Question 1 - Single Best Answer
Which of the following is NOT a concern regarding Vaccinia-based Smallpox vaccines?
A) incidence of post-vaccinia encephalitis
B) incidence of dermatologic complications
C) failure of the vaccine due to antigenic drift
D) increased risk in the immunocompromised
Question 2 - Single Best Answer
A young woman with a swollen red throat, cervical lymphadenopathy and splenomegaly has a positive monospot test. She might also have which of the following
A) jaundice
B) streptococcal pharyngitis
C) pneumonitis
D) antibody to sheep red blood cells
E) all of the above
Question 3 - Single Best Answer
Which of the following is true for picornavirus replication in cells:
A) Replication occurs in the nucleus.
B) The cellular receptor binds to the glycoprotein attachment protein on the virion.
C) The RNA genome is infectious since it can be translated directly.
D) The virus buds through the plasma membrane of the cell to release progeny virus.
Question 4 - Single Best Answer
Different families of viruses are classified according to
A) nucleic acid type, i.e. DNA or RNA, only
B) nucleocapsid symmetry only
C) possession of a lipid envelope only
D) nucleic acid polarity, i.e. Ò(+)Ó or Ò(-)Ó sense only
E) multiple characteristics
Question 5 - Single Best Answer
Which of the following is true of poliovirus infection of humans?
A) The majority of infections are symptomatic.
B) Bulbar poliomyelitis results from infection of the anterior horn cells of the spinal cord.
C) Post-polio syndrome is due to persistent long term infection with the virus resulting in disease years later.
D) Paralytic poliomyelitis gives asymmetric flaccid paralysis of one or more limbs with no loss of sensory neurons.
Question 6 - Single Best Answer
A high urine specific gravity might be found in which of the following
A) Eastern equine encephalitis
B) EBV mononucleosis
C) rotavirus diarrhea
D) congenital rubella syndrome
E) hepatitis B
Question 7 - Single Best Answer
Which of the following viruses is not associated with long-term persistence in the human host?
A) HSV-1
B) CMV
C) HBV
D) HIV
E) HAV
Question 8 - Single Best Answer
Adenovirus replication
A) requires host RNA polymerase
B) requires host DNA polymerase
C) occurs in the cell cytoplasm
D) occurs through a proviral DNA intermediate integrated into host chromosomal DNA
E) none of the above
Question 9 - Single Best Answer
A rotavirus infection
A) of the intestinal tract causes the loss of electrolytes and prevents readsorption of water leading to dehydration.
B) is spread by respiratory droplets.
C) has a currently licensed live virus vaccine.
D) has a profile where infections in adults are more severe than in children.
E) does not lead to shedding of the virus in the feces during asymptomatic infections.
Question 10 - Single Best Answer
Which of the following is the best test for diagnosis of fetal CMV infection?
A) placental biopsy
B) fetal blood sample
C) amniocentesis
D) maternal blood sample
Question 11 - Single Best Answer
Which of the following is NOT a reason to explain the difficulty in developing an effective vaccine against HIV?
A) the antigenic drift of gp120
B) gp120 is highly glycosylated
C) inability of a natural infection to clear the virus
D) the lack of humoral response to gp120
Question 12 - Single Best Answer
Positive (+) sense RNA
A) is double stranded
B) is reverse transcribed into DNA
C) is mRNA like in its base sequence
D) refers to the RNA that is packaged into the virion of RNA viruses and serves as genomic RNA
E) is usually segmented.
Question 13 - Single Best Answer
Which of the following is true of hepatitis viruses?
A) The severity of the acute hepatitis is mild or subclinical for HAV and HCV.
B) HGV causes 20% mortality in pregnant women.
C) HCV infection gives rise to good neutralizing antibody response.
D) HEV and HAV infections give rise to poor neutralizing antibody and cell mediated immune responses.
E) All of the above.
Question 14 - Single Best Answer
Influenza vaccine is recommended for the elderly
A) once every 10 years
B) once every 5 years
C) once every year
D) only in epidemic years
E) only in pandemic years
Question 15 - Single Best Answer
The reactivation of which of the following herpesviruses is associated with a high incidence of post-herpetic neuralgia?
A) HSV-2
B) CMV
C) VZV
D) EBV
E) HHV-8
Question 16 - Single Best Answer
Adenovirus infections are transmitted by
A) the respiratory route
B) the fecal-oral route
C) both the respiratory route and the fecal oral route
D) arthropod vectors
E) sexual contact
Question 17 - Single Best Answer
Treatment with which of the following chemotherapeutic agents helps at least some HCV chronic infections?
A) amantadine
B) ribavirin
C) AZT.
D) alpha-interferon
E) ganciclovir
Question 18 - Single Best Answer
Rabies has NOT been reported to be spread through
A) corneal transplants
B) mosquito bites
C) kidney transplants
D) raccoon bites
E) horse bites
Question 19 - Single Best Answer
An individual that is infected with HBV under 5 years of age is more likely than an adult to:
A) develop jaundice during the acute infection and have an increased risk of primary hepatocellular carcinoma (PHC)
B) develop jaundice during the acute infection and have a decreased risk of PHC
C) have an inapparent acute infection and have an increased risk of PHC
D) have an inapparent acute infection and have an decreased risk of PHC
Question 20 - Single Best Answer
Which of the following is most common in virus infections?
A) inapparent infection: no disease
B) acute infection
C) latent infection
D) persistent infection
E) chronic infection
Question 21 - Single Best Answer
Parainfluenza virus
A) infection causes bronchitis and croup.
B) is a non-enveloped virus.
C) does not package the virus encoded RNA polymerase in the virion.
D) infects cells by endocytosis and pH dependent fusion of the virus envelope with the membrane of the endosome.
E) is transmitted by the fecal-oral route.
Question 22 - Single Best Answer
What is the cause of the increase in bacterial pneumonia following an influenza infection?
A) immunosuppression by the neuraminidase of influenza
B) denuding of the ciliated epithelium
C) increased number of macrophages in the lung
D) antigenic shift in the influenza virus
Question 23 - Single Best Answer
According to the theory of viruses tending to seek an equilibrium with their hosts, which of the following is the most likely evolutionary outcome for HIV infection of humans?
A) decrease in lethality; decrease in persistence
B) decrease in lethality; maintain persistence
C) no change in lethality; maintain persistence
D) decrease in ability to infect humans
Question 24 - Single Best Answer
The influenza virus hemagglutinin
A) is a tetramer in the virion envelope
B) removes sialic acid from any glycoconjugate
C) helps virus penetrate mucin barrier
D) is encoded by two different genome RNA segments
E) is responsible for virus penetration
Question 25 - Single Best Answer
Dengue virus:
A) can cause breakbone fever.
B) can cause hemorrhagic fever.
C) can cause shock.
D) infection can be enhanced by non-neutralizing antibody.
E) all of the above.
Question 26 - Single Best Answer
The infectious phase of measles results from replication of the virus in
A) lymphocytes
B) respiratory tract
C) skin
D) brain
E) spleen
Question 27 - Single Best Answer
Which of the following is the HIV co-receptor associated with the M-tropic form of the virus and in which mutations are linked to resistance to HIV infection?
A) CXCR4
B) ICAM
C) CD4
D) CCR5
Question 28 - Single Best Answer
Which of the following describes a chronic infection?
A) Virus is detected shortly after infection concurrent with an early episode of disease, then both the virus and the disease clear permanently.
B) Virus is detected shortly after infection concurrent with an early episode of disease, then both the virus and the disease clear temporarily, followed by a later appearance of both infectious virus and disease.
C) Virus is detected shortly after infection concurrent with an early episode of disease, then the disease clears but infectious virus continues to be produced in the absence of disease.
D) Low levels of virus are detected early during infection in the absence of disease. Virus accumulates over a long period and disease becomes apparent only at a very late time.
E) none of the above
Question 29 - Single Best Answer
Acute hemorrhagic conjunctivitis is caused by which of the following viruses?
A) coxsackievirus B
B) coxsackievirus A
C) poliovirus
D) Norwalk virus
E) enterovirus
Question 30 - Single Best Answer
A young woman has gone to the ER with fever, chills, headache, myalgia, and genital lesions. Genital herpes is diagnosed. What problems may she have in the future?
A) she will never be able to become pregnant due to cervical scarring
B) none, as she will die of encephalitis shortly
C) if she becomes pregnant, her baby may be at risk of neonatal encephalitis
D) she will suffer mental impairment as a result of the meningitis
E) she will be at a high risk for cervical cancer
Question 31 - Single Best Answer
As a result of serological testing, you determine that a patient has been exposed to HBV. Which of the following serological profiles would lead you to determine that this patient has a greatly increased risk of developing primary hepatocellular carcinoma?
A) HBsAg (+), anti-HBc (+), IgM anti-HBc (-), and anti-HBs (-)
B) HBsAg (-), anti-HBc (+), IgM anti-HBc (-), and anti-HBs (+)
C) HBsAg (-), anti-HBc (-), IgM anti-HBc (-), and anti-HBs (+)
D) HBsAg (-), anti-HBc (-),IgM anti-HBc (-), and anti-HBs (-)
Question 32 - Single Best Answer
The parvovirus B19
A) is transmitted through the respiratory route
B) causes a viremia
C) is tropic for cells of the erythroid lineage
D) produces mostly asymptomatic infections
E) all of the above
Question 33 - Single Best Answer
One of the major disadvantages of the live oral poliovirus vaccine is:
A) It doesn't give lifelong immunity.
B) The virus can revert to wildtype during replication in the body and cause disease.
C) The vaccine does not induce secretory IgA antibody.
D) It does not produce immunity to all three serotypes of poliovirus.
E) The ease of administration.
Question 34 - Single Best Answer
Which of the following is the most likely manifestation of congenital parvovirus infection?
A) blindness
B) deafness
C) renal dysplasia
D) limb hypoplasia
E) hydrops fetalis
Question 35 - Single Best Answer
The best evidence to date suggests that nvCJD is primarily acquired by:
A) a spontaneous mutation in the PrP protein
B) high risk sexual contact
C) ingesting BSE-tainted meat products
D) not cooking pork brains to an internal temperature of at least160ûF No. nvCJD is believed to be spread by ingesting tainted beef products (esp. CNS material). Even if there was a link to spread of nvCJD by eating pork, the prion agents are resistant to cooking
Question 36 - Single Best Answer
Most cervical carcinomas contain papillomavirus DNA which has become integrated into the cellular chromosomal DNA, however some cervical carcinomas contain papillomavirus DNA which is not integrated but rather in its normal episomal form. How do most of these episomal papillomavirus genomes in cervical carcinomas differ from normal papillomavirus genomes:
A) they contain mutations which inactivate the viral E1 protein involved with initiation of viral DNA replication
B) they contain mutations which inactivate the viral E2 transcriptional regulatory gene
C) they contain mutations which inactivate the viral E5 oncoprotein gene.
D) they contain mutations which inactivate the viral E6 gene, whose product interacts with the cellular p53 protein
E) they contain mutations which inactivate the viral E7 gene, whose product interacts with the cellular Rb protein
Question 37 - Single Best Answer
Measles virus and mumps virus infections are similar in which of the following?
A) The incubation period is the same.
B) The viruses rarely cause asymptomatic infections.
C) The infected individual is shedding infectious virus before the onset of symptoms of the diseases.
D) Virus infections can be prevented by killed virus vaccines.
E) The viruses are stable to detergents and heat.
Question 38 - Single Best Answer
The highest risk for hearing loss in congenital or neonatal infection occurs when
A) CMV is acquired in utero from a mother with a recurrent CMV infection
B) Rubella is acquired in utero at 6 weeks of gestation
C) Varicella is acquired in utero at 6 months of gestation
D) Parvovirus is acquired by a pregnant woman from a sick dog at 8 weeks of gestation
E) Herpes zoster is acquired as the baby is being born to a mother with shingles
Question 39 - Single Best Answer
Which of the following herpesviruses is associated with tumors?
A) HSV-2
B) CMV
C) VZV
D) EBV
E) HHV-6
Question 40 - Single Best Answer
Reassortment of influenza genome segments
A) occurs only in birds
B) involves only the HA and NA segments; the other segments do not exchange with each other
C) is a major contributor to the evolution of new pandemic strains of influenza
D) is a major contributor to the occurrence of the periodic influenza epidemics that occur between pandemics
E) all of the above
Question 41 - Single Best Answer
Which of the following is true for the neurological involvement after measles virus infection?
A) Meningitis occurs about 1 week following the rash.
B) Lethal SSPE can occur years after infection and is due to persistent mutant measles virus replication in the brain.
C) Acute disseminated encephalomyelitis or ADEM occurs only in immunosuppressed people and is due to virus replication in the brain.
D) Measles inclusion body encephalitis or MIBE occurs in normal people with no virus replication in the brain and is due to a demyelination autoimmune response.
Question 42 - Single Best Answer
The yellow skin/jaundice seen in hepatitis is due to which of the following?
A) increased synthesis of unconjugated bilirubin
B) increased breakdown of hemoglobin
C) accumulation of conjugated bilirubin
D) pancreatic carcinoma
Question 43 - Single Best Answer
Which of the following is spread by the Deer Mouse?
A) Ebola-Reston
B) SARS
C) Hantavirus
D) Marburg virus
Question 44 - Single Best Answer
Why do RNA viruses mutate faster than DNA viruses?
A) RNA viruses replicate slower than DNA viruses.
B) RNA viruses have smaller genomes than DNA viruses.
C) RNA is more susceptible to environmental damage than DNA.
D) RNA viruses have segmented genomes and DNA viruses do not.
E) DNA polymerases have a proofreading function that is lacking in RNA polymerases.
Question 45 - Single Best Answer
Arthropod transmitted togaviruses and flaviviruses all cause flu like symptoms with fever, headache and malaise due to:
A) their site of replication in the upper respiratory tract.
B) the infection of the meninges.
C) the good induction of interferon.
D) the common final target organ of each virus.
E) their site of replication in the liver.
Question 46 - Single Best Answer
Which of the following is the most likely source of toxoplasmosis in the U.S.?
A) exposure to infected sheep
B) eating undercooked beef
C) blood transfusion
D) exposure to infected humans
E) eating overcooked cat
Question 47 - Single Best Answer
Which of the following two enzymes are responsible for acyclovir's high therapeutic index?
A) HSV thymidine kinase and HSV uracil glycosylase
B) HSV thymidine kinase and HSV DNA polymerase
C) HSV ICP4 and HSV DNA polymerase
D) HSV ICP4 and HSV uracil glycolsylase
Question 48 - Single Best Answer
A PAP smear detects
A) abnormal cells, called koilocytes, diagnostic of cervical dysplasia
B) papilloma virus particles
C) papilloma virus DNA
D) anti-papillomavirus antibody
E) Negri bodies
Question 49 - Single Best Answer
The sylvan and urban cycles of togavirus and flavivirus transmission can be distinguished:
A) by the type of animal reservoir.
B) by the nature of the insect vector.
C) because the urban cycle does not require an insect vector.
D) by the level of viremia of the virus in the human host.
E) by the final target organ of the virus.
Question 50 - Single Best Answer
To develop mucosal immunity, adenovirus vaccines are delivered
A) through the skin
B) as a respiratory mist, ÒAdenomistÓ
C) in an enteric coated capsule
D) intramuscularly
Question 51 - Single Best Answer
Which of the following is an example of a virus that is in equilibrium with humans?
A) Ebola
B) HIV
C) HSV
D) Hantavirus
E) SARS
Question 52 - Single Best Answer
Which type of virus MUST contain virus coded enzyme(s) in the virion?
A) dsDNA viruses
B) ssDNA viruses.
C) (+) sense RNA viruses.
D) (-) sense RNA viruses
E) All of the above.
Question 53 - Single Best Answer
Which of the following is true of a rabies virus infection?
A) The short incubation period necessitates pre-exposure immunization with rabies vaccine.
B) The virus has a viremic stage.
C) Antibody response to the virus infection occurs two weeks after the replication of the virus in muscle cells at the site of the bite.
D) Disease can usually be prevented post-exposure with a killed virus vaccine and injections of rabies immune globulin.
Question 54 - Single Best Answer
An examination of the spinal fluid of a rabies patient would show which of the following?
A) Negri bodies
B) a preponderance of PMN's
C) a preponderance of lymphocytes
D) Gram positive organisms
E) Pasteur bodies
Question 55 - Single Best Answer
Individuals with which of the following serological profiles would have the most severe symptoms following superinfection with HDV?
A) HBsAg (+), anti-HBc (+), IgM anti-HBc (+), and anti-HBs (-)
B) HBsAg (-), anti-HBc (+), IgM anti-HBc (-), and anti-HBs (+)
C) HBsAg (-), anti-HBc (-), IgM anti-HBc (-), and anti-HBs (+)
D) HBsAg (-), anti-HBc (-),IgM anti-HBc (-), and anti-HBs (-)
Question 56 - Single Best Answer
Assay of a preparation of influenza virus by direct count in the electron microscope reveals 1012 particles/ml. Assay of the same preparation of influenza virus by HA assay yields 104 HA units/ml. How many influenza virus particles are required for one HA unit in these assays?
A) 8
B) 108
C) 108
D) 107
E) 1016
Question 57 - Single Best Answer
Feature(s) of rotaviruses include:
A) a double capsid shell
B) eleven segments of double stranded RNA
C) the synthesis within the virus core of mRNAs that are extruded from the particle
D) an RNA dependent RNA polymerase
E) all of the above
Question 58 - Single Best Answer
A severe and recurrent vaginal yeast infection in a woman should alert the physician to the possibility of
A) a simultaneous papilloma infection
B) a simultaneous Herpes Simplex infection
C) early HIV infection
D) AIDS
Question 59 - Single Best Answer
You are performing a differential diagnosis and considering smallpox vs. varicella zoster virus. Which of the following sets of clinical presentations are most consistent with a small pox infection?
A) pocks at same stage; fever before onset of rash; pocks on palms of hands
B) pocks at same stage; fever after onset of rash; pocks on soles of feet
C) pocks at different stages; fever before onset of rash; no pocks on palms of hands
D) pocks at different stages; fever after onset of rash; more pocks on the chest than elsewhere
Question 60 - Single Best Answer
The HIV western blot assay is used to measure
A) anti-HIV antibody in patient serum
B) HIV antigen in patient serum
C) reverse transcriptase activity in patient serum
D) HIV RNA in patient serum
E) HIV infectivity in patient serum
Question 61 - Single Best Answer
Which virus can cause both fatal myocarditis in newborns and pleurodynia?
A) coxsackievirus B
B) coxsackievirus A
C) poliovirus
D) Norwalk virus
E) enterovirus
Question 62 - Best 2 Answers
Kaposi's sarcoma can be caused by
A) suppression of the immune system by HHV8
B) synthesis of cytokine homologs by HHV8
C) inhibition of tumor suppressors by HHV8
D) transformation of neurons by HHV8
E) transformation of lymphocytes by HHV6
F) is obtained from primates
G) is a culture of cells taken directly from a tissue or an organism and which has not been passaged.
H) is a culture of cells that has been passaged only once.
I) contains only stem cells.
J) is a culture of cells that is immortalized and can be passaged in culture indefinitely.
Question 63 - Single Best Answer
Which of the following viruses are associated with chronic liver disease?
A) hepatitis A and B
B) hepatitis E and D
C) hepatitis A and C
D) hepatitis B, C and D
Question 64 - Single Best Answer
Prions are infectious entities that can reproduce by:
A) (-) stranded RNA template
B) a virally encoded polypeptide
C) catalyzing the refolding of homologous peptides
D) triplet repeat expansion within the gene encoding the protein
Question 65 - Single Best Answer
A mutation in the HIV nef gene would most likely be associated with:
A) a preference for binding to the CXCR4 receptor
B) a delay in progression to AIDS
C) inefficient primer flipping during reverse transcription
D) increased resistance profile for nefinavir
Question 66 - Single Best Answer
Papillomavirus DNA replication
A) uses cellular DNA polymerase
B) requires the viral E1 protein for initiation
C) starts within the viral LCR, or long control region
D) maintains the viral DNA as an episome, a circular molecule which exists in the cell nucleus not covalently associated with cellular DNA
E) occurs at high rates (vegetative DNA replication) in the upper spinous layers of the epithelium
F) all of the above
Question 67 - Single Best Answer
A vaccine is available for which of the following viruses?
A) HCV
B) HAV
C) HEV
D) dengue virus
E) rhinovirus
Question 68 - Single Best Answer
B19 parvovirus infection is usually benign. For what groups of people is it very dangerous?
A) newborns and very old individuals
B) pregnant women and sickle cell anemics
C) smokers and alcoholics
D) dog owners and cave explorers
Question 69 - Single Best Answer
Which of the following viruses requires an RNA-dependent DNA polymerase activity in order to produce new virus?
A) HBV, HIV, HSV
B) HBV, HIV, HTLV
C) HDV, HIV, HTLV
D) HAV, HIV, HTLV
Question 70 - Single Best Answer
Influenza genome replication
A) is catalyzed by a virus coded RNA dependent RNA polymerase
B) occurs in the cytoplasm
C) involves a non-segmented intermediate which is then processed into genome segments
D) is inhibited by amantadine
E) all of the above
Question 71 - Single Best Answer
Respiratory syncytial virus
A) infection includes a viremic stage.
B) infects infants in the presence of maternal antibody.
C) causes bronchiolitis due to the virus killing the bronchioles.
D) infection gives lifetime immunity to reinfection.
E) infection can be treated with amantadine.
Question 72 - Single Best Answer
What are the defining symptoms of croup?
A) fever and cough
B) barking cough and stridor
C) SSPE
D) rash and anemia
E) runny nose and crackles in the chest
Question 73 - Single Best Answer
Which of the following viruses would be MOST stable in the environment?
A) Epstein Barr virus
B) SARS virus
C) HIV
D) Adenovirus
E) Influenza virus
Question 74 - Single Best Answer
The polyomavirus BK
A) infects only a small percentage of the human population
B) is oncogenic in adult humans
C) is associated with hemorrhagic cystitis in immunosuppressed patients
D) is transmitted by the fecal oral route
E) all of the above
Question 75 - Single Best Answer
Rotavirus diarrhea presents with
A) fecal leukocytes
B) bloody diarrhea
C) watery diarrhea
D) inflammatory diarrhea
E) all of the above
Question 76 - Single Best Answer
Influenza hemagglutinin molecules of the same subtype
A) are found in viruses infecting only one species of animal
B) are invariant in amino acid sequence
C) are all serologically cross reactive
D) may vary in amino acid sequence by as much as 10%
E) are always associated with a neuraminidase of a single subtype
Question 77 - Single Best Answer
If you wanted to measure the Òparticle to infectivityÓ ratio of a virus preparation, that is, the ratio of the total number of virus particles to the number of infectious virus particles, which two assays would best serve the purpose?
A) a plaque assay and an egg infectious dose assay
B) a plaque assay and an electron microscopic direct count assay
C) a plaque assay and a hemagglutination assay
D) a hemagglutination assay and an electron microscopic direct count assay
E) an egg infectious dose assay and a hemagglutination inhibition assay.