MMID Exam 1 October 15 2005

Question 1 - Single Best Answer

Rabies has NEVER been contracted from

fox bites
blood
corneal transplants
solid organ transplants
none of the above Ð rabies has been contracted from all of the above sources

Question 2 - Single Best Answer

Which of the following viruses have a live attenuated virus vaccine currently used for prevention of disease in humans?

hepatitis A
rabies virus
yellow fever virus
Norwalk virus
West Nile virus

Question 3 - Single Best Answer

The nucleocapsid protein of influenza virus

is the major target of neutralizing antibodies made against the virus during infection
binds directly to the viral genome forming a helical structure
forms a layer on the undersurface of the virion envelope
transcribes the viral genome into mRNA
is responsible for binding of the virus to cellular receptors

Question 4 - Single Best Answer

A 62 year old female presents with a persistent searing pain over her right eye that corresponds with a recent episode of shingles. While the shingles has receded, the pain persists. Your diagnosis is post-herpetic neuralgia that is caused by?

variola virus
varicella zoster virus
HSV-1
HSV-2
HHV-6

Question 5 - Single Best Answer

The nucleocapsid of enveloped viruses

may contain glycoproteins
contains the viral attachment proteins
may be either icosahedral or helical, depending on the virus family
contains lipid
all of the above

Question 6 - Single Best Answer

Which of the following is NOT true of rhinoviruses:

they are not good candidates for the development of a vaccine because there are over 100 serotypes
they infect only humans
they replicate well at 37oC and are acid stable
the same receptor on cells is used for a significant portion of the virus serotypes
they cause a significant portion, but not all, of the common cold

Question 7 - Single Best Answer

In a Biodefense training drill, you are shown a patient with skin lesions that resemble smallpox. Your differential diagnosis focuses on either chicken pox or smallpox. You ultimately base your diagnosis of smallpox based on

fever appeared before rash
pocks on the palms or soles of feet
greater density of lesions on the face than other parts of the body
all of the above
none of the above

Question 8 - Single Best Answer

A disease with symptoms in the neonate of fever and sudden heart failure with high mortality is caused by:

Coxsackievirus A
echovirus
enterovirus
Coxsackievirus B
poliovirus

Question 9 - Single Best Answer

Which of the following statements are NOT true regarding the use of vaccinia as a vaccine?

produces robust antibody response but does not elicit a protective cellular immune response
replicates locally and produces a pustule
vaccine was freeze-dried and reconstituted on site prior to vaccination
vaccine could be administered with a bifurcated needle

Question 10 - Single Best Answer

Which of the following viruses is most likely to require both a humoral and a cellular immune response for protection and control?

adenovirus
B19
measles virus
Coxsackie virus
Norwalk virus

Question 11 - Single Best Answer

Mumps virus:

causes asymptomatic as well as symptomatic infections
has a live attenuated viral vaccine
can cause aseptic meningitis
all of the above
none of the above

Question 12 - Single Best Answer

A 45 year old male Peruvian forestry worker is brought to a local health facility with a fever of 103 F, vomiting, and bleeding from his mouth. Three days earlier, when his fever began, he also had a headache, myalgia, and backache. He appears to be jaundiced and is vomiting blood. He likely acquired this disease

directly, via respiratory droplets from a person with the same disease
directly via sexual transmission
by ingestion of contaminated food
by ingestion of contaminated water
from the bite of an infected mosquito

Question 13 - Single Best Answer

You receive the following serological data from a 18 year old female presenting with a sore throat, malaise and tender abdomen:

VCA IgM ------ positive
Heterophile antibody --------- positive
Anti-HBc ------ negative

Based on the serology, your diagnosis is?

EBV mononucleosis
CMV mononucleosis
Strep throat
acute HBV
acute HAV

Question 14 - Single Best Answer

Mutations in which of the following viruses are likely to have the lowest reversion rate?

cytomegalovirus
influenza virus
hepatitis A virus
HIV
hepatitis B virus

Question 15 - Single Best Answer

Dengue virus infection gives more severe disease when the individual already has

cell mediated immune response to another serotype of Dengue
neutralizing antibody to another serotype of Dengue
non-neutralizing antibody to another serotype of Dengue
non-neutralizing antibody to yellow fever virus

Question 16 - Single Best Answer

Congenital CMV infection

is worst if contracted during the third trimester
presents with a slapped cheek rash
occurs only after primary infection of the mother with CMV
can be corrected by intrauterine blood transfusion
is most common during the first trimester

Question 17 - Single Best Answer

Which of the following vaccines would have the best chance of inducing a protective sIgA response?

polio (Salk)
influenza A (FluMist)
HBV
rabies
vaccinia

Question 18 - Single Best Answer

Which of the following is NOT useful in laboratory diagnosis of papillomavirus infections?

cytology
PCR
immunofluorescence
electron microscopy
culture

Question 19 - Single Best Answer

Which of the following is TRUE for rotavirus

the cell killing action of virus on intestinal epithelium causes loss of electrolytes and prevents readsorption of water leading to watery diarrhea
infection, like that of Norwalk virus, causes serious disease in people of all ages
replication occurs within capsids in the nucleus
a live attenuated vaccine is licensed
the genome serves as messenger RNA

Question 20 - Single Best Answer

The following chart graphs severity of disease versus time of infection with influenza virus. The green line would likely indicate Line bacterial pneumonia

Question 21 - Single Best Answer

Initial binding of an "M-tropic" HIV virion to a cell is mediated by

gp120, CD4 and CCR5
gp120, CD4 and CXCR4
gp41, CD4 and CXCR4
gp41, CD4 and CCR5

Question 22 - Single Best Answer

Hepatitis G virus and its infection are most like:

hepatitis A virus
hepatitis B virus
hepatitis C virus
hepatitis D virus
hepatitis E virus

Question 23 - Single Best Answer

Which of the following replication steps do all viruses have in common?

uptake by endocytosis
transcription by a cellular DNA dependent RNA polymerase
proteolytic processing of a polyprotein
translation of viral mRNA by cellular ribosomes
cell lysis

Question 24 - Single Best Answer

Respiratory syncytial virus infection:

causes more severe disease in adults
can be treated with amantidine
is restricted to the respiratory tract and causes bronchiolitis
induces good neutralizing antibody response
is spread by the fecal oral route

Question 25 - Single Best Answer

A pregnant 16 yr old female living in Haiti is brought to the hospital in labor. During the mother's second month of pregnancy, she had a flu-like illness with a low-grade fever, maculopapular rash, and lymphadenophy. The child is born deaf and with cataracts. This could have been prevented

if the mother had not handled cat litter
if the mother had not eaten raw beef
if the mother had received acyclovir at the time of the rash
if the mother had been vaccinated with the appropriate childhood vaccines
none of the above, this was a genetic anomaly

Question 26 - Single Best Answer

The experiment in which IL-4 was inserted into ectromelia virus to induce a TH-2 response and resulted in increased virulence in the mouse highlight the fact that

CMI is dominant in the control of ectromelia infections
neutralizing antibody is dominant in the control of ectromelia infection
induction of IL-10 is critical in mounting a protective anti-ectromelia response
all of the above
none of the above

Question 27 - Single Best Answer

Adenoviruses can cause

acute respiratory disease
conjunctivitis
hemorrhagic cystitis
gastroenteritis
all of the above

Question 28 - Single Best Answer

Which of the following is TRUE:

acute hemorrhagic conjunctivitis is caused by enterovirus 70 and Coxsackievirus A24
pleurodynia with sudden onset of fever and severe thoracic pain is caused by Coxsackievirus A
herpangina with fever, sore throat, pain on swallowing and vesicular ulcerated lesions on the soft palate is caused by echovirus
paralysis is caused only by poliovirus in the enterovirus family

Question 29 - Single Best Answer

Kaposi's sarcoma is a malignancy of which of the following?

red blood cells
endothelial cells
columnar epithelium
stratified epithelium
lymphocytes

Question 30 - Single Best Answer

The fact that Ebola has not yet resulted in a pandemic is probably based on the fact that

it kills its host before there is time to efficiently spread
most "out-breaks" have occurred in relatively remote areas
its natural reservoir may have only intermittent contact with humans
it may not spread efficiently from its natural reservoir to humans
all of the above

Question 31 - Single Best Answer

Which of the following viruses encodes its own DNA dependent DNA polymerase

adeno associated virus
BK polyomavirus
human papillomavirus
adenovirus
all of the above

Question 32 - Single Best Answer

Negri bodies are diagnostic for

measles infection
mumps infection
Eastern equine encephalitis
rubella infection
rabies infection

Question 33 - Single Best Answer

A 29 yr old man with a history of injection drug use presents with complaints of fever, fatigue, nausea, loss of appetite, joint pain and abdominal soreness for the past few weeks. He has no pharyngitis or swollen cervical lymph nodes. He reports that his urine is dark and you see that the sclera of his eyes appear yellowish. His urine is dark due to

dehydration
conjugated bilirubin
unconjugated bilirubin
blood
AST and ALT (liver enzymes)

Question 34 - Single Best Answer

You receive the following serological data for a 42 year old male that presented in your office with fever, jaundice and malaise:

HBsAg -------- positive
IgG anti-HBc ------ positive
IgM anti-HBc ------- positive
Anti-HBsAg ------- negative

Your diagnosis based on these findings is?

acute HBV infection
chronic HBV infection
previously vaccinated against HBV
superinfection with HDV

Question 35 - Single Best Answer

What is the most common outcome of a human polyomavirus infection?

inapparent infection
hemorrhagic cystitis
progressive multifocal leukoencaphalopathy
erythema infectiosum
hydrops fetalis

Question 36 - Single Best Answer

Hepatitis A and hepatitis E infections are similar in that

they both establish a chronic carrier state
they are both transmitted parenterally or sexually
most infections in children are more severe than in adults
they occur mostly in developed countries
they cause similar levels of bilirubin and jaundice*

Question 37 - Single Best Answer

A 60 year old woman undergoing chemotherapy for metastatic breast cancer is seen by her oncologist because of itchy, burning blisters on her rib cage that began 3 days earlier as a tingly or numb sensation. Physical examination reveals an otherwise healthy patient with vesicular eruptions along a thoracic dermatome. Which of the following statements regarding this disease and its causative agent is TRUE?

the virus is spread mainly via respiratory droplets
the virus was acquired 2 weeks prior to the onset of the blisters
the disease can be controlled by antibody mediated immunity
the disease is worse in the presence of cell-mediated immunity

Question 38 - Single Best Answer

By performing a "single cycle" or "one step" growth experiment on a virus, one may determine

the fraction of defective or non infectious viruses produced during the infection
the mechanism of virus spread from cell to cell
the time during infection during which the virus genome is replicated
the number of virus particles produced per cell
all of the above

Question 39 - Single Best Answer

For rubella virus

infection of the pregnant mother and the fetus in the first trimester results in clearing of the virus from the mother within a month but continued shedding of virus in the fetus to term and beyond
infection of children results in disease with neurological complications like postinfectious encephalitis
there are three serotypes of virus
the virus makes a fusion protein that mediates pH independent cell to cell spread
the virus is spread by insect vector

Question 40 - Single Best Answer

A 19 yr old college student presents to the student health clinic complaining of fever, fatigue, and sore throat developed about a month after spring break. Physical examination shows pharyngitis, cervical and axillary lymphadenopathy and splenomegaly. Laboratory tests show atypical lymphocytes. What other tests/observations would be most likely to be positive in this patient?

mumps IgM antibody
monospot test
Streptococcal antigen test
HBs Ag
denuded ciliated epithelium

Question 41 - Single Best Answer

HIV's tat and HSV's ICP4 proteins are both examples of a classic

promoter
enhancer
primase
protease
transactivator

Question 42 - Single Best Answer

Which of the following is most likely to be acquired by someone who has NEVER traveled outside of the US?

hepatitis E
eastern equine encephalitis
HIV 2
avian influenza
dengue

Question 43 - Single Best Answer

Which of the following is NOT a property of a killed-virus vaccine?

elicits cellular immune responses
elicits protective antibody responses
no chance of reverting to a virulent form
not heat labile in the tropics

Question 44 - Single Best Answer

Which of the following virus infections would be most likely to be positive in a hemadsorption test?

adenovirus
influenza virus
adeno associated virus
polyoma virus
poliovirus

Question 45 - Single Best Answer

Which of the following is NOT true of hepatitis C infection:

a significant portion of the infections are asymptomatic
chronic infections with the virus are common
chronic infection correlates with the development of hepatocellular carcinomas
good neutralizing antibody response occurs after infection
interferon treatment can be somewhat effective for some serotypes of the virus

Question 46 - Single Best Answer

The decrease in EBV mononucleosis in affluent young adults in the US is likely due to

the efficacy of the vaccine
better sanitation
an increase in the number of children in day care
less frequent travel to the Middle East
an increase in antibiotic resistance of Streptococcus

Question 47 - Single Best Answer

A person exposed to HBV as a young child is statistically most likely to

develop fulminant disease
be clinically asymptomatic and become a chronic carrier
develop mild jaundice and then clear the infection
not become infected at all

Question 48 - Single Best Answer

Name two influenza virus proteins that are targets of approved antiviral drugs. Line neuraminidase and matrix protein

Question 49 - Single Best Answer

Giant cell pneumonia in measles virus infection

occurs in normal individuals
occurs in immunocompromised individuals
has an associated rash
has a low mortality rate
is due to a mutated measles virus

Question 50 - Single Best Answer

Lesions at different stages of development due to successive waves of viremia are characteristic of Line chickenpox

Question 51 - Single Best Answer

A 30 year old is diagnosed with CJD, and is believed to have been infected from ingesting large amounts of CNS-tainted meat. What form of CJD would be most likely?

nvCJD
spontaneous CJD
sporadic CJD
McCJD

Question 52 - Single Best Answer

Name two different viruses that induce syncytia formation. Line paramyxoviruses, HSV, VZV, HIV

Question 53 - Single Best Answer

For which viral disease(s) is the pathology caused directly by virus cell killing

measles rash
paralytic poliomyelitis
hepatitis A infection of the liver
measles encephalomyelitis
hepatitis C infection of the liver

Question 54 - Single Best Answer

A 2 year old child with RSV infection should be treated with

acyclovir
intravenous ribivarin
RSV hyper immune serum
RSV vaccine
humid air

Question 55 - Single Best Answer

In order for acyclovir to inhibit HSV DNA replication, this drug first must be

phosphorylated to a monophosphate by HSV-1 thymidine kinase
phosphorylated to a triphosphate by HSV-1 thymidine kinase
phosphorylated to a diphosphate by cellular thymidine kinase
cleaved by the HSV-1 serine protease

Question 56 - Single Best Answer

Name three different ways a virus may spread from a primary site of replication to a secondary site during infection. Line viremia (blood), nervous system, lymphatic system.

Question 57 - Single Best Answer

What is the primary risk factor for the oral poliovirus vaccine that has caused it not to used in the US any longer ? Line the reversion of vaccine to wild type virus

Question 58 - Single Best Answer

Counseling for a woman with genital herpes would NOT include which of the following

sex is safe except during outbreaks of lesions
if she gets pregnant her baby may be at risk
she should be tested for HIV
her disease cannot be transmitted by kissing
none, you would tell a patient with HHV2 all of the above

Question 59 - Single Best Answer

Which of the following would NOT be considered an "equilibrium virus" in the human population?

herpes simplex virus
influenza (H5N1)
influenza (H1N1)
CMV
HBV

Question 60 - Single Best Answer

Integration of papillomavirus DNA into the host chromosome

always occurs at the same place in the host chromosome virus
always occurs using the same breakpoint in the viral chromosome
is an obligatory part of the virus life cycle
can result in transcriptional upregulation of viral oncogenes
occurs more frequently with some papillomavirus strains than others

Question 61 - Single Best Answer

Sickle cell anemia would make what viral disease worse for those who contract it? Line B19 or parvovirus

Question 62 - Single Best Answer

Which of the following is NOT a function or component of retroviral LTRs?

promoter
enhancer
junction of genome integration
initiation of transcription
transactivator

Question 63 - Single Best Answer

Which of the following is true of rabies virus infection:

rabies antibody can be detected in the sera two-three weeks following infection
the virus reaches the brain by viremia
the postexposure vaccination protocol includes washing the wound, injection of rabies IG at the wound and 5 doses of vaccine over the period of one month
the virus first replicates in skin cells at the site of the infection
neutralizing antibody to rabies is directed against the N protein

Question 64 - Single Best Answer

All of the following are true statements about the HBsAg EXCEPT

it is a component of the Dane particle
it is a decoy antigen
it is the only protein component of the HBV vaccine
it forms filaments
it primes first strand synthesis from the pgRNA

Question 65 - Single Best Answer

Which of the following are relevant to antigenic drift in influenza?

interspecies transmission
segmented genome
virus coded RNA dependent RNA polymerase
nucleocapsid protein
matrix protein

Question 66 - Single Best Answer

What enzyme must paramyxoviruses package in the virus particle? Line an RNA dependent RNA polymerase

Question 67 - Single Best Answer

Which of the following test measures virus infectivity?

hemagglutination
direct particle count
western blot
transformation assay
PCR

Question 68 - Single Best Answer

Congenital infection with parvovirus B19

can be diagnosed with ultrasound
can cause congestive heart failure in the fetus
attacks red-cell progenitors in the fetus
can be corrected with intrauterine transfusion
all of the above

Question 69 - Single Best Answer

Which virus infection is likely to have the shortest prodrome?

varicella (chickenpox)
measles
rabies
influenza
mumps

Question 70 - Single Best Answer

Which of the following enzymes is used for papillomavirus genome replication?

host DNA dependent DNA polymerase
virus coded DNA dependent DNA polymerase
host RNA dependent RNA polymerase
virus coded RNA dependent RNA polymerase
reverse transcriptase

Question 71 - Single Best Answer

Which of the following is NOT a complication of an influenza virus infection?

primary viral pneumonia
aplastic crisis
secondary bacterial infection
myositis and cardiac involvement
encephalitis

Question 72 - Single Best Answer

Prevention of perinatal transmission of HIV from the mother to her child is best done by

Caesarian section after labor has begun
treatment of the mother with antibody to HIV
treatment of the mother from the time of diagnosis with 3 antiviral medications
treatment of the baby after birth with antibody plus antiviral medication
intrapartum (during delivery) treatment with 3 antiviral medications

Question 73 - Single Best Answer

What are hemagglutination inhibition and virus neutralization assays designed to measure? Line virus specific serum antibody

Question 74 - Single Best Answer

What do HIV and hepatitis B virus have in common? Line reverse transcription or reverse transcriptase

Question 75 - Single Best Answer

Burkitt's lymphoma is caused by the virus that also causes

roseola
Kaposi's sarcoma
cervical carcinoma
infectious mononucleosis
shingles

Question 76 - Single Best Answer

Influenza B virus does not undergo antigenic shift. Why? Text Influenza B virus infects only humans. It has no animal reservoir and is not subject to interspecies transmission. Therefore it does not have the opportunity to be sequestered from the human population while undergoing reassortment to create new viruses.


   

  Updated: October 18, 2005