Antivirals Multiple Choice Questions

Question 1
What is the primary mechanism of action for Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)?
A) Inhibit the protease enzyme
B) Bind directly to reverse transcriptase and inhibit its activity
C) Inhibit the integrase enzyme
D) Block entry of the virus into the host cell
E) Inhibit the synthesis of viral DNA

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Question 2
Which NNRTI is associated with CNS toxicity, including vivid dreams?
A) Nevirapine
B) Efavirenz
C) Etravirine
D) Rilpivirine
E) Doravirine

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Question 3
Which Protease Inhibitor (PI) is known to cause crystal-induced nephropathy and hyperbilirubinemia?
A) Ritonavir
B) Lopinavir
C) Indinavir
D) Darunavir
E) Atazanavir

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Question 4
Which Protease Inhibitor is a strong CYP3A4 inhibitor and commonly used as a pharmacokinetic booster for other HIV medications?
A) Atazanavir
B) Fosamprenavir
C) Ritonavir
D) Saquinavir
E) Indinavir

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Question 5
Which Integrase Strand Transfer Inhibitor (INSTI) is known to increase creatine kinase (CK) levels and may cause rhabdomyolysis?
A) Raltegravir
B) Elvitegravir
C) Dolutegravir
D) Bictegravir
E) All of the above

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Question 6
Which of the following antiretroviral drug classes requires careful timing with polyvalent cation-containing antacids or supplements?
A) Protease Inhibitors (PIs)
B) Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
C) Integrase Strand Transfer Inhibitors (INSTIs)
D) Entry Inhibitors
E) Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

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Question 7
Which NNRTI is considered teratogenic and should be avoided in pregnancy?
A) Nevirapine
B) Efavirenz
C) Etravirine
D) Doravirine
E) Rilpivirine

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Question 8
What is a key difference between Rifampin and Rifabutin regarding their use in HIV patients?
A) Rifampin is preferred due to less drug-drug interaction
B) Rifabutin is preferred due to less CYP450 enzyme induction
C) Rifampin has no impact on liver enzymes
D) Rifabutin is less effective in treating tuberculosis
E) Both have the same effect on CYP450

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Question 9
Which of the following is NOT a side effect commonly associated with Protease Inhibitors (PIs)?
A) Lipodystrophy
B) Hyperglycemia
C) Tendonitis
D) Diarrhea
E) Nephrolithiasis

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Question 10
Which INSTI is most likely to cause an increase in creatine kinase (CK) levels?
A) Raltegravir
B) Elvitegravir
C) Dolutegravir
D) Bictegravir
E) All have an equal effect on CK levels

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Question 11:
Which of the following is a fusion inhibitor used in the treatment of HIV?

A) Maraviroc
B) Zidovudine
C) Enfuvirtide
D) Tenofovir
E) Abacavir

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Question 12:
What is the primary mechanism of action for CCR5 antagonists in HIV treatment?

A) Inhibiting reverse transcriptase
B) Blocking the CCR5 co-receptor on CD4 cells
C) Inhibiting integrase
D) Preventing viral fusion with the host cell membrane
E) Mimicking nucleotides

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Question 13:
Which NRTI is known for causing the highest risk of hypersensitivity reactions, particularly in patients with the HLA-B-5701 allele?

A) Tenofovir
B) Emtricitabine
C) Abacavir
D) Zidovudine
E) Lamivudine

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Question 14:
Which of the following NRTIs is primarily associated with nephrotoxicity?

A) Tenofovir Disoproxil Fumarate (TDF)
B) Zidovudine
C) Emtricitabine
D) Lamivudine
E) Abacavir

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Question 15:
Which of the following side effects is most commonly associated with Zidovudine?

A) Mitochondrial toxicity
B) Peripheral neuropathy
C) Bone marrow suppression
D) Nephrotoxicity
E) Pancreatitis

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Question 16:
Which of the following is a neuraminidase inhibitor used to treat and prevent influenza A and B?

A) Oseltamivir
B) Amantadine
C) Baloxavir marboxil
D) Zanamivir
E) Peramivir

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Question 17:
Which influenza treatment is delivered via inhalation and is not recommended for patients with asthma or COPD due to the risk of bronchospasm?

A) Oseltamivir
B) Zanamivir
C) Peramivir
D) Amantadine
E) Baloxavir marboxil

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Question 18:
What is the mechanism of action of Baloxavir marboxil in treating influenza?

A) Inhibits neuraminidase enzyme
B) Inhibits the PA protein, interfering with viral RNA transcription
C) Blocks M2 protein ion channel
D) Prevents viral uncoating
E) Enhances immune response to influenza virus

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Question 19:
Which antiviral is no longer recommended for the treatment of influenza due to widespread resistance?

A) Oseltamivir
B) Zanamivir
C) Amantadine
D) Baloxavir marboxil
E) Peramivir

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Question 20:
Which of the following side effects is commonly associated with neuraminidase inhibitors like Oseltamivir?

A) Diarrhea
B) Nausea and vomiting
C) Bronchospasm
D) QT prolongation
E) Ataxia

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Question 21
Which of the following NRTIs used in treating chronic Hepatitis B is associated with lower renal and bone toxicity?
A) Tenofovir disoproxil fumarate (TDF)
B) Entecavir (ETV)
C) Lamivudine (3TC)
D) Tenofovir alafenamide (TAF)
E) Adefovir dipivoxil

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Question 22
Why should Entecavir not be used in patients with HIV co-infection who are not on antiretroviral therapy (ART)?
A) It has poor efficacy against HIV.
B) It can cause severe hepatotoxicity in HIV patients.
C) It can lead to the development of HIV resistance.
D) It causes significant bone marrow suppression in HIV patients.
E) It interacts negatively with most ART regimens.

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Question 23
Which of the following is a key indication for the use of Pegylated Interferon in the treatment of chronic Hepatitis B?
A) It is used as a first-line treatment in all patients with chronic HBV.
B) It is preferred for patients who cannot tolerate oral NRTIs.
C) It is often used for a finite duration of treatment.
D) It is preferred in patients with renal insufficiency.
E) It is the treatment of choice for acute Hepatitis B.

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Question 24
Which of the following drugs is NOT typically used as a first-line treatment for chronic Hepatitis B?
A) Tenofovir disoproxil fumarate (TDF)
B) Entecavir (ETV)
C) Lamivudine (3TC)
D) Adefovir dipivoxil
E) Tenofovir alafenamide (TAF)

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Question 25
What is the primary mechanism of action for NS3/4A Protease Inhibitors used in the treatment of HCV?
A) Inhibition of viral RNA replication
B) Induction of lethal mutations in viral RNA
C) Inhibition of viral protein processing
D) Enhancement of immune response
E) Blocking viral replication and assembly

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Question 26
Which of the following is a common side effect associated with the use of Simeprevir, an NS3/4A Protease Inhibitor?
A) Bradycardia
B) Hemolytic anemia
C) Rash
D) Bone marrow suppression
E) Depression

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Question 27
Which drug class includes Sofosbuvir, a cornerstone in many HCV treatment regimens?
A) NS3/4A Protease Inhibitors
B) NS5A Inhibitors
C) NS5B Polymerase Inhibitors
D) Interferons
E) Ribavirin

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Question 28
What significant side effect should be closely monitored when using Ribavirin in HCV treatment?
A) Teratogenicity
B) Bradycardia
C) Liver enzyme elevation
D) Rash
E) Depression

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Question 29
Which of the following is a key point regarding the use of Peginterferon alfa-2a in HCV treatment?
A) It is commonly used in combination with DAAs for all HCV genotypes.
B) It has largely been replaced by DAAs due to lower efficacy and higher side effects.
C) It is known for its minimal side effects compared to other HCV treatments.
D) It is the first-line treatment for all cases of HCV.
E) It does not cause bone marrow suppression.

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Question 30:
Which antiviral drug is indicated for the treatment of cytomegalovirus (CMV) retinitis in patients with AIDS and requires concomitant use of probenecid to reduce nephrotoxicity?

A) Acyclovir
B) Valacyclovir
C) Cidofovir
D) Foscarnet
E) Famciclovir

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Question 31:
Which of the following is a pyrophosphate analog used to treat acyclovir-resistant herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections?

A) Acyclovir
B) Valacyclovir
C) Foscarnet
D) Famciclovir
E) Penciclovir

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Question 32:
Which nucleoside analogue is a prodrug of acyclovir with better oral bioavailability, allowing for less frequent dosing?

A) Cidofovir
B) Foscarnet
C) Valacyclovir
D) Ganciclovir
E) Penciclovir

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Question 33:
Which of the following anti-herpes drugs is administered topically for the treatment of herpes labialis (cold sores)?

A) Acyclovir
B) Valacyclovir
C) Famciclovir
D) Penciclovir
E) Ganciclovir

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Question 34:
What is a significant side effect associated with Ganciclovir, a nucleoside analogue used in the treatment of CMV infections?

A) Nephrotoxicity
B) Pancytopenia
C) Neurotoxicity
D) Hepatotoxicity
E) Seizures

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Question 35:

A 50-year-old woman presents to the clinic with symptoms of eye pain, redness, and blurred vision. The ophthalmologist diagnoses her with keratoconjunctivitis caused by the herpes simplex virus and prescribes an antiviral treatment. Which antiviral medication is the first choice for treating her keratoconjunctivitis caused by the herpes simplex virus?

A) Oseltamivir
B) Trifluridine
C) Acyclovir
D) Famciclovir
E) Zanamivir

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Question 36:

A 45-year-old man presents with flu-like symptoms, including fever, chills, and body aches. The rapid influenza diagnostic test confirms that he has influenza A. His medical history includes mild asthma, which is well-controlled with a short-acting beta-agonist inhaler. Which antiviral medication is specifically indicated for the treatment of influenza A but not influenza B?

A) Oseltamivir
B) Zanamivir
C) Amantadine
D) Peramivir
E) Baloxavir marboxil

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Question 37:

A 60-year-old woman with chronic obstructive pulmonary disease (COPD) is diagnosed with influenza. Her physician wants to prescribe an antiviral that can treat both influenza A and B. Which of the following drugs are neuraminidase inhibitors used to treat both influenza A and B?

A) Amantadine and Trifluridine
B) Oseltamivir and Zanamivir
C) Acyclovir and Valacyclovir
D) Famciclovir and Penciclovir
E) Baloxavir and Peramivir

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Question 38:

A 35-year-old man presents to the clinic with cold sores and a history of genital herpes. His physician explains that these are common infections caused by the herpes simplex virus (HSV). Which of the following infections is NOT typically caused by the herpes simplex virus?

A) Genital herpes
B) Keratoconjunctivitis
C) Cold sores
D) Influenza
E) Encephalitis

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Question 39:

A 70-year-old man with chronic obstructive pulmonary disease (COPD) visits his pharmacist for advice on the influenza vaccine. He is concerned about his risk of complications from the flu. Which groups of patients are particularly advised to receive the influenza vaccination?

A) Children under 5 years old
B) Patients with chronic respiratory and cardiovascular diseases, diabetes, HIV, elderly over 65, healthcare workers, and those in long-term care facilities
C) Patients with an active herpes simplex infection
D) Only healthy adults under 50 years old
E) Patients allergic to eggs

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Question 40:

A 38-year-old nurse working in a hospital setting asks the pharmacist about the importance of receiving the flu vaccine each year. What is the primary role of healthcare workers concerning the transmission of influenza?

A) They are vectors (carriers) of the flu virus.
B) They are immune to the flu virus.
C) They do not require flu vaccination.
D) They should avoid vaccination to prevent side effects.
E) They are unaffected by flu due to workplace immunity.

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Question 41:

A 40-year-old man with HIV presents with a CD4 count of 100 cells/mm³. His physician discusses the need for prophylaxis against specific opportunistic infections. Which opportunistic infection requires prophylaxis when the CD4 count drops to 100 in HIV patients?

A) Tuberculosis
B) Pneumocystis carinii pneumonia
C) Toxoplasmosis
D) Candidiasis
E) Cytomegalovirus

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Question 42:

A 45-year-old woman with HIV is receiving antiretroviral therapy (ART) that includes tenofovir. She asks her pharmacist about the potential side effects of her medications. Which antiretroviral drug is a nucleotide reverse transcriptase inhibitor (NtRI) and is associated with renal toxicity?

A) Didanosine
B) Zidovudine
C) Stavudine
D) Tenofovir
E) Lamivudine

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Question 43:

A 52-year-old man with HIV is receiving a combination of antiretroviral drugs that include tenofovir, didanosine, and stavudine. His physician reviews the combination and considers making adjustments. Why should the combination of Tenofovir, Didanosine, and Stavudine (TDS) be avoided in HIV therapy?

A) They cause neurotoxicity.
B) They are ineffective against HIV.
C) They cause pancreatitis.
D) They increase the risk of cardiovascular disease.
E) They cause severe anemia.

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Question 44:

A 60-year-old woman with HIV is experiencing peripheral neuropathy, which she believes may be related to her antiretroviral therapy. Her regimen includes zalcitabine, didanosine, and stavudine. Which combination of antiretroviral drugs should not be used together due to the risk of neuropathic pain?

A) Tenofovir, Zidovudine, and Stavudine
B) Zalcitabine, Didanosine, and Stavudine
C) Lamivudine, Abacavir, and Zidovudine
D) Emtricitabine, Tenofovir, and Efavirenz
E) Abacavir, Lamivudine, and Zidovudine