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NBME 24 Answers

nbme24/Block 3/Question#3 (32.5 difficulty score)
A 37-year-old woman with HIV infection is ...
Nucleoside reverse transcriptase inhibitorπŸ”
tags: HIV pharm antivirals 

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 +8 
submitted by neonem(549),
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usJt adh ot kwon that TRIsN lfpicsaecliy( teh euoi)edsnlcs ucesa liatcc cdssioia

brethren_md  Also NRTIs are hepatotoxic, cause the increased liver enzymes seen in the patient. +5  
sherry  Actually, NNRTIs are more well-known for hepatotoxicity. But I guess NRTIs is the next best option for this one. +10  



 +4 
submitted by krewfoo99(88),
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TIRN - Bneo roramw nsoisurp,es ciLtca si,sdociA NaAmRi aTNneI - tpHetoxiac,tyio aIsregtrahn se rihinotib at(gs)er - thpyyoaM ugsina(c easnIderc riienetnaC etsrinsPoeae aK) hiibIsonrt virn)(a - opioptsyyrhLd, ,Helapyyicrme GI etnoencairl hn(ikt of onoahrlm fee)fsc

madojo  building off on this... answer choice A would be something like Maraviroc, and B is basically the same thing as A because a fusion inhibitor would be something like Maraviroc where you don't have any interaction with CCR5 and gp120. +1  
overa  ^ With B, they are referring to Enfuvirtide, which blocks FUSION via gp41 blockade. Maraviroc blocks ATTACHMENT by preventing gp120 binding the chemokine receptor CCR5 on macrophages mainly. -lolnotacop +2  



 +1 
submitted by sunshinesweetheart(69),
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uto of s,ocyrtuii ywh era AST and TLA gh?ih is htta isyagn teh RITN dues asw iendisaoend hwich edl ot naraptieisct a?ols

krewfoo99  AST and ALT will not be elevated in pancreatitis, they will only be increased during liver damage. NRTI causes hepatoxicity (although FA 2018 states NNRTI causes hepatotoxicity, NRTI could also be an option considering the two classes are similar. The hepatoxicity will cause an increase in ALT and AST +  



 +0 
submitted by abhishek021196(49),

Bone marrow suppression (can be reversed with granulocyte colony-stimulating factor [G-CSF] and erythropoietin), peripheral neuropathy, lactic acidosis (nucleosides), anemia (ZDV), pancreatitis (didanosine).

abhishek021196  Adverse effects of NRTIs +