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NBME 21 Answers

nbme21/Block 4/Question#35 (25.1 difficulty score)
A 50-year-old woman is admitted to the ...
Didanosine (ddI)πŸ”

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submitted by niboonsh(336),
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isht asw a umbd qonsie.ut hte enmoiumnc "DIDanieosn scuaes rneaacpDIDis" si uflseu ereh

submitted by sahusema(137),
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eTh oeiDdsnnia ugy ni eht NIRT sctekh si dihogln a apesranc

qball  Sir Dan, my boi. +5  

submitted by madojo(160),

Going over other answers:

  • Abacavir is a NRTI so all of this inhibit nucleotide binding to RT and terminate the DNA chain. It doesnt end in the typical -vudine that we are used to for NRTI's but I guess we should keep it in mind because its contraindicated in patients with HLA B5701 mutation due to an increased risk in hypersensitivity. *Sketchy remember the Wizard aba cadabra guy with his spell book opened to HLAB5701 and associated skin rash on the wizards arm

  • Acyclovir is a guanosine analog that is monophosphorylated by thymidine kinase that inhibits viral DNA polymerase onces its incorporated into the replicating chain and terminates dNA. Its for HSV or VSV which doesn't fit in this question. Remember crystalline nephropathy and need for IV fluids with this one.

  • Didanosine is a NRTI as already mentioned that now we know causes pancreatitis.

  • Lamivudine is also a NRTI, Zidovudine also NRTI that causes anemia and can be used during pregnancy to decrease the risk of fetal transmission.

  • Ribavirin is an IMP inhibitor used in Hep C and inhibits purine synthesis. Side effects: causes hemolytic anemia and is a severe teratogen.

submitted by yotsubato(966),
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Bthlsuil oitmozeirman uostnqie. ouY eavh ot kown atth eth lgisne TRIN that sasecu tiietrnpacsa is dads.ioenni

Pgea 302 F1092A

rsp  Aren't 85% of these questions memorization questions. How many do you really review later and say, I didn't know that concept? My reviews are always "oh, that is the name of that thing they were trying to get at." +2