Science Biology Virology

Clinical Virology Access Medicine

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Microbiology Review (Viruses) Microbiology 38 Micr

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Terms in this set (142)

Each of the following D
statements concerning Latent infection by measles virus can be
measles virus is correct explained by the integration of provirus into the
EXCEPT: host cell DNA.
A
Measles virus is an
enveloped virus with a
single-stranded RNA
genome.
B
One of the important
complications of measles is
encephalitis.
C
The initial site of measles
virus replication is the upper
respiratory tract, from which
it spreads via the blood to
the skin.
D
Latent infection by measles
virus can be explained by
the integration of provirus
into the host cell DNA.
Each of the following B
statements concerning HIV probably arose as an endogenous virus of
human immunodeficiency humans because HIV proviral DNA is found in
virus (HIV) is correct the DNA of certain normal human cells.
EXCEPT:
A
Patients infected with HIV
typically form antibodies
against both the envelope
glycoproteins (gp120 and
gp41) and the internal
group-specific antigen (p24).
B
HIV probably arose as an
endogenous virus of humans
because HIV proviral DNA is
found in the DNA of certain
normal human cells.
C
Transmission of HIV occurs
primarily by the transfer of
blood or semen in adults,
and neonates can be
infected at the time of
delivery.
D
The diagnosis of early HIV
infection is made by testing
the patient's serum for
antibodies against HIV and
for p24 antigen.
Regarding the serologic B
diagnosis of infectious A heterophil antibody is formed that
mononucleosis, which one of agglutinates sheep or horse red blood cells.
the following is CORRECT?
A
A heterophil antibody is
formed that reacts with a
capsid protein of Epstein-
Barr virus.
B
A heterophil antibody is
formed that agglutinates
sheep or horse red blood
cells.
C
A heterophil antigen occurs
that cross-reacts with
Proteus OX19 strains.
D
A heterophil antigen occurs
following infection with
cytomegalovirus.

Clinical Virology Access Medicine

Regarding the adverse B
effects of drugs used in the Lopinavir
treatment of human
immunodeficiency virus
(HIV) infection, which one of
the following is most likely to
cause lipodystrophy (i.e.,
abnormal fat deposits)?
A
Lamivudine
B
Lopinavir
C
Nevirapine
D
Maraviroc
E
Zidovudine
Regarding the adverse E
effects of drugs used in the Zidovudine
treatment of human
immunodeficiency virus
(HIV) infection, which one of
the following is most likely to
cause bone marrow
suppression?
A
Lamivudine
B
Lopinavir
C
Nevirapine
D
Maraviroc
E
Zidovudine
Regarding the main B
mechanism by which They carry the genes for proteins that act as
oncogenic retroviruses cellular growth factors.
cause malignant
transformation, which one of
the following is most
accurate?
A
They cause point mutations
in cellular regulatory genes.
B
They carry the genes for
proteins that act as cellular
growth factors.
C
They synthesize a protein
that inhibits the action of the
cellular p53 protein.
D
They encode a recombinase
that causes translocation of
certain chromosomes.
E
They encode a DNA
polymerase that increases
the rate of cellular DNA
synthesis.
Regarding human D
papillomavirus (HPV), which The early proteins of HPV play a more important
one of the following role in malignant transformation than the late
statements is most accurate? proteins.
A
There is no vaccine available
against HPV.
B
Acyclovir is effective in
preventing lesions caused by
HPV but does not cure the
latent state.
C
Antigen-antibody complexes
play an important role in the
pathogenesis of warts
caused by HPV.
D
The early proteins of HPV
play a more important role in
malignant transformation
than the late proteins.
E
The diagnosis of HPV
infection is usually made by
detecting cytoplasmic
inclusions within giant cells
in the lesions.
A 24-year-old woman has A
had fever and a sore throat Norovirus
for the past week.
Moderately severe
pharyngitis and bilateral
cervical lymphadenopathy
are seen on physical
examination. Which one of
the following viruses is
LEAST likely to cause this
picture?
A
Norovirus
B
Adenovirus
C
Coxsackie virus
D
Epstein-Barr virus
Which one of the following B
statements concerning viral Herpes simplex virus type 1 is an important
meningitis and viral cause of viral encephalitis.
encephalitis is CORRECT?
A
Herpes simplex virus type 2
is the leading cause of viral
meningitis.
B
Herpes simplex virus type 1
is an important cause of viral
encephalitis.
C
The spinal fluid protein is
usually decreased in viral
meningitis.
D
The diagnosis of viral
meningitis can be made by
using the India ink stain on a
sample of spinal fluid.
Regarding the oncogenes of D
DNA tumor viruses, which They encode proteins that bind to the proteins
one of the following is most encoded by tumor suppressor genes.
accurate?
A
They encode protein kinases
that phosphorylate p53
protein.
B
They interact with cellular
proto-oncogenes and
activate them.
C
They encode cellular growth
factors that activate S-phase
DNA synthesis.
D
They encode proteins that
bind to the proteins
encoded by tumor
suppressor genes.
Each of the following B
statements regarding Pathogenesis by poliovirus primarily involves the
poliovirus and its vaccine is death of sensory neurons.
correct EXCEPT:
A
Poliovirus is transmitted by
the fecal-oral route.
B
Pathogenesis by poliovirus
primarily involves the death
of sensory neurons.
C
The live, attenuated vaccine
contains all three serotypes
of poliovirus.
D
An unimmunized adult
traveling to countries where
there is a known risk of being
infected with poliovirus
should receive the
inactivated vaccine.
Your patient is a 22-year-old A
woman with several Cytomegalovirus
episodes of bloody diarrhea.
She is HIV antibody positive
with a CD4 count of 50.
Stool cultures for Shigella,
Salmonella, and
Campylobacter were
negative. An assay for
Clostridium difficile toxin
was negative. Colonoscopy
revealed many ulcerated
lesions. Biopsy revealed cells
with "owl's eye" inclusions in
the nucleus. Which one of
the following is the most
likely cause of this disease?
A
Cytomegalovirus
B
Epstein-Barr virus
C
Herpes simplex virus type 1
D
Human herpesvirus 8
E
Varicella-zoster virus
Regarding hepatitis B virus B
(HBV) and the disease HBV has a circular, partially double-stranded
hepatitis B, which one of the DNA as its genome and has a DNA polymerase
following is most accurate? in the virion.
A
The most reliable indicator
that a person can transmit
HBV is the presence of
HBsAg in the blood.
B
HBV has a circular, partially
double-stranded DNA as its
genome and has a DNA
polymerase in the virion.
C
Healthcare personnel who
sustain a needle-stick injury
while taking blood from a
person with hepatitis B
should receive acyclovir.
D
HBV infection induces
antibody to HBcAg (core
antigen), which protects the
person from a second attack
by the same strain of HBV.
E
A person in the "window
period" can be diagnosed as
having been infected by HBV
if antibody to the surface
antigen (HBsAg) is present.
A 6-month-old child D
develops a persistent cough Rotavirus
and a fever. Physical
examination and chest X-ray
suggest pneumonia. Which
one of the following
organisms is LEAST likely to
cause this infection?
A
Respiratory syncytial virus
B
Adenovirus
C
Parainfluenza virus
D
Rotavirus
Each of the following A
statements concerning the The vaccine contains live, attenuated rabies
rabies vaccine for use in virus.
humans is correct EXCEPT:
A
The vaccine contains live,
attenuated rabies virus.
B
If your patient is bitten by a
wild animal (e.g., a skunk) the
rabies vaccine should be
given.
C
When the vaccine is used for
postexposure prophylaxis,
rabies immune globulin
should also be given.
D
The virus in the vaccine is
grown in human cell cultures,
thus decreasing the risk of
allergic encephalomyelitis.
Each of the following D
statements concerning A major problem with testing for antibody to the
human immunodeficiency virus is its cross-reactivity with human T-cell
virus is correct EXCEPT: leukemia virus type I.
A
The CD4 protein on the T-
cell surface is one of the
receptors for the virus.
B
There is appreciable
antigenic diversity in the
envelope glycoprotein of
the virus.
C
One of the viral genes codes
for a protein that augments
the activity of the viral
transcriptional promoter.
D
A major problem with testing
for antibody to the virus is its
cross-reactivity with human
T-cell leukemia virus type I.
Regarding the mode of B
action of drugs used in the Raltegravir inhibits the integration of HIV DNA
treatment of human into host cell DNA.
immunodeficiency virus
(HIV) infection, which one of
the following is most
accurate?
A
Maraviroc acts by inhibiting
the reverse transcriptase in
the virion.
B
Raltegravir inhibits the
integration of HIV DNA into
host cell DNA.
C
Zidovudine is a nucleoside
analog that inhibits
messenger RNA (mRNA)
synthesis of HIV.
D
Ritonavir acts by binding to
the Tat protein, which
prevents budding and
release of the HIV virion.
E
Lamivudine is a "chain-
terminating" drug because it
inhibits the growing
polypeptide chain by
causing misreading of the
viral mRNA.
Your patient is a 30-year-old B
man who has frequent The main site of latency by HSV-1 is the neurons
episodes of herpes labialis. in the sensory ganglia of the face.
He asks you to tell him
something about herpes
simplex virus type 1 (HSV-1).
Which one of the following
would be the most accurate
statement to make?
A
Acyclovir can eradicate the
latent state of HSV-1 but not
HSV-2.
B
The main site of latency by
HSV-1 is the neurons in the
sensory ganglia of the face.
C
HSV-1 is an enveloped virus
that has a DNA genome and
a DNA polymerase in the
virion.
D
The lesions of primary HSV-1
infections are less extensive
and less severe than the
lesions of recurrent HSV-1
infections.
E
The laboratory diagnosis of
HSV-1 infections typically
involves the detection of a
greater than fourfold rise in
antibody titer against the
virus.
Regarding measles virus and E
the disease measles, which This virus has only one antigenic type, and
one of the following lifelong immunity occurs in patients who have
statements is most accurate? had measles.
A
The measles vaccine
contains killed virus as the
immunogen.
B
One of the main sequelae of
measles is autoimmune
glomerulonephritis and
kidney failure.
C
Measles is unlikely to be
eradicated because there is
a significant animal reservoir
for this virus.
D
Fecal-oral transmission
during the diaper stage is
the main mode of acquisition
of measles virus.
E
This virus has only one
antigenic type, and lifelong
immunity occurs in patients
who have had measles.
Your patient is a 35-year-old D
man who complains that the IgM antibody to hepatitis A virus
whites of his eyes have
turned yellow. After taking a
history and doing a physical,
you order serologic tests to
determine whether he has
viral hepatitis. On the basis
of the results, you tell him
that he has a mild form of
hepatitis that does not cause
long-term damage to the
liver. Your conclusion is
based on a positive result on
which one of the following
tests?
A
Antibody to hepatitis C virus
B
Hepatitis B surface antigen
C
Hepatitis delta antigen
D
IgM antibody to hepatitis A
virus
Regarding rabies virus and C
the disease rabies, which In the United States, skunks and bats are more
one of the following likely to transmit rabies virus to people than are
statements is most accurate? dogs and cats.
A
Finding intranuclear inclusion
bodies within macrophages
is presumptive evidence of
rabies virus infection.
B
Lamivudine is used to treat
rabies because it inhibits the
RNA-dependent DNA
polymerase in the virion.
C
In the United States, skunks
and bats are more likely to
transmit rabies virus to
people than are dogs and
cats.
D
The incubation period of the
disease is usually 2 to 4 days,
leading to the rapid
progression of the
encephalitis and death.
E
After the animal bite, rabies
virus enters the
bloodstream, replicates in
internal organs such as the
liver, and then reaches the
central nervous system
during the secondary
viremia.
Each of the following C
statements concerning Mumps orchitis in children prior to puberty often
mumps is correct EXCEPT: causes sterility.
A
Mumps virus is a
paramyxovirus and hence
has a single-stranded RNA
genome.
B
Meningitis is a recognized
complication of mumps.
C
Mumps orchitis in children
prior to puberty often
causes sterility.
D
During mumps, the virus
spreads through the
bloodstream (viremia) to
various internal organs.
Regarding prion-mediated A
diseases, which one of the Prion-mediated diseases are characterized by
following is the most vacuoles in the brain called "spongiform
accurate? changes."
A
Prion-mediated diseases are
characterized by vacuoles in
the brain called "spongiform
changes."
B
Variant Creutzfeldt-Jakob
disease is a disease of cattle
caused by the ingestion of
sheep brain mixed into cattle
feed.
C
Kuru is a prion-mediated
disease for which the
diagnosis can be confirmed
in the laboratory by a
fourfold or greater rise in
antibody titer.
D
In Creutzfeldt-Jakob disease,
only neurons latently
infected by JC virus produce
the prion filaments that
disrupt neuronal function.
E
Creutzfeldt-Jakob disease
occurs primarily in children
under the age of 2 years
because they cannot mount
an adequate immune
response to the prion
protein.
Regarding the structure and D
replication of human HIV has an enzyme in the virion that synthesizes
immunodeficiency virus double-stranded DNA using the single-stranded
(HIV), which one of the genome RNA as the template.
following is most accurate?
A
Viral mRNA is the template
for the synthesis of the
genome RNA.
B
During entry of HIV into the
cell, the viral p24 protein
interacts with the CD4
protein on the cell surface.
C
HIV contains an integrase
within the virion that
integrates copies of the viral
genome into the progeny
virions.
D
HIV has an enzyme in the
virion that synthesizes
double-stranded DNA using
the single-stranded genome
RNA as the template.
E
The HIV genome encodes a
protease that cleaves
cellular ribosomal proteins,
resulting in the inhibition of
cell-specific protein
synthesis.
Your patient is a 20-year-old C
woman with chronic hepatitis Entecavir
B that was diagnosed by
detecting hepatitis B antigen
in her blood more than 6
months after her acute
infection. Which one of the
following is the best choice
of drug to treat her chronic
hepatitis B?
A
Acyclovir
B
Foscarnet
C
Entecavir
D
Ritonavir
E
Zidovudine
Which one of the following D
statements concerning the One of the influenza virus vaccines contains
prevention of viral disease is killed virus that induces neutralizing antibody
CORRECT? directed against the hemagglutinin.
A
Adenovirus vaccine contains
purified penton fibers and is
usually given to children in
conjunction with polio
vaccine.
B
Coxsackie virus vaccine
contains live virus that
induces IgA, which prevents
reinfection by homologous
serotypes.
C
Flavivirus immunization
consists of hyperimmune
serum plus a vaccine
consisting of subunits
containing the surface
glycoprotein.
D
One of the influenza virus
vaccines contains killed virus
that induces neutralizing
antibody directed against
the hemagglutinin.
Each of the following B
statements concerning The vaccine should not be given at the same
measles vaccine is correct time as the mumps vaccine because the immune
EXCEPT: system cannot respond to two viral antigens
A given at the same time.
The vaccine contains live,
attenuated virus.
B
The vaccine should not be
given at the same time as the
mumps vaccine because the
immune system cannot
respond to two viral antigens
given at the same time.
C
Virus in the vaccine contains
only one serotype.
D
The vaccine should not be
given prior to 15 months of
age because maternal
antibodies can prevent an
immune response.
An outbreak of dengue C
hemorrhagic fever (DHF) Dengue virus is transmitted by Aedes
recently occurred in two mosquitoes, and monkeys are an important
Central American countries. natural reservoir.
Regarding dengue and DHF,
which one of the following is
the most accurate?
A
Humans are dead-end hosts
for dengue virus.
B
DHF occurs primarily in
individuals who are deficient
in the late-acting
complement components.
C
Dengue virus is transmitted
by Aedes mosquitoes, and
monkeys are an important
natural reservoir.
D
The vaccine containing live,
attenuated dengue virus is
recommended for those
living or traveling in endemic
areas.
E
DHF occurs more often in
people infected for the first
time than when they are
reinfected because antibody
protects against reinfection.
There are several influenza A
vaccines administered in the One of the vaccines contains purified peptide
United States. Regarding subunits of neuraminidase produced in yeast.
these vaccines, which one of
the following statements is
LEAST accurate?
A
One of the vaccines contains
purified peptide subunits of
neuraminidase produced in
yeast.
B
One of the vaccines is an
inactivated vaccine
consisting of formaldehyde-
treated influenza virions.
C
One of the vaccines contains
a temperature-sensitive
mutant of influenza virus that
replicates in the nose but not
in the lungs.
D
Influenza vaccines contain
influenza A and B strains but
not C strains.
Each of the following D
statements concerning the The protein involved in antigenic drift is primarily
antigenicity of influenza A the internal ribonucleoprotein.
virus is correct EXCEPT:
A
Antigenic shifts, which
represent major changes in
antigenicity, occur
infrequently and are due to
the reassortment of
segments of the viral
genome.
B
Antigenic shifts affect both
the hemagglutinin and the
neuraminidase.
C
The worldwide epidemics
caused by influenza A virus
are due to antigenic shifts.
D
The protein involved in
antigenic drift is primarily the
internal ribonucleoprotein.

Each of the following B

pathogens is likely to Hepatitis A virus
establish chronic or latent
infection EXCEPT:
A
Cytomegalovirus
B
Hepatitis A virus
C
Hepatitis B virus
D
Herpes simplex virus
Causes diarrhea C
A Rotavirus
Yellow fever virus
B
Rabies virus
C
Rotavirus
D
Rubella virus
E
Rhinovirus
Regarding rhinoviruses, C
which one of the following is Rhinoviruses have many serologic types, so a
most accurate? person can have many infections caused by
A these viruses.
Rhinoviruses are an
important cause of viral
meningitis and myocarditis.
B
The rhinovirus vaccine is
recommended for all
children over 2 years of age.
C
Rhinoviruses have many
serologic types, so a person
can have many infections
caused by these viruses.
D
Rhinoviruses are not
inactivated by stomach acid,
so they infect the upper
gastrointestinal tract and are
one of the causes of viral
diarrhea.
E
An important feature of the
laboratory diagnosis of
rhinoviruses is finding
cytopathic effect in cell
culture consisting of
multinucleated giant cells.
Regarding West Nile virus D
(WNV), which one of the Most infections are asymptomatic, but the
following is the most elderly are at risk for encephalitis.
accurate?
A
Rodents are the main
reservoir for WNV.
B
WNV does not cause
disease in the United States.
C
WNV is transmitted primarily
by Ixodes ticks.
D
Most infections are
asymptomatic, but the
elderly are at risk for
encephalitis.
E
The live, attenuated vaccine
should be administered to
elderly adults in endemic
areas.
Each of the following B
statements concerning The earlier in life primary infection is acquired,
Epstein-Barr virus is correct the more likely the typical picture of infectious
EXCEPT: mononucleosis will be manifest.
A
Many infections are mild or
inapparent.
B
The earlier in life primary
infection is acquired, the
more likely the typical
picture of infectious
mononucleosis will be
manifest.
C
Latently infected
lymphocytes regularly
persist following an acute
episode of infection.
D
Infection confers immunity
against second episodes of
infectious mononucleosis.
Each of the following C
statements concerning In the United States, dogs are the most common
rabies and rabies virus is reservoir.
correct EXCEPT:
A
The virus has a lipoprotein
envelope and single-
stranded RNA as its genome.
B
The virus has a single
antigenic type (serotype).
C
In the United States, dogs
are the most common
reservoir.
D
The incubation period is
usually long (several weeks)
rather than short (several
days)

Causes tumors in laboratory A

rodents Adenovirus
A
Adenovirus
B
Parainfluenza virus
C
Rhinovirus
D
Coxsackie virus
E
Epstein-Barr virus
A 70-year-old retired C
carpenter has signed up with Give the killed vaccine containing types 1, 2, and
a volunteer organization to 3.
build houses in a developing
country where polio is still
endemic. He plans to be
there about 9 months. He
thinks he has never been
immunized against polio.
Which one of the following
is the most appropriate thing
to do?
A
Give immune serum
globulins (ISG).
B
Give the killed vaccine
containing only type 3.
C
Give the killed vaccine
containing types 1, 2, and 3.
D
Give the live vaccine
containing only type 3.
E
Give the live vaccine
containing types 1, 2, and 3.
An outbreak of jaundice A
occurs in several young Hepatitis A virus
children who attend the
same day care center. If the
outbreak was caused by a
virus, which one of the
following is the most likely
cause?
A
Hepatitis A virus
B
Hepatitis B virus
C
Hepatitis C virus
D
Hepatitis D virus

The routine screening of B

transfused blood has greatly Hepatitis C virus
reduced the problem of
post-transfusion hepatitis.
For which one of the
following viruses has
screening eliminated a large
number of cases of post-
transfusion hepatitis?
A
Hepatitis A virus
B
Hepatitis C virus
C
Cytomegalovirus
D
Epstein-Barr virus
Each of the following D
statements concerning The antigenic changes that occur with antigenic
influenza is correct EXCEPT: drift are due to reassortment of the multiple
A pieces of the influenza virus genome.
Major epidemics of the
disease are caused by
influenza A viruses rather
than influenza B and C
viruses.
B
Likely sources of new
antigens for influenza A
viruses are the viruses that
cause influenza in animals.
C
Major antigenic changes
(shifts) of viral surface
proteins are seen primarily in
influenza A viruses rather
than in influenza B and C
viruses.
D
The antigenic changes that
occur with antigenic drift are
due to reassortment of the
multiple pieces of the
influenza virus genome.
A 45-year-old man was C
attacked by a bobcat and Use hyperimmune serum and active
bitten repeatedly about the immunization
face and neck. The animal
was shot by a companion
and brought back to the
public health authorities.
Once you decide to
immunize against rabies
virus, how would you
proceed?
A
Use hyperimmune serum
only
B
Use active immunization only
C
Use hyperimmune serum
and active immunization
D
Use active immunization and
follow this with
hyperimmune serum if
adequate antibody titers are
not obtained in the patient's
serum
Each of the following D
statements concerning The presence of circulating antibodies that
human immunodeficiency neutralize HIV is evidence that an individual is
virus (HIV) is correct protected against HIV-induced disease.
EXCEPT:
A
Screening tests for
antibodies are useful to
prevent transmission of HIV
through transfused blood.
B
The opportunistic infections
seen in AIDS are primarily
the result of a loss of cell-
mediated immunity.
C
Zidovudine (azidothymidine)
inhibits the RNA-dependent
DNA polymerase.
D
The presence of circulating
antibodies that neutralize
HIV is evidence that an
individual is protected
against HIV-induced disease.
Each of the following C
statements concerning HDV is transmitted primarily by the fecal-oral
hepatitis C virus (HCV) and route.
hepatitis D virus (HDV) is
correct EXCEPT:
A
HCV is an RNA virus that
causes post-transfusion
hepatitis.
B
HDV is a defective virus that
can replicate only in a cell
that is also infected with
hepatitis B virus.
C
HDV is transmitted primarily
by the fecal-oral route.
D
People infected with HCV
commonly become chronic
carriers of HCV and are
predisposed to
hepatocellular carcinoma.
Regarding prions, which one B
of the following is the most Prion proteins are characterized by having
accurate? changes in conformation from the alpha-helical
A form to the beta-pleated sheet form.
The genome of prions
consists of a negative-
polarity RNA that has a
defective polymerase gene.
B
Prion proteins are
characterized by having
changes in conformation
from the alpha-helical form
to the beta-pleated sheet
form.
C
Prions are very sensitive to
ultraviolet (UV) light, which is
why UV light is used in
hospital operating rooms to
prevent their transmission.
D
The main host defense
against prions consists of an
inflammatory response
composed primarily of
macrophages and CD4-
positive T cells.
Regarding varicella-zoster E
virus (VZV), which one of the When zoster occurs in an immunocompromised
following is most accurate? patient, acyclovir should be given to prevent
A disseminated infection.
High-dose acyclovir can
eliminate the latent state
caused by VZV.
B
The principal site of latency
of VZV is in the nucleus of
motor neurons.
C
Domestic animals, such as
pigs and chickens, are the
main reservoir for VZV.
D
The vaccine against varicella
contains all three serotypes
of formalin-killed VZV as the
immunogen.
E
When zoster occurs in an
immunocompromised
patient, acyclovir should be
given to prevent
disseminated infection.
Adenovirus causes C
A Pharyngitis
Bronchiolitis
B
Meningitis
C
Pharyngitis
D
Shingles
E
Subacute sclerosing
panencephalitis

Which one of the following C

outcomes is MOST common Establishment of latent infection
following a primary herpes
simplex virus infection?
A
Complete eradication of
virus and virus-infected cells
B
Persistent asymptomatic
viremia
C
Establishment of latent
infection
D
Persistent cytopathic effect
in infected cells
 Causes encephalitis B
A Rabies virus
Yellow fever virus
B
Rabies virus
C
Rotavirus
D
Rubella virus
E
Rhinovirus

Grows better at 33°C than C

37°C Rhinovirus
A
Adenovirus
B
Parainfluenza virus
C
Rhinovirus
D
Coxsackie virus
E
Epstein-Barr virus

Each of the following clinical C

syndromes is associated with Mononucleosis
infection by picornaviruses
EXCEPT:
A
Myocarditis/pericarditis
B
Hepatitis
C
Mononucleosis
D
Meningitis
Which one of the following B
is the BEST evidence on A fourfold rise in antibody titer to mumps
which to base a decisive antigen
diagnosis of acute mumps
disease?
A
A positive skin test
B
A fourfold rise in antibody
titer to mumps antigen
C
A history of exposure to a
child with mumps
D
Orchitis in young adult male
Regarding Japanese D
encephalitis virus (JEV), The killed vaccine should be given to those
which one of the following is living in an endemic area.
most accurate?
A
The principal reservoir of JEV
is bats.
B
It is transmitted by the bite
of the dog tick,
Dermacentor.
C
Acyclovir is the drug of
choice for encephalitis
caused by JEV.
D
The killed vaccine should be
given to those living in an
endemic area.
E
JEV is a nonenveloped virus
with a circular double-
stranded RNA genome.

Coxsackie virus causes B

A Meningitis
Bronchiolitis
B
Meningitis
C
Pharyngitis
D
Shingles
E
Subacute sclerosing
panencephalitis
An outbreak of febrile B
disease involving severe joint It is transmitted by Aedes mosquitoes.
pain and an erythematous
macular rash has occurred
on several Caribbean
islands. Infection with
chikungunya virus is
suspected. Which one of the
following is correct
regarding this virus?
A
Its genome is composed of
double-stranded DNA.
B
It is transmitted by Aedes
mosquitoes.
C
Wild birds are the most
important reservoir.
D
Laboratory diagnosis
involves electron
microscopy to observe the
very long filamentous shape
of the virus.
E
The killed vaccine should be
administered to travelers to
endemic regions.
Regarding viruses that play a C
role in human Hepatitis B virus is implicated as the cause of
carcinogenesis, which one of hepatocellular carcinoma because countries
the following statements is with a high incidence of chronic hepatitis B also
the most accurate? have a high incidence of hepatocellular
A carcinoma
Epstein-Barr virus is
implicated as the cause of
nasopharyngeal carcinoma
primarily in Asia, where it is
transmitted by mosquitoes in
rural areas.
B
Evidence for hepatitis C virus
(HCV) as a cause of
hepatocellular carcinoma
includes finding a DNA copy
of the HCV genome
integrated into the DNA of
hepatocytes.
C
Hepatitis B virus is implicated
as the cause of
hepatocellular carcinoma
because countries with a
high incidence of chronic
hepatitis B also have a high
incidence of hepatocellular
carcinoma.
D
Human T-cell leukemia virus
is a retrovirus that was found
to be associated with
leukemia in Japan but is not
found in the United States.
A woman who is hepatitis B D
surface antigen (HBsAg) Give both the HBV vaccine and HBIG.
positive and hepatitis B
surface antibody (HBsAb)
negative has just given birth.
Which one of the following
is the most appropriate thing
to do for the newborn?
A
Nothing. The child is
protected against hepatitis B.
B
Immunize with the vaccine
containing HBsAg (HBV
vaccine).
C
Give hepatitis B
hyperimmune globulin
(HBIG).
D
Give both the HBV vaccine
and HBIG.
A 24-year-old woman is D
seen by her gynecologist for Penile intraepithelial neoplasia associated with
a routine Pap smear. The HPV-16
smear shows cervical
intraepithelial neoplasia
grade 3 (CIN 3). You decide
to examine her long-term
male sexual partner. Which
one of the following is the
most likely finding?
A
Condylomata lata
B
Condylomata acuminata
C
Penile intraepithelial
neoplasia associated with
HPV-6
D
Penile intraepithelial
neoplasia associated with
HPV-16
Your patient is a 27-year-old C
man with a history of Sofosbuvir and velpatasvir
intravenous drug use who
now is diagnosed with
chronic hepatitis C. He is HIV
antibody negative. Which
one of the following is the
best choice of drugs to treat
his chronic hepatitis C?
A
Acyclovir and foscarnet
B
Ganciclovir and enfuvirtide
C
Sofosbuvir and velpatasvir
D
Zidovudine and lamivudine
E
Tenofovir and simiprevir
Each of the following C
statements concerning The diagnosis of hepatitis A is usually made by
hepatitis A virus (HAV) is isolating HAV in cell culture.
correct EXCEPT:
A
The hepatitis A vaccine
contains inactivated HAV as
the immunogen.
B
HAV commonly causes
asymptomatic infection in
children.
C
The diagnosis of hepatitis A
is usually made by isolating
HAV in cell culture.
D
Gamma globulin is used to
prevent hepatitis A in
exposed persons.
Varicella-zoster virus and A
herpes simplex virus share Inapparent disease, manifested only by virus
many characteristics. Which shedding, is common
one of the following
characteristics is NOT
shared?
A
Inapparent disease,
manifested only by virus
shedding, is common
B
Persistence of latent virus
after recovery from acute
disease
C
Vesicular rash
D
Linear, double-stranded
DNA genome

Causes myocarditis and D

pleurodynia Coxsackie virus
A
Adenovirus
B
Parainfluenza virus
C
Rhinovirus
D
Coxsackie virus
E
Epstein-Barr virus
The principal reservoir for B
the antigenic shift variants of Animals, specifically pigs, horses, and fowl
influenza virus appears to
be:
A
People in isolated
communities such as the
Arctic
B
Animals, specifically pigs,
horses, and fowl
C
Soil, especially in the tropics
D
Sewage
Many of the oncogenic D
retroviruses carry Proto-oncogenes are closely related to
oncogenes closely related transposons found in bacteria.
to normal cellular genes,
called proto-oncogenes.
Which one of the following
statements concerning
proto-oncogenes is
INCORRECT?
A
Several proto-oncogenes
have been found in mutant
form in human cancers that
lack evidence for viral
etiology.
B
Several viral oncogenes and
their progenitor proto-
oncogenes encode protein
kinases specific for tyrosine.
C
Some proto-oncogenes
encode cellular growth
factors and receptors for
growth factors.
D
Proto-oncogenes are
closely related to
transposons found in
bacteria.
Each of the following B
statements concerning Rhinoviruses are an important cause of lower
rhinoviruses is correct respiratory tract infections, especially in patients
EXCEPT: with chronic obstructive pulmonary disease.
A
Rhinoviruses are
picornaviruses (i.e., small,
nonenveloped viruses with
an RNA genome).
B
Rhinoviruses are an
important cause of lower
respiratory tract infections,
especially in patients with
chronic obstructive
pulmonary disease.
C
Rhinoviruses do not infect
the gastrointestinal tract
because they are inactivated
by the acid pH in the
stomach.
D
There is no vaccine against
rhinoviruses because they
have too many antigenic
types.
Each of the following D
statements concerning Acyclovir is effective in the treatment of
rubella is correct EXCEPT: congenital rubella syndrome.
A
Congenital abnormalities
occur primarily when a
pregnant woman is infected
during the first trimester.
B
Women who say that they
have never had rubella can,
nevertheless, have
neutralizing antibody in their
serum.
C
In a 6-year-old child, rubella
is a mild, self-limited disease
with few complications.
D
Acyclovir is effective in the
treatment of congenital
rubella syndrome.
Yellow fever still exists in B
many tropical areas of the Both humans and monkeys are reservoirs for
globe. Which one of the yellow fever virus.
following is the best reason
yellow fever still exists?
A
Sewage disposal is
inadequate in many areas.
B
Both humans and monkeys
are reservoirs for yellow
fever virus.
C
The virus has mutated, so the
existing vaccine is no longer
effective.
D
The vaccine has been
withdrawn because it was
found to have unacceptable
side effects.
E
The people in developing
countries cannot afford to
take amantadine when they
enter endemic areas.
A 64-year-old man with D
chronic lymphatic leukemia Progressive multifocal leukoencephalopathy
develops progressive
deterioration of mental and
neuromuscular function. At
autopsy the brain shows
enlarged oligodendrocytes
whose nuclei contain naked,
icosahedral virus particles.
The MOST likely diagnosis is:
A
Herpes encephalitis
B
Creutzfeldt-Jakob disease
C
Subacute sclerosing
panencephalitis
D
Progressive multifocal
leukoencephalopathy
E
Rabies
Each of the following C
statements concerning Adenoviruses have only one serologic type.
adenoviruses is correct
EXCEPT:
A
Adenoviruses are composed
of a double-stranded DNA
genome and a capsid
without an envelope.
B
Adenoviruses cause both
sore throat and pneumonia.
C
Adenoviruses have only one
serologic type.
D
Adenoviruses are implicated
as a cause of tumors in
animals but not humans.
Each of the following A
statements concerning Immunosuppression is a frequent predisposing
subacute sclerosing factor.
panencephalitis is correct
EXCEPT:
A
Immunosuppression is a
frequent predisposing factor.
B
Aggregates of helical
nucleocapsids are found in
infected cells.
C
High titers of measles
antibody are found in
cerebrospinal fluid.
D
Gradual progressive
deterioration of brain
function occurs.
Your patient is a 35-year-old A
man who had a grand-mal Acyclovir
seizure this morning.
Magnetic resonance imaging
revealed a lesion in the
temporal lobe. A brain
biopsy showed
multinucleated giant cells
with intranuclear inclusion
bodies. Which one of the
following is the best choice
of drug to treat his infection?
A
Acyclovir
B
Lamivudine
C
Oseltamivir
D
Ritonavir
E
Zidovudine
Regarding Epstein-Barr virus C
(EBV) and infectious People with infectious mononucleosis produce
mononucleosis, which one of antibodies that agglutinate sheep red cells.
the following is most
accurate?
A
EBV enters the latent state
primarily in CD4-positive
helper T cells.
B
Approximately 10% of
people in the United States
have been exposed to EBV.
C
People with infectious
mononucleosis produce
antibodies that agglutinate
sheep red cells.
D
The atypical lymphs in the
blood of people with
infectious mononucleosis are
EBV-infected T helper cells.
E
Patients with deficient cell-
mediated immunity should
receive passive-active
immunization against EBV.
Your patient is a woman who B
is due to give birth next The risk is higher if the mother has visible lesions
week. She asks you about than if she does not.
the risk of her baby
becoming infected with
herpes simplex virus type 2
(HSV-2). Which one of the
following is the most
accurate response?
A
HSV-2 is a significant cause
of congenital abnormalities.
B
The risk is higher if the
mother has visible lesions
than if she does not.
C
The risk is higher if the
mother has IgG antibody to
HSV-2 than if she has IgM
antibody.
D
The risk is higher if the
delivery occurs by cesarean
section than if the delivery is
performed vaginally.
E
The risk is higher if the
mother is having an episode
of recurrent disease caused
by HSV-2 than if it were a
primary episode.
Regarding influenza virus B
and the disease influenza, Influenza A virus causes more severe disease
which one of the following and more widespread epidemics than does
statements is most accurate? influenza B virus.
A
Both the killed and the live,
attenuated vaccines induce
lifelong immunity.
B
Influenza A virus causes
more severe disease and
more widespread epidemics
than does influenza B virus.
C
The genome of influenza A
virus has eight segments, but
the genome of influenza B
virus is in one piece.
D
The classification of
influenza viruses into A, B,
and C viruses is based on
antigenic differences in their
hemagglutinin.
E
Chronic carriers (i.e., patients
from whom influenza virus is
isolated at least 6 months
after the acute disease) are
an important source of
human infection.
F
This virus has only one
antigenic type, and lifelong
immunity occurs in patients
who have had measles.
Which one of the following D
strategies is MOST likely to Oral immunization with live vaccine
induce lasting intestinal
mucosal immunity to
poliovirus?
A
Parenteral (intramuscular)
immunization with
inactivated vaccine
B
Oral administration of
poliovirus immune globulin
C
Parenteral immunization with
live vaccine
D
Oral immunization with live
vaccine

Each of the following D

statements concerning RSV infections can be effectively treated with
respiratory syncytial virus acyclovir.
(RSV) is correct EXCEPT:
A
RSV has a single-stranded
RNA genome.
B
RSV induces the formation of
multinucleated giant cells.
C
RSV causes pneumonia
primarily in children.
D
RSV infections can be
effectively treated with
acyclovir.
Regarding parvovirus B19, C
which one of the following Parvovirus B19 causes a severe anemia because
statements is most accurate? it preferentially infects erythrocyte precursors
A such as erythroblasts.
A vaccine is available that
contains killed virus as the
immunogen.
B
Patients infected by
parvovirus B19 can be
diagnosed in the laboratory
using the cold agglutinin
test.
C
Parvovirus B19 causes a
severe anemia because it
preferentially infects
erythrocyte precursors such
as erythroblasts.
D
It commonly infects
neutrophils, resulting in an
immunodeficiency that
predisposes to infections by
pyogenic bacteria.
E
Parvoviruses have a double-
stranded DNA genome but
require a DNA polymerase in
the virion because they
replicate in the cytoplasm.
Regarding rotavirus, which B
one of the following is most The vaccine against rotavirus contains live,
accurate? attenuated virus as the immunogen.
A
Rotavirus is a major cause of
nosocomial diarrhea in
intensive care units.
B
The vaccine against rotavirus
contains live, attenuated
virus as the immunogen.
C
Rotavirus has a
nonsegmented, single-
stranded RNA genome, and
there is no polymerase in the
virion.
D
The diagnosis of rotavirus
diarrhea is typically made by
the detection of a fourfold
or greater rise in antibody
titer to the virus.
E
Diarrhea caused by rotavirus
is due to a viral protein that
increases the release of IgA
from many submucosal B
lymphocytes.
Regarding influenza virus, B
which one of the following Its surface proteins, hemagglutinin and
statements is most accurate? neuraminidase, have multiple serologic types.
A
The virion contains an RNA-
dependent DNA
polymerase.
B
Its surface proteins,
hemagglutinin and
neuraminidase, have multiple
serologic types.
C
The protein that undergoes
antigenic variation most
often is the internal
ribonucleoprotein.
D
Antigenic drift involves major
changes in antigenicity that
result from reassortment of
the segments of its RNA
genome.
E
The neuraminidase on the
virion surface mediates the
interaction of the virus with
the receptors on the
respiratory tract epithelium.
Your patient is a 35-year-old C
man who had a grand-mal Herpes simplex virus type 1
seizure this morning.
Magnetic resonance imaging
revealed a lesion in the
temporal lobe. A brain
biopsy showed
multinucleated giant cells
with intranuclear inclusion
bodies. Which one of the
following is the most likely
cause of this disease?
A
Cytomegalovirus
B
Epstein-Barr virus
C
Herpes simplex virus type 1
D
Human herpesvirus 8
E
Varicella-zoster virus
Your patient is a 22-year-old C
woman with several Ganciclovir
episodes of bloody diarrhea.
She is HIV antibody positive
with a CD4 count of 50.
Stool cultures for Shigella,
Salmonella, and
Campylobacter were
negative. An assay for
Clostridium difficile toxin
was negative. Colonoscopy
revealed many ulcerated
lesions. Biopsy revealed cells
with "owl's eye" inclusions in
the nucleus. Which one of
the following is the best
choice of drug to treat her
infection?
A
Amantadine
B
Enfuvirtide
C
Ganciclovir
D
Nevirapine
E
Ribavirin
Each of the following D
statements concerning the To prevent disease caused by rhinoviruses, a
prevention of viral vaccine containing purified capsid proteins is
respiratory tract disease is used.
correct EXCEPT:
A
To prevent disease caused
by adenoviruses, a live
enteric-coated vaccine that
causes asymptomatic enteric
infection is used in the
military.
B
To prevent disease caused
by influenza A virus, an
inactivated vaccine is
available for the civilian
population.
C
There is no vaccine available
against respiratory syncytial
virus.
D
To prevent disease caused
by rhinoviruses, a vaccine
containing purified capsid
proteins is used.
Which of the following is the A
MOST common lower Respiratory syncytial virus
respiratory pathogen in
infants?
A
Respiratory syncytial virus
B
Adenovirus
C
Rhinovirus
D
Coxsackie virus

Causes croup in young B

children Parainfluenza virus
A
Adenovirus
B
Parainfluenza virus
C
Rhinovirus
D
Coxsackie virus
E
Epstein-Barr virus
The eradication of smallpox D
was facilitated by several It multiplies in the cytoplasm of infected cells.
features of the virus. Which
one of the following
contributed LEAST to
eradication?
A
It has one antigenic type.
B
Inapparent infection is rare.
C
Administration of live
vaccine reliably induces
immunity.
D
It multiplies in the cytoplasm
of infected cells.

It is an important cause of B
pneumonia in Cytomegalovirus
immunocompromised
patients.
A
Hepatitis C virus
B
Cytomegalovirus
C
Human papillomavirus
D
Dengue virus
E
St. Louis encephalitis virus
Causes infectious E
mononucleosis Epstein-Barr virus
A
Adenovirus
B
Parainfluenza virus
C
Rhinovirus
D
Coxsackie virus
E
Epstein-Barr virus

Which one of the following A

statements about the src The src protein inactivates a protein encoded by
gene and src protein of Rous p53, a tumor suppressor gene.
sarcoma virus is
INCORRECT?
A
The src protein inactivates a
protein encoded by p53, a
tumor suppressor gene.
B
The src protein is a protein
kinase that preferentially
phosphorylates tyrosine in
cellular proteins.
C
The src protein is required to
maintain neoplastic
transformation of infected
cells.
D
The viral src gene is derived
from a cellular gene found in
many vertebrate species.
Regarding clinical aspects of E
human immunodeficiency People with a high level of viral RNA in their
virus (HIV), which one of the plasma are more likely to have symptomatic
following is most accurate? AIDS (i.e., opportunistic infections) than those
A with low levels.
During the primary infection
with HIV, Pneumocystis
pneumonia commonly
occurs.
B
During the long
asymptomatic period that
can last for years, no HIV is
synthesized.
C
During the period when
many opportunistic
infections occur, HIV usually
cannot be detected in the
blood.
D
The antibody response to a
primary HIV infection usually
is detected within 7 to 10
days after infection.
E
People with a high level of
viral RNA in their plasma are
more likely to have
symptomatic AIDS (i.e.,
opportunistic infections)
than those with low levels.
Each of the following A
statements concerning the The inactivated influenza vaccine contains H1N1
prevention and treatment of virus, whereas the live, attenuated influenza
influenza is correct EXCEPT: vaccine contains H3N2 virus.
A
The inactivated influenza
vaccine contains H1N1 virus,
whereas the live, attenuated
influenza vaccine contains
H3N2 virus.
B
The vaccine is
recommended to be given
each year because the
antigenicity of the virus
drifts.
C
Oseltamivir (Tamiflu) is
effective against both
influenza A and influenza B
viruses.
D
The main antigen in the
vaccine that induces
protective antibody is the
hemagglutinin.
Regarding hepatitis A virus C
(HAV), which one of the The diagnosis is typically made by serologic
following statements is most tests rather than by culturing the virus.
accurate?
A
The HAV vaccine contains
live, attenuated virus as the
immunogen.
B
The screening of blood for
transfusion has greatly
reduced the spread of this
virus.
C
The diagnosis is typically
made by serologic tests
rather than by culturing the
virus.
D
Multiple episodes of
hepatitis A are common
because it has three
serotypes.
E
It has a segmented,
negative-polarity, single-
stranded RNA genome and
an RNA polymerase in the
virion.
The slow virus disease that A
MOST clearly has Progressive multifocal leukoencephalopathy
immunosuppression as an
important factor in its
pathogenesis is:
A
Progressive multifocal
leukoencephalopathy
B
Subacute sclerosing
panencephalitis
C
Creutzfeldt-Jakob disease
D
Kuru
Your patient is a 25-year-old D
man who was just found to Emtricitabine, tenofovir, efavirenz, and
be infected with HIV based atazanavir plus ritonavir
on a positive enzyme-linked
immunosorbent assay
(ELISA) and a positive
Western blot test. His CD4
count is 125, and his viral
load is 7000. He has not
received any antiretroviral
medications. Which one of
the following is the best
regimen to treat his
infection?
A
Acyclovir, foscarnet, and
ribavirin
B
Enfuvirtide, raltegravir, and
maraviroc
C
Lamivudine, ribavirin, and
ritonavir/lopinavir
D
Emtricitabine, tenofovir,
efavirenz, and atazanavir
plus ritonavir
Regarding Ebola virus, which E
one of the following is most The appearance of Ebola virus in the electron
accurate? microscope is that of a long thread, which often
A has a curved end.
Skunks and raccoons are the
main natural reservoirs for
Ebola virus.
B
In endemic areas, most
people are latently infected
with Ebola virus.
C
People known to be
exposed to Ebola virus
should be given ganciclovir
to prevent disease.
D
Ebola hemorrhagic fever
occurs primarily in people
with deficient cell-mediated
immunity.
E
The appearance of Ebola
virus in the electron
microscope is that of a long
thread, which often has a
curved end.
Herpes simplex virus and B
cytomegalovirus share many Congenital abnormalities due to transplacental
features. Which one of the passage
following features is LEAST
likely to be shared?
A
Important cause of
morbidity and mortality in
the newborn
B
Congenital abnormalities
due to transplacental
passage
C
Important cause of serious
disease in
immunosuppressed
individuals
D
Mild or inapparent infection

Wild birds are an important E

reservoir. St. Louis encephalitis virus
A
Hepatitis C virus
B
Cytomegalovirus
C
Human papillomavirus
D
Dengue virus
E
St. Louis encephalitis virus
Regarding hepatitis D virus B
(HDV), which one of the Immunization against hepatitis B virus (HBV) will
following is most accurate? reduce the incidence of hepatitis caused by
A HDV.
Alpha interferon can
eradicate the latent state
established by HDV.
B
Immunization against
hepatitis B virus (HBV) will
reduce the incidence of
hepatitis caused by HDV.
C
HDV has DNA as its genome
and an RNA-dependent
DNA polymerase in the
virion.
D
The laboratory diagnosis of
HDV infection is made by
growing HDV in cells
coinfected with HBV.
E
Many HDV infections occur
in young children in the
diaper stage in day care
centers because the virus is
transmitted primarily by the
fecal-oral route.
Regarding cytomegalovirus E
(CMV), which one of the CMV infection of a fetus during the first
following is most accurate? trimester results in more congenital
A abnormalities than infection in the third
CMV is usually acquired by trimester.
the fecal-oral route in adults.
B
Neonates born from
infected mothers should be
given the subunit vaccine.
C
Reactivation of CMV in
sensory ganglion cells leads
to painful vesicles along
nerves.
D
Lamivudine should be used
to treat CMV infections in
immunocompromised
patients.
E
CMV infection of a fetus
during the first trimester
results in more congenital
abnormalities than infection
in the third trimester.
Causes congenital D
abnormalities Rubella virus
A
Yellow fever virus
B
Rabies virus
C
Rotavirus
D
Rubella virus
E
Rhinovirus

Measles virus causes E

A Subacute sclerosing panencephalitis
Bronchiolitis
B
Meningitis
C
Pharyngitis
D
Shingles
E
Subacute sclerosing
panencephalitis