Antivirals: CMV drugs: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Antivirals: CMV drugs

Sample item

A transplant recipient with CMV retinitis is treated with ganciclovir and develops a neutrophil count of 0.6 thousand per microlitre. Another patient on a different anti-CMV drug develops rising creatinine and electrolyte disturbances. Which pair fits?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Ganciclovir with neutropenia, and foscarnet with nephrotoxicity

Ganciclovir causes dose-limiting bone marrow suppression, while foscarnet is nephrotoxic and causes hypocalcaemia and other electrolyte disorders. Cidofovir is also nephrotoxic and is given with probenecid and hydration.

Option by option

  • A. Oseltamivir with neutropenia, and foscarnet with hepatotoxicity

    Oseltamivir is not myelotoxic.

  • B. Ganciclovir with neutropenia, and foscarnet with nephrotoxicity (correct)

    Correct. Each pairing is characteristic.

  • C. Ganciclovir with nephrotoxicity, and foscarnet with neutropenia

    The toxicities are reversed in this option.

  • D. Cidofovir with neutropenia, and aciclovir with ototoxicity

    Cidofovir is nephrotoxic, not mainly myelosuppressive.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Ganciclovir with neutropenia, and foscarnet with nephrotoxicity. Ganciclovir causes dose-limiting bone marrow suppression, while foscarnet is nephrotoxic and causes hypocalcaemia and other electrolyte disorders.

Why is "Oseltamivir with neutropenia, and foscarnet with hepatotoxicity" not the answer?

Oseltamivir is not myelotoxic.

Why is "Ganciclovir with nephrotoxicity, and foscarnet with neutropenia" not the answer?

The toxicities are reversed in this option.

Why is "Cidofovir with neutropenia, and aciclovir with ototoxicity" not the answer?

Cidofovir is nephrotoxic, not mainly myelosuppressive.

What concept does this question test?

It tests Antivirals: CMV drugs in Pharmacology. Cidofovir is also nephrotoxic and is given with probenecid and hydration.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antivirals: CMV drugs?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.