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Retired NBME 16 Answers

nbme16/Block 2/Question#1 (reveal difficulty score)
A previously healthy 59-year-old man comes to ...
DNA polymerase ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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This man has HSV meningitis. The treatment of choice is acyclovir/valacyclovir which are guanosine analogs which preferentially inhibit viral DNA polymerase by chain termination (FA2020 p201). Cidofovir also preferentially inhibits viral DNA polymerase and is used for acyclovir-resistant HSV. Foscarnet is also a viral DNA/RNA polymerase inhibitor used for acyclovir-resistant HSV.

Remember HSV are DNA viruses (HHAPPPPy) (p163)

Other answers:

  • Neuraminadase inhibitors (oseltamivir[tami-flu], zanamavir) are used for influenza
  • Protease inhibitors are used for HIV (-navir) and hepatitis C (-previr)
  • Reverse transcriptase inhibitors are used for HIV (NNRTIs and NRTIs). Foscarnet is technically also a reverse-transcriptase inhibitor but is used for acyclovir resistant HSV.
  • RNAase A inhibitor is not a viral treatment
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