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NBME 20 Answers

nbme20/Block 1/Question#7 (35.7 difficulty score)
A 5-year-old girl with AIDS develops a ...
Thymidine kinaseπŸ”

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submitted by hayayah(1056),
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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  

submitted by andremosq(1),

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

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