Answers to Multiple Choice Questions - Paper 3

Instructions for candidates

The examination consists of 30 multiple choice questions, each divided into 5 different parts. Each part contains a statement which could be true or
false. Each question will have at least one part which is true. For each part, you should indicate whether you think it is true (T), false (F), or dont
know (DN). You must fill in the relevant square with a black pen. One mark will be given for each correct answer and one mark deducted for each
incorrect answer. You will not be marked for those questions for which you have indicated "dont know".

1. The following are DNA viruses

False Influenza A virus

False Rubella Virus

True Hepatitis B Virus

True CMV Virus

True Parvovirus

Influenza A virus and Rubella Virus are RNA viruses. CMV Virus and Hepatitis B Virus are double-stranded DNA viruses.
Parvovirus is a single-stranded DNA virus

2. The following are negatively stranded RNA viruses

False Picornaviruses

True Orthomyxoviruses

False Coronaviruses

False Flaviviruses
True Rhabdoviruses

Picornaviruses, coronaviruses and flaviviruses are positively stranded RNA viruses

3. The following viruses have segmented genomes

True Orthomyxoviruses

False Herpesviruses
False Paramyxoviruses

True Bunyaviruses

True Rotaviruses

The genome of orthomyxoviruses consists of 7 or 8 single stranded RNA segments, bunyaviruses 3 single stranded RNA
segments, and rotaviruses 11 double stranded RNA segments.

4. The following are enveloped viruses

True Herpesviruses

False Adenoviruses

False Rotaviruses

False Parvoviruses

True Orthomyxoviruses

5. All viruses

False Contain DNA

False Contain RNA

True Contain protein

False Are susceptible to lipid solvents

True Are intracellular parasites

Viruses contain either DNA or RNA. All viruses contain protein. Only enveloped viruses are susceptible to lipid solvents. All
viruses are intracellular parasites.

6. The following viruses are associated with human cancers

False HSV-2

True EBV

True HCV

False Adenoviruses

True HHV-8

HSV-2 was associated with genital cancers at one time but this has now been disproved. EBV is associated with Burkitt's
lymphoma, nasopharyngeal carcinoma, and large-cell lymphomas in immunocompromised individuals. Although adenoviruses
may be oncogenic in vitro, there is no evidence that they are associated with human cancers. HHV-8 is associated with Kaposi's
sarcoma.

7. The following viruses may cause congenital infection

True HSV-2

True Rubella
True HIV

True HBV

True CMV

All the above viruses may cause congenital infection. Rubella and CMV are usually transmitted transplacentally in utero, whilst
HIV, HBV and HSV-2 are usually transmitted perinatally during the birth process.

8. The following viruses have reverse transcriptase

True HIV

False Parvovirus

True HBV

False CMV

True HTLV-1

HIV and HTLV-1 are retroviruses. HBV is a DNA virus whose replication depend on a reverse transcriptase

9. The following viruses replicate in the nucleus

True Herpseviruses

False Poxviruses

False Picornaviruses
True Orthomyxoviruses

False Paramyxoviruses

All DNA viruses, with the exception of poxviruses replicate in the nucleus. All RNA viruses, with the exception of
orthomyxoviruses, replicate in the cytoplasm

10. The following are viral zoonoses

False Rubella

True Rabies

True Hantaviruses

True Lassa Fever

True Japanese Encephalitis

Zoonoses are infections which are transmitted from a vertebrate animal to humans either directly, or indirectly through an
arthropod vector. Rabies may be transmitted to human from various mammals. Hantaviruses and Lassa fever from rodents. The
reservoir of Japanese encephalitis is in birds and pigs and it is transmitted to humans via culex mosquitoes

11. Reassortment of genes may occur with

False HSV-1

False HBV

False HIV

True Influenza A Virus

True Rotaviruses
Reassortment of genes occur in influenza A and rotaviruses. It is thought to be responsible for large changes in antigenicity

12. The following statements are true of prions

False Readily inactivated by autoclave at 121oC

False Contain

True Have long incubation periods

False Highly immunogenic

False May be readily cultured

Prions required autoclaving at 134 oC in order to be effectively inactivated.They consist probably solely of protein: no DNA had
ever had demonstrated. Prion diseases are characterised by long incubation periods. Being host-derived, prion proteins are not
immunogenic. They may not be cultured readily.

13. The following are "slow virus" diseases

False Herpes Simplex Encephalitis

True Creutzfeldt-Jacob disease

True Subacute Scelerosing Panecephalitis (SSPE)

False Rabies
True Progressive multifocal leucoencephalopathy (PML)

"Slow virus infections" refer to viral or prion infections of the brain characterised by a long incubation period which is in terms
of years. Human prion diseases, Subacute Scelerosing Panecephalitis (SSPE), and Progressive multifocal leucoencephalopathy
(PML) are considered as slow virus infections. Herpes Simplex Encephalitis and rabies are not.

14. HSV-1 infection may result in

True Encephalitis

True Gingivostomatitis
True Genital Herpes
True Corneal Ulcers

False Shingles
 HSV-1 infection may result in encephalitis, gingivostomatitis, genital herpes, and corneal ulcers. Shingles arise from a previous
infection by VZV

15. The following viruses are associated with a vesicular rash

False Rubella Virus

False Measles Virus

False Parvovirus

True HSV-1
True VZV

Rubella, measles, and parvoviruses cause a maculopapular rash

16. Cytomegalovirus (CMV)

True Primary infection is usually asymptomatic

True An infectious mononucleosis-like syndrome may occur during primary infection.

True May cause severe infection in immunocompromised individuals
True May cause congenital infection

True Reactivate from time to time

All the above

17. Epstein-Barr Virus (EBV) is associated with

True Infectious Mononucleosis

False Kaposi's Sarcoma

True Burkitt's lymphoma

True Nasopharyngeal carcinoma

False Adult T-cell lymphoma

HHV-8 is associated with Kaposi's sarcoma, HTLV-1 is associated with Adult T-cell lymphoma

18. HHV-8 is associated with

False Fifth disease

False Roseala Infantum

True Kaposi's Sarcoma

False Nasopharyngeal Carcinoma

False Oral leukoplakia

Parvovirus is associated with fifth disease, HHV-6 with Roseala Infantum, EBV with Nasopharyngeal Carcinoma and oral
leukoplakia

19. The following viruses are thought to cause gastroenteritis

False Enteroviruses

True Caliciviruses
True Norwalk-like viruses

True Astroviruses
False Paramyxoviruses

Although enteroviruses may be found in the faeces, they are not associated with gastroenteritis. Paramyxoviruses are not
associated with gastroenteritis

20. The following statements are true

True Human polyoma virus JC is associated with progressive multifocal leucoencephalopathy (PML)

False Human polyoma virus JC is associated with warts

False HPV-6 and HPV-11 are associated with genital cancers

True HPV-6 and HPV-11 are associated with Juvenile laryngeal papillomatosis
True Patients with Epidermodysplasia verruciformis are susceptible to widespread warts caused by HPV

Human papillomaviruses (HPV) are associated with warts. HPV-16 and 18 are associated with genital cancers. Patients with
Epidermodysplasia verruciformis are susceptible to widespread warts caused by a variety of HPV types. These lesions may
become cancerous later on in life.

21. The following statements are true

True Influenza A may undergo antigenic shift

False Influenza B may undergo antigenic shift

True Influenza A may undergo antigenic drift

True Influenza B may undergo antigenic drift

False Influenza B may respond to amantidine

Only influenza A is known to undergo antigenic shift. Both influenza A and influenza B may undergo antigenic drift. Only
influenza A respond to amantidine

22. Respiratory Syncytial Virus

False Cause disease mainly in adults

True May cause bronchiolitis

False May be prevented by vaccination

False May be treated by amantidine

False May cause latent infections

RSV mainly causes disease in infants. It is the main cause of bronchiolitis. There is no vaccine available. It will not respond to
amantidine but will respond to ribavirin. It is not known to cause latent infections,

23. HIV may respond to

True Nucleoside analogues

True Protease inhibitors

False Neuraminidase inhibitors

True Reverse transcriptase inhibitors

True Acyclovir
HIV may respond to reverse transcriptase inhibitors, many of which are nucleoside analogues. It may also respond to HIV
protease inhibitors which are the most potent agents to date. Neuraminidase inhibitors are used for the treatment of influenza virus
infections whilst acyclovir is used for herpesvirus infections.

24. During the incubation period of HIV infection, there is

False Little HIV replication
False HIV is mainly integrated into the genome of long-lived cell populations
True High turnover of CD4 cells

True The viral load has a direct bearing on the prognosis

False Little antibody against the HIV envelope

During the incubation period, there is a huge amount of viral replication and consequently a high turnover of CD4 cells. Only a
very small proportion of HIV is integrated into the genome of long-lived cell populations. The viral load has a direct bearing on
the prognosis. HIV envelope antibody remains at a high level throughout the incubation period.

25. Hepatitis A infection

False May result in chronic infection

True May be prevented by immunoglobulin

True May be prevented by vaccination
False Is highly infectious during the jaundice phase
False May result in cirrhosis

HAV infection does not result in chronic infection and therefore cirrhosis. It may be prevented by the administration of human
normal immunoglobulin (HNIG), and active vaccination by an inactivated vaccine. By the time jaundice appears, there is little
viral excretion and thus infectivity.

26. Hepatitis B infection

True May result in chronic infection

True May result in cirrhosis of the liver
True May result in hepatocellular carcinoma

True Is highly infectious when positive for HBeAg

True May respond to interferon therapy
HBV infection may result in chronic infection, cirrhosis of the liver and hepatocellular carcinoma. The presence of HbeAg
indicates viral replication and thus infectivity. Chronic HBV infection may respond to interferon therapy.

27. The following statements are true of hepatitis B core escape mutants

True Associated with fulminant hepatitis

False HbeAg positive
True anti-HbeAg antibody positive
True HBV-DNA positive
False Anti-HbsAg antibody positive

Hepatitis B core escape mutants are associated with acute fulminant hepatitis. They are anti-HbeAg antibody positive and HBV-
DNA positive. HbsAg is present and therefore they should be no anti-HbsAg antibody.

28. Hepatitis C virus

True May be transmitted by blood
True Is associated with hepatocellular carcinoma

True May respond to interferon therapy

False Has one stable genotype only
False May cause chronic infection
HCV is mainly transmitted by blood. It may cause chronic infection and is associated with hepatocellular carcinoma. It may
respond to interferon therapy. There are a number of HCV genotypes.
 29. The following statements are true

True Dengue virus infection result from bites by Aedes mosquitoes

True Cases of dengue haemorrhagic fever usually result from reinfection by a different serotype of dengue virus
False Pigs act as the reservoir for dengue virus
False Yellow fever is prevalent throughout Asia

True Yellow fever may be prevented by vaccination

Dengue virus infection result from bites by Aedes mosquitoes. Cases of dengue haemorrhagic fever usually result from
reinfection by a different serotype of dengue virus: an immunopathological mechanism is thought to be involved. No animal
reservoir is involved in the vast majority of dengue cases: transmission arise from a man-mosquito-man cycle. Yellow fever is not
found in Asia, it is prevalent in some West African and Central and South American countries. It can be prevented by vaccination
with a live attenuated vaccine.

30. Measles virus

True Infection may result in pneumonia

True Infection may result in encephalitis

False Undergo antigenic drift
False May respond to acyclovir
True May be prevented by vaccination

Measles virus infection may result in pneumonia and encephalitis. There is one stable serotype. Measles will not respond to
acyclovir but can be prevented by vaccination.