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Retired NBME 24 Answers

nbme24/Block 2/Question#21 (reveal difficulty score)
A 50-year-old woman with HIV infection comes ...
Zidovudine ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—neonem(629)
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NRTIs are the main HIV therapy drug that can cause bone marrow suppression (not as common with NNRTIs). This class includes zidovudine, didanosine, emtricitabine, lamivudine, stavudine, abacavir. Zidovudine is most known for this side effect.

Nelfinavir = protease inhibitor azithromycin = aminoglycoside (not really used for HIV) pentamidine = another antimicrobial, mostly used for pneumocystis I think? Lamivudine = another NRTI but less known for bone marrow suppression

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adisdiadochokinetic  Azithromycin is a macrolide, not an aminoglycoside FYI, and its use in HIV is primarily as prophylaxis at very low CD4 counts for, among other things, the mycobacterium avium complex. +8
nbmehelp  How would we have known to choose Zidovudine over Lamivudine tho +5
mjmejora  @nbmehelp the sketchy with Princess Izolde (Zidovudine) eating bone marrow was my only tip off +8
niboonsh  you have ero bone marrow if you take idovudine +1
niboonsh  the z's were supposed to be bold idk what happened. you have Zero bone marrow if you take Zidovudine +5
t123  Zidovudine is also a very early NRTI developed. As a good rule of thumb, older drugs have worse side effects +2
therealslimshady  Zidovudine Zaps your bone marrow (sorry) +2
hunter_dr  Lamivudine is "lame" so less side effects, at least that's how I remember it. +1



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