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Pharm Antivirals

Total questions: 64

Worksheet time: 37mins

Name
Class
Date
1.

Chickenpox, Shingles, HSV-1, HSV-2, and CMV are:

a)

RNA viruses

b)

DNA viruses

2.

HSV-1 tends to hang out in the _ ganglia

a)

trigeminal

b)

sacral

3.

HSV-1

a)

fever blister, cold sore

b)

genital herpes

4.

HSV-2

a)

fever blister, cold sore

b)

genital herpes

5.

HSV-2 tends to hang out in the _ ganglia

a)

trigeminal

b)

sacral

6.

The primary Herpes Simplex virus infection includes:

a)

prodrome period

b)

systemic symptoms (burning, aches, pains, headache)

c)

blisters and vesicles

d)

reactivation

7.

The secondary Herpes Simplex virus infection is triggered by:

a)

stress

b)

illness

c)

sun exposure

8.

Which Herpes Simplex virus infection is more severe

a)

primary

b)

secondary

9.

HSV-1 infection are most likely to RECUR and cause which form of the disease?

a)

oral herpes

b)

genital herpes

10.

Varicella Zoster is

a)

chicken pox

b)

shingles

11.

Herpes Zoster is:

a)

chicken pox

b)

shingles

12.

With Varicella Zoster virus, vesicular lesions appear in __ while Herpes Zoster lesions appear __

a)

different stages ; unilaterally

b)

unilaterally ; different stages

13.

The incidence of Herpes Zoster _ with age

a)

increases

b)

decreases

c)

remains constant

14.

Which is true of Varicella vaccines?

a)

live attenuated

b)

humoral response through IgG

c)

cell mediated (CD4 helper cells)

d)

can be given during pregnancy and lactation

15.

Timing of Varicella Vaccines

a)

2 doses 2-6 months apart

b)

given within 3 day of exposure

c)

12-18 months and again between 4-6 years old

16.

Can chickenpox still occur if someone's been given the Varicella Vaccines?

a)

yes

b)

no

17.

Varicella Vaccines:

a)

Varivax

b)

ProQuad

c)

Shingrix

18.

Varivax vaccine is for:

a)

chicken pox only

b)

combination of measles, mumps, rubella, and varicella

19.

ProQuad vaccine is for:

a)

combination of measles, mumps, rubella, and varicella

b)

chicken pox only

20.

Post-Exposure Vaccine Prophylaxis

management depends on:

a)

the intent of the exposure

b)

patient's immune status

c)

eligibility for vaccine

d)

temperature upon administration

21.

Eligibility criteria for Post-Exposure Vaccine Prophylaxis includes:

a)

at least 12 months of age

b)

not pregnant

c)

intact immune system

d)

no history of severe reaction to varicella vaccine or components

22.

Can someone considered immunosuppressed receive Post-Exposure Vaccine Prophylaxis?

a)

yes

b)

no

23.

Post-Exposure Vaccine Prophylaxis will __ the severity of disease for those who develop __

a)

increase ; herpes zoster

b)

decrease ; herpes zoster

c)

increase ; varicella

d)

decrease ; varicella

24.

Post-Exposure Passive Immuno-prophylaxis is used for:

a)

immunocompetent patients

b)

immunodeficient patients

25.

Post-Exposure Passive Immuno-prophylaxis is indicated for:

a)

immunocompromised patients

b)

neonates whose mothers develop varicella 5 days before or 2 days after delivery

c)

preterm infants exposed to varicella while hospitalized

d)

susceptible pregnant women

26.

Post-Exposure Passive Immuno-prophylaxis involves:

a)

live attenuated vaccine

b)

varicella vaccines

c)

immunoglobulins

27.

A 7 day course of __ or __ may prevent clinical varicella infections after exposure

a)

acyclovir

b)

valacyclovir

c)

famciclovir

28.

The Shingrix vaccine is:

a)

live attenuated vaccine

b)

recombinant vaccine (RZV)

c)

passive immunization

29.

The Shingrix vaccine requires:

a)

1 dose 2-6 months apart

b)

2 doses 2-6 months apart

c)

1 dose 4-12 months apart

d)

2 doses 4-12 months apart

30.

Can Shingrix be used in those with compromised immune systems?

a)

yes

b)

no

31.

How effective is Shingrix at preventing post-herpetic neuralgia?

a)

very (89-91%)

b)

not great

32.

What is the minimum duration of protection after receiving the Shingrix vaccine? (still 85% effective)

a)

7 years

b)

10 years

c)

2 years

d)

5 years

33.

CMV transmission

a)

person-person

b)

blood transfusion

c)

organ transplantation

d)

droplet

34.

What percent of Americans over 40 years old harbor CMV?

a)

50-85%

b)

90%

c)

30%

35.

Can you see an "owl-eye inclusion" on a blood smear in a CMV + patient?

a)

yes

b)

no

36.

CMV places _ at high risk for serious morbidity and death

a)

immunocompromised patients

b)

immunocompetent patients

37.

Common sites for CMV infection include:

a)

eyes

b)

lungs

c)

GI tract

d)

heart

38.

Which antiviral may cause blurred vision?

a)

acyclovir

b)

valacyclovir

c)

famciclovir

39.

Anti-herpes medications may lead to __ in serum BUN and creatinine levels with possible __

a)

decreased ; nephrotoxicity

b)

increased ; nephrotoxicity

c)

decreased ; hepatotoxicity

d)

increased ; hepatotoxicity

40.

There is a risk of TTP/HUS in immunocompromised patients with

a)

acyclovir

b)

valacyclovir

c)

famciclovir

41.

The "critical step" of Acyclovir MOA is:

a)

the activity of HSV Thymidine Kinase

b)

must be phosphorylated intracellularly

c)

oral administration

42.

T/F: HSVs are sensitive to Acyclovir because: the drug is a much better substrate for thymidine kinase produced by HSVs than it is for mammalian thymidine kinase

a)

true

b)

false

43.

Acyclovir triphosphate

a)

competes with 2-deoxyguanosine triphosphate (dGTP) as a substrate for viral DNA polymerase

b)

acting as a chain terminator

44.

Nucleoside analogs incorporate into the DNA and _, therefore halting strand growth

a)

lack a free 3'-OH group

b)

have a free 3'-OH group

45.

When prescribing Acyclovir, you should know that __ are most the sensitive ; __ are moderately sensitive ; and __ is resistant

a)

HSV ; VZV ; CMV

b)

VZV ; HSV ; CMV

c)

HSV ; CMV ; VZV

46.

Resistance to acyclovir develops by:

a)

Decreased production of thymidine kinase

b)

Alteration of thymidine kinase such that it no longer converts acyclovir to acyclo-GMP

c)

Alteration of viral DNA polymerase such that it is less sensitive to inhibition

d)

Increased production of thymidine kinase

47.

The formation of acyclo-GMP occurs almost exclusively in cells infected with:

a)

HSV

b)

VZV

c)

CMV

48.

Acyclovir therapeutic uses include:

a)

Mucocutaneous Herpes Simplex Infections

b)

Varicella-Zoster Infections

c)

Herpes simplex genitalis (genital herpes)

d)

Herpes labialis (cold sores)

49.

Acyclovir can be administered topically, orally, and IV, but has

a)

low bioavailability

b)

high bioavailability

50.

T/F: acyclovir elimination is renal

a)

true

b)

false

51.

IV Acyclovir adverse effects:

a)

Phlebitis and inflammation

b)

Reversible nephrotoxicity

c)

Irreversible nephrotoxicity

d)

Neurological toxicity

52.

Oral and Topical Acyclovir adverse effects:

a)

N/V/D

b)

headache

c)

vertigo

d)

neurological toxicity

53.

Acyclovir 50% topical Ointment treats:

a)

herpes genitalis

b)

mucocutaneous HSV infection

c)

immunocompetent host

d)

immunocompromised host

54.

Acyclovir (5%) topical Cream treats:

a)

herpes labialis (cold sores)

b)

herpes genitalis

55.

IV administration is indicated for __ hosts or severe infection of __ hosts

a)

immunocompromised ; immunocompetent

b)

immunocompetent ; immunocompromised

56.

Valacyclovir is a prodrug of __ and has __ bioavailability

a)

acyclovir ; increased

b)

famciclovir ; increased

c)

acyclovir ; decreased

d)

famciclovir ; decreased

57.

Valacyclovir is approved for the treatment of:

a)

Herpes zoster (shingles)

b)

Herpes simplex genitalis (genital herpes)

c)

Herpes labialis (cold sores)

d)

Varicella (chickenpox)

58.

Valacyclovir is ONLY used in __ because of the risk of __, which can be fatal

a)

immunoCOMPETENT patients ; TTP/HUS

b)

immunoCOMPROMISED patients ; TTP/HUS

c)

immunoCOMPETENT patients ; nephrotoxicity

d)

immunoCOMPROMISED patients ; nephrotoxicity

59.

Famciclovir is a prodrug of __ and REQUIRES viral thymidine kinase so it is selective for __.

a)

penciclovir ; HSV

b)

penciclovir ; VZV

c)

acyclovir ; HSV

d)

acyclovir ; VZV

60.

Famciclovir treats:

a)

acute herpes zoster

b)

genital herpes

61.

T/F: Penciclovir cream is indicated for recurrent herpes labialis

a)

true

b)

false

62.

Docosanol Cream:

a)

blocks viral entry into cells

b)

inhibits viral replication

c)

inhibits release of viral cell to infect others

63.

Which of the following represents an immunocompetent patient?

a)

A 45 YO male with the common cold

b)

A 17 YO female with a B cell deficiency

c)

A 64 YO female undergoing chemotherapy

d)

A 32 YO male kidney recipient 

64.

T/F: Kidney disease requires dose reduction of thymidine kinase inhibitors

a)

true

b)

false

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