NBME 24 Nucleoside reverse transcriptase inhibitor (NBME Answers)

NBME 24 Answers

nbme24/Block 3/Question#3 (reveal difficulty score)
A 37-year-old woman with HIV infection is ...
Nucleoside reverse transcriptase inhibitor 🔍 / 📺 / 🌳 / 📖
tags: pharm HIV antivirals

+8 upvote downvote
submitted by ∗neonem(629)

get full access to all content ⋅ pick a username

Just had to know that NRTIs (specifically the nucleosides) cause lactic acidosis

get full access to all content ⋅ pick a username

brethren_md Also NRTIs are hepatotoxic, cause the increased liver enzymes seen in the patient. +5

sherry Actually, NNRTIs are more well-known for hepatotoxicity. But I guess NRTIs is the next best option for this one. +11

and bone marrow suppression, specifically Zidovudine.

+1/- lilyo(94)

+5 upvote downvote
submitted by ∗krewfoo99(115)

get full access to all content ⋅ pick a username

NRTI - Bone marrow supression, Lactic Acidosis, Anaemia NNRTI - Hepatotoxicity, rash Integrase inhibitor (tegras) - Myopathy (causing Increased Creatinine Kinase) Protease Inhibitors (navir) - Lipodystrophy, Hyperlycemia, GI intolerance (think of hormonal effecs)

get full access to all content ⋅ pick a username

madojo building off on this... answer choice A would be something like Maraviroc, and B is basically the same thing as A because a fusion inhibitor would be something like Maraviroc where you don't have any interaction with CCR5 and gp120. +1

overa ^ With B, they are referring to Enfuvirtide, which blocks FUSION via gp41 blockade. Maraviroc blocks ATTACHMENT by preventing gp120 binding the chemokine receptor CCR5 on macrophages mainly. -lolnotacop +3

+1 upvote downvote
submitted by ∗sunshinesweetheart(112)

get full access to all content ⋅ pick a username

out of curiosity, why are AST and ALT high? is that saying the NRTI used was diadenosine which led to pancreatitis also?

get full access to all content ⋅ pick a username

krewfoo99 AST and ALT will not be elevated in pancreatitis, they will only be increased during liver damage. NRTI causes hepatoxicity (although FA 2018 states NNRTI causes hepatotoxicity, NRTI could also be an option considering the two classes are similar. The hepatoxicity will cause an increase in ALT and AST +

+0 upvote downvote
submitted by ∗abhishek021196(119)

get full access to all content ⋅ pick a username

Bone marrow suppression (can be reversed with granulocyte colony-stimulating factor [G-CSF] and erythropoietin), peripheral neuropathy, lactic acidosis (nucleosides), anemia (ZDV), pancreatitis (didanosine).

get full access to all content ⋅ pick a username

abhishek021196 Adverse effects of NRTIs +

+0 upvote downvote
submitted by ∗beltorres23(10)

get full access to all content ⋅ pick a username

Fanconi syndrome induced by NRTIs.. High concentrations of NRTIs in the proximal convoluted tubule interfere with mitochondrial DNA synthesis resulting in cellular damage.

"Nucleoside analogues are associated with mitochondrial toxicity, which may manifest as lactic acidosis" https://journals.lww.com/aidsonline/fulltext/2008/07110/fanconi_syndrome_and_lactic_acidosis_associated.17.aspx

Also Uworld 155113

get full access to all content ⋅ pick a username

Must-See Comments from nbme24

seagull on Intestinal mucosa
tissue creep on Ask the roommate not to smoke in the apartment
drdoom on Adenosine
seagull on Increased serum testosterone concentration
atstillisafraud on Lamins
niboonsh on Only cookies are independently associated ...
atstillisafraud on Scar formation
lamhtu on Decreased adherence
drachenx on Damage to the rectovaginal septum
drdoom on Intestinal mucosa
azibird on Coronavirus
lsmarshall on Organic acid metabolism disorder
sympathetikey on Inhalant abuse
tea-cats-biscuits on Eosinophils