma capsulatam in HIV vs immune comp
immune comp = mild pulmonary disease, bird or bat drop pins in Ohio/Missisippi river basen HIV - systemic disease w/ Fever and cough
145
Ring enhancing lesion on Brain MRI in an HIV patient think of?
Toxoplasmosis Primary CNS lymphoma
146
CD4 less than 50 and see cotton wool spots on the retina in an HIV patient
CNV retinitis
147
CMV retinitis
cotton wool spots on retina in an HIV positive patent w/ CD4<50
148
Progressive multifocal leukoenecphalapothy is?
JC virus reactivation in HIV patient w/ CD4 demylination
149
Meningitis in an HIV patient
cryptococcal meningitis
150
Severe diarrhea in an HIV patient w/ acid fast cysts in the stool
cryptosporidium
151
HIV dementia is?
directly associated w/ the virus
152
Tuberculosis like disease in an HIV patient rx? CD4 count is where?
Mycobacterium avum Azithromycin CD4 < 50
153
Toxoplasmosis prophylaxis in an HIV patient begins when and w/ what
CD4 <100 TMP;SMX
154
Protease inhibitors (9)
``` Lopinavir Ataznavir Darunavir Fosamprenavir Saquinavir Ritonavir Indinavir Nelfinavir Tipranivir ```
155
Class of Antiretrovirals w/ GI intollerance
protease inhibitors
156
Class of antiretrovirals that block Cyp P 450 especially?
protease inhibitors ritonavir
157
class of antiretrovirals that have lipodystrophy
protease inhibitors also jyperlipidemia, and hypertriglycemia
158
nephrolithithias confers w/ these protease inhibitors(2)
indinavir | atazanavir
159
increased bilirubin w/ this protease inhibitor
atazanavir
160
Pancreatitis concerns w/ these antiretrovirals (2)
didanosine (NRTI) | ritonavir (PI)
161
NRTIs(7)
``` Tenovir Emtricitabine Abacavir lamivudine Zidovudine didanosine stavudine ```
162
Bone marrow suppression is a big concern w/ this ARV
zidovudine
163
NRTI that does not need to phosphorylated to work
Tenofovir
164
lactic acidosis is a class risk of this ARV
NRTIs
165
Hepatic steatosis is a risk of these 2 NRTIs
didanosine and stavudine | NRTIs
166
peripheral neuropathy is a risk w/ which ARVs
NRTIs - didanosine, stavudine, zalcitabine
167
NNRTIs(5)
``` Nevirapine Efavirenz Delavirdine Etravine Rilpivirine ``` they all have a V in them (vudine's are NRTIs)
168
Efavienz is associated w. what additional SFx (3)
neuropsychaitic symptoms false + canaboid teratogenic
169
Rash is a problem w/ what ARV class
NNRTIs
170
SFx of raltegravir
Inhibits HIV genome integration into host cell chromosome by binding to integrase Nausea, rash and myopathy
171
What drug must tropism test be done 1st
Maraviroc
172
Injection site run and increased risk of bacterial pneumonia associated w/ this ARV
enfuvirtide HIV fusion inhibitor
173
Which 2 HIV viral envelope proteins are directly or indirectly blocked by ARVs
gp41 blocked by enfuvirtide gp100 blocked by maraviroc binding to CCR5 tropism HIV viral dna ( blocks the co-receptor)
174
councilman bodies
apoptotic liver cells seen w/ yellow fever or viral hepatitis

Micro (2 decks)

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