NR 566 Midterm Exam Questions with Verified Answers (Correct
Update)
Question 1: Aspergillosissystemic mycosis
Answer: Causative agent: Aspergillus spp. Drug of choice: Voriconazole Alternative Drugs:
Amphotericin B, isavuconzonium, itraconazole, posaconazole, caspofungin, micafungin
Question 2: Blastomycosis -systemic mycosis
Answer: Causative agent: Blastomyces dermatitidis Drug of choice: Amphotericin B OR itraconazole
Alternative Drugs: none
Question 3: Candidiasissystemic mycosis
Answer: Causative agent: Candida spp Drug of choice: Amphotericin B OR fluconazole, either one +/-
flucytosine Alternative Drugs: itraconazole, voriconazole, caspofungin
Question 4: Coccidiodomycosissystemic mycosis
Answer: Causative agent: coccidioides immitis Drug of choice: Amphotericin B OR fluconazole
Alternative Drugs: itraconazole, ketoconazole
Question 5: Cryptococcosissystemic mycosis
Answer: Causative agent: cryptococcus neoformans Drug of choice: Amphotericin B +/- flucytosine
Alternative Drugs: itraconazole Chronic suppression: Drug of choice: Fluconazole Alternative Drugs:
Amphotericin B
Question 6: Histoplasmosissystemic mycosis
Answer: Causative agent: histoplasma capsulatum Drug of choice: Amphotericin B OR itraconazole
Alternative Drugs: Fluconazole, ketoconazole Chronic suppression: Drug of choice: itraconazole
Alternative Drugs: Amphotericin B
Question 7: Mucormycosissystemic mycosis
Answer: Causative agent: Mucor Drug of choice: Amphotericin B Alternative Drugs: Isavuconazonium
Question 8: Paracoccidioidomycosissystemic mycosis
Answer: Causative agent: paracoccidioides brasiliensis Drug of choice: amphotericin B OR itraconazole
Alternative Drugs: Ketoconazole
Page 1
,Question 9: Sporotrichosissystemic mycosis
Answer: Causative agent: sporothrix schenckii Drug of choice: Amphotericin B OR itraconazole
Alternative Drugs: Fluconazole
Question 10: Itraconazole Drug interactions
Answer: PPIs, H2 inhibitors, antacidsmay have insuflcient stomach acid content for absorption. Take 1
hour prior or 2 hours after itraconazole. CYP3A4 inhibitorcan increase levels of other drugs such as
cisapride, pimozide, dofetilide, quinidine (increases the risk of ventricular dysrhythmias), cyclosporine,
digoxin, warfarin, sulfonylureas
Question 11: Therapeutic uses of caspofungin
Answer: Systemic Fungal infections- IV therapy of invasive aspergillosis in patients unresponsive or
intolerant to amphotericin B or itraconazole Systemic candida infectionsincluding Candice is and candid
-related peritonitis
Question 12: Acyclovir MOA
Answer: inhibits viral replication by suppressing the synthesis of viral DNA. must undergo activation.
critical step to activation is the conversion of acyclovirr to acyclovir-guanosine monophosphate (GMP)
by thymidine kinase. when formed, acyclovir-GMP is directly responsible for inhibiting DNA synthesis.
Selectively is based on the ability of the virus to activate the drug.
Question 13: acyclovir indications
Answer: mucocutaneous herpes simplex infections; varicella zoster infections; herpes simplex genitalis
Question 14: acyclovir route of administration considerations
Answer: IV, PO, topical PO bioavailability is low (15-30%) normal renal function: half life is 2.5 hours
anuric half life up to 20 hours. baseline renal function and dose reduction for renal impairment
Question 15: oseltamivir MOA inhibits
Answer: neuraminidase, a viral enzyme required for replication. this causes newly formed viral particles
from budding ott the cytoplasmic membrane of the host cells. Stops the viral spread.
Question 16: oseltamivir administration
Answer: PO suspension or capsule Treatment: twice a day prophylaxis once a day treatment: should be
started within 48 hours of treatment
Page 2
, Question 17: oseltamivir indications
Answer: prevention and treatment of influenza for patients 1 years old and older. can reduce symptom
severity, duration, and prevent complications. can be used in elderly and pregnancy after exposure to
illness and for treatment
Question 18: palivizumab indications
Answer: monoclonal antibody for preventing RSV infections in premature infants and young children
with chronic lung disease. binds to the surface protein on RSV and prevents replication. Dosing should
start before RSV season and continue until season end. IM injection, monthly, dosed by weight
Question 19: purpose of the annual flue vaccine
Answer: best protection against influenza due to virus constantly mutating. vaccines are changed yearly
as well. trivalent or quadrivalent vaccines available. provides protection against the three-four strains of
influenza deemed the most likely to cause disease in the upcoming season. jointly created by the CDC,
FDA, WHO
Question 20: flu vaccine contraindications
Answer: acute febrile illness, take once symptoms resolve precautions: severe egg allergy
Guillain-Barré syndrome (GBS) within 6 weeks following vaccine administration. pregnant women
should not receive the LIVE flu vaccine, okay to receive the inactivated vaccine severe allergic reaction
to influenza vaccine in the past
Question 21: Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) drugs
Answer: Abacavir (prototype) Didanosine Emtricitabine Lamivudine Stavudine Tenofovir Zidovudine
Question 22: Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) MOA
Answer: inhibit HIV replication by suppressing synthesis of viral DNA. undergoes intracellular
conversion to active (phosphate) form. active form acts as a substrate for reverse transcriptase. After
becoming incorporated into the growing DNA, they prevent reverse transcriptase from adding more
bases. DNA strand growth is blocked. leads to premature strand termination. activated NRTIs compete
with natural nucleoside triphosphate for finding to the active site of reverse transcriptase
Question 23: Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) adverse effects
Answer: side ettects are associated with the mitochondrial toxicity. lactic acidosis: dysfunctional
mitochondria cannot breakdown lactic acid. S/S: N, malaise, fatigue, anorexia, hyperventilation
(BLACK BOX WARNING) hepatic steatosis and hepatomegaly: decreased breakdown of fatty acids by
the mitochondria leads to fatty deposits in the liver pancreatitis, and myopathies
Page 3
Update)
Question 1: Aspergillosissystemic mycosis
Answer: Causative agent: Aspergillus spp. Drug of choice: Voriconazole Alternative Drugs:
Amphotericin B, isavuconzonium, itraconazole, posaconazole, caspofungin, micafungin
Question 2: Blastomycosis -systemic mycosis
Answer: Causative agent: Blastomyces dermatitidis Drug of choice: Amphotericin B OR itraconazole
Alternative Drugs: none
Question 3: Candidiasissystemic mycosis
Answer: Causative agent: Candida spp Drug of choice: Amphotericin B OR fluconazole, either one +/-
flucytosine Alternative Drugs: itraconazole, voriconazole, caspofungin
Question 4: Coccidiodomycosissystemic mycosis
Answer: Causative agent: coccidioides immitis Drug of choice: Amphotericin B OR fluconazole
Alternative Drugs: itraconazole, ketoconazole
Question 5: Cryptococcosissystemic mycosis
Answer: Causative agent: cryptococcus neoformans Drug of choice: Amphotericin B +/- flucytosine
Alternative Drugs: itraconazole Chronic suppression: Drug of choice: Fluconazole Alternative Drugs:
Amphotericin B
Question 6: Histoplasmosissystemic mycosis
Answer: Causative agent: histoplasma capsulatum Drug of choice: Amphotericin B OR itraconazole
Alternative Drugs: Fluconazole, ketoconazole Chronic suppression: Drug of choice: itraconazole
Alternative Drugs: Amphotericin B
Question 7: Mucormycosissystemic mycosis
Answer: Causative agent: Mucor Drug of choice: Amphotericin B Alternative Drugs: Isavuconazonium
Question 8: Paracoccidioidomycosissystemic mycosis
Answer: Causative agent: paracoccidioides brasiliensis Drug of choice: amphotericin B OR itraconazole
Alternative Drugs: Ketoconazole
Page 1
,Question 9: Sporotrichosissystemic mycosis
Answer: Causative agent: sporothrix schenckii Drug of choice: Amphotericin B OR itraconazole
Alternative Drugs: Fluconazole
Question 10: Itraconazole Drug interactions
Answer: PPIs, H2 inhibitors, antacidsmay have insuflcient stomach acid content for absorption. Take 1
hour prior or 2 hours after itraconazole. CYP3A4 inhibitorcan increase levels of other drugs such as
cisapride, pimozide, dofetilide, quinidine (increases the risk of ventricular dysrhythmias), cyclosporine,
digoxin, warfarin, sulfonylureas
Question 11: Therapeutic uses of caspofungin
Answer: Systemic Fungal infections- IV therapy of invasive aspergillosis in patients unresponsive or
intolerant to amphotericin B or itraconazole Systemic candida infectionsincluding Candice is and candid
-related peritonitis
Question 12: Acyclovir MOA
Answer: inhibits viral replication by suppressing the synthesis of viral DNA. must undergo activation.
critical step to activation is the conversion of acyclovirr to acyclovir-guanosine monophosphate (GMP)
by thymidine kinase. when formed, acyclovir-GMP is directly responsible for inhibiting DNA synthesis.
Selectively is based on the ability of the virus to activate the drug.
Question 13: acyclovir indications
Answer: mucocutaneous herpes simplex infections; varicella zoster infections; herpes simplex genitalis
Question 14: acyclovir route of administration considerations
Answer: IV, PO, topical PO bioavailability is low (15-30%) normal renal function: half life is 2.5 hours
anuric half life up to 20 hours. baseline renal function and dose reduction for renal impairment
Question 15: oseltamivir MOA inhibits
Answer: neuraminidase, a viral enzyme required for replication. this causes newly formed viral particles
from budding ott the cytoplasmic membrane of the host cells. Stops the viral spread.
Question 16: oseltamivir administration
Answer: PO suspension or capsule Treatment: twice a day prophylaxis once a day treatment: should be
started within 48 hours of treatment
Page 2
, Question 17: oseltamivir indications
Answer: prevention and treatment of influenza for patients 1 years old and older. can reduce symptom
severity, duration, and prevent complications. can be used in elderly and pregnancy after exposure to
illness and for treatment
Question 18: palivizumab indications
Answer: monoclonal antibody for preventing RSV infections in premature infants and young children
with chronic lung disease. binds to the surface protein on RSV and prevents replication. Dosing should
start before RSV season and continue until season end. IM injection, monthly, dosed by weight
Question 19: purpose of the annual flue vaccine
Answer: best protection against influenza due to virus constantly mutating. vaccines are changed yearly
as well. trivalent or quadrivalent vaccines available. provides protection against the three-four strains of
influenza deemed the most likely to cause disease in the upcoming season. jointly created by the CDC,
FDA, WHO
Question 20: flu vaccine contraindications
Answer: acute febrile illness, take once symptoms resolve precautions: severe egg allergy
Guillain-Barré syndrome (GBS) within 6 weeks following vaccine administration. pregnant women
should not receive the LIVE flu vaccine, okay to receive the inactivated vaccine severe allergic reaction
to influenza vaccine in the past
Question 21: Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) drugs
Answer: Abacavir (prototype) Didanosine Emtricitabine Lamivudine Stavudine Tenofovir Zidovudine
Question 22: Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) MOA
Answer: inhibit HIV replication by suppressing synthesis of viral DNA. undergoes intracellular
conversion to active (phosphate) form. active form acts as a substrate for reverse transcriptase. After
becoming incorporated into the growing DNA, they prevent reverse transcriptase from adding more
bases. DNA strand growth is blocked. leads to premature strand termination. activated NRTIs compete
with natural nucleoside triphosphate for finding to the active site of reverse transcriptase
Question 23: Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) adverse effects
Answer: side ettects are associated with the mitochondrial toxicity. lactic acidosis: dysfunctional
mitochondria cannot breakdown lactic acid. S/S: N, malaise, fatigue, anorexia, hyperventilation
(BLACK BOX WARNING) hepatic steatosis and hepatomegaly: decreased breakdown of fatty acids by
the mitochondria leads to fatty deposits in the liver pancreatitis, and myopathies
Page 3
