NBME 20 Thymidine kinase (NBME Answers)

NBME 20 Answers ↦

nbme20/Block 1/Question#7 (38.1 difficulty score)
A 5-year-old girl with AIDS develops a ...
Thymidine kinase🔍,📺
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+18
submitted by hayayah(1081),

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,clrAyvioc if,laromcvic ovcryvcalail are nsugnoaei .onasalg eyhT dngreuo osnrvecion ot yiolacrcv hpoapnhsmoteo iav sviru cenoedd iaeends.ht-nimyik atymeltUi,l tyeh iinithb alivr NAD yalrmepose by nacih a.ntotinimer

duMtaet liarv ynitdhime naksei anc saecu scrs.entiea

len49 Foscarnet and Cidofovir on the other hand do not require phosphorylation by viral kinase, therefore should be used in strains that are shown to be resistant. +3

+0
submitted by andremosq(3),

this question is asking about mechanism of resistance of Acyclovir, famciclovir, valacyclovir. They are Monophosphorylated by HSV/VZV thymidine kinase. Clinical use: HSV and VZV. Mechanism of resistance: Mutated viral thymidine kinase

-1
submitted by nafilnaf(1),

What does she have? My assumption was that she was getting NRTIs for HIV/AIDS which get phosphorylated by HOST thymidine kinases and the mechanism for viral resistance is mutations in reverse transcriptase

azibird I think she has chickenpox, caused by varicella-zoster virus. From FA 2020 p 183: "Vesicular rash begins on trunk; spreads to face D and extremities with lesions of different stages" +3