NEET PG MEdical Virology MCQs

Question 1

A 25-year-old man is diagnosed with HIV, and therapy is initiated. After the first week of therapy, the patient complains of headaches, irritability, and nightmares. Which one of the following antiretroviral drugs is most likely to be causing these symptoms?

• Efavirenz.
• Indinavir.
• Lamivudine.
• Nevirapine.
• Stavudine.

Explanation -

CNS symptoms are characteristic of efavirenz, especially at the beginning of therapy, and occur in nearly 50 percent of patients. These adverse effects abate with continued administration of efavirenz. The other drugs are unlikely to cause CNS side effects.

Question 2

JR is a 56-year-old HIV-negative man with a history of chronic renal dysfunction who was recently diagnosed with chronic hepatitis B infection. Which of the following should be used cautiously in treatment of his hepatitis B infection?

• Entecavir.
• Lamivudine.
• Adefovir.
• Interferon.
• Ribavirin.

Explanation -

Adefovir can also cause renal toxicity and therefore should be used cautiously in patients with a history of renal dysfunction.

Question 3

GG is a 36-year-old woman whose only past medical history is recurrent genital HSV infections, and she has been off and on acyclovir for years. Her current infection is not responding to treatment and her physician is worried about acyclovir resistance. Which of the following is the best recommendation for acyclovir resistance?

• Valacyclovir.
• Famciclovir.
• Ganciclovir.
• Foscarnet.
• Vidarabine.

Explanation -

Unlike most of the antiviral agents, foscarnet is not a purine or pyrimidine analog. Instead, it is phosphonoformate—a pyrophosphate derivative—and does not require activation by viral (or human) kinases. Foscarnet has broad in vitro antiviral activity. It is approved for CMV retinitis in immunocompromised hosts and for acyclovir-resistant HSV and herpes zoster infections.

Question 4

CC is a 45-year-old HIV-infected woman who has been on antiretroviral medications for 2 years. She has tolerated them well, but recently has noticed that the whites of her eyes are appearing yellow and that she is having burning and tingling in her feet. Which of the following medication combinations is most likely her antiretroviral regimen?

• Atazanavir/ritonavir, zidovudine and lamivudine.
• Efavirenz, lamivudine and tenofovir.
• Atazanavir/norvir, didanosine and tenofovir.
• Darunavir/ritonavir, abacavir and lamivudine.
• Raltegravir, zidovudine and emtricitabine.

Explanation -

Atazanavir is associated with hyperbilirubinemia which can cause jaundice and didanosine is associated with peripheral neuropathy causing pain and tingling in the feet and hands.