The following chart graphs severity of disease versus time of infection with influenza virus. The green line would likely indicate Line bacterial pneumoniaQuestion 1 - Single Best Answer
Rabies has NEVER been contracted from
A) fox bites
B) blood
C) corneal transplants
D) solid organ transplants
E) 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?
A) hepatitis A
B) rabies virus
C) yellow fever virus
D) Norwalk virus
E) West Nile virus
Question 3 - Single Best Answer
The nucleocapsid protein of influenza virus
A) is the major target of neutralizing antibodies made against the virus during infection
B) binds directly to the viral genome forming a helical structure
C) forms a layer on the undersurface of the virion envelope
D) transcribes the viral genome into mRNA
E) 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?
A) variola virus
B) varicella zoster virus
C) HSV-1
D) HSV-2
E) HHV-6
Question 5 - Single Best Answer
The nucleocapsid of enveloped viruses
A) may contain glycoproteins
B) contains the viral attachment proteins
C) may be either icosahedral or helical, depending on the virus family
D) contains lipid
E) all of the above
Question 6 - Single Best Answer
Which of the following is NOT true of rhinoviruses:
A) they are not good candidates for the development of a vaccine because there are over 100 serotypes
B) they infect only humans
C) they replicate well at 37oC and are acid stable
D) the same receptor on cells is used for a significant portion of the virus serotypes
E) 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
A) fever appeared before rash
B) pocks on the palms or soles of feet
C) greater density of lesions on the face than other parts of the body
D) all of the above
E) 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:
A) Coxsackievirus A
B) echovirus
C) enterovirus
D) Coxsackievirus B
E) poliovirus
Question 9 - Single Best Answer
Which of the following statements are NOT true regarding the use of vaccinia as a vaccine?
A) produces robust antibody response but does not elicit a protective cellular immune response
B) replicates locally and produces a pustule
C) vaccine was freeze-dried and reconstituted on site prior to vaccination
D) 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?
A) adenovirus
B) B19
C) measles virus
D) Coxsackie virus
E) Norwalk virus
Question 11 - Single Best Answer
Mumps virus:
A) causes asymptomatic as well as symptomatic infections
B) has a live attenuated viral vaccine
C) can cause aseptic meningitis
D) all of the above
E) 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
A) directly, via respiratory droplets from a person with the same disease
B) directly via sexual transmission
C) by ingestion of contaminated food
D) by ingestion of contaminated water
E) 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?
A) EBV mononucleosis
B) CMV mononucleosis
C) Strep throat
D) acute HBV
E) acute HAV
Question 14 - Single Best Answer
Mutations in which of the following viruses are likely to have the lowest reversion rate?
A) cytomegalovirus
B) influenza virus
C) hepatitis A virus
D) HIV
E) hepatitis B virus
Question 15 - Single Best Answer
Dengue virus infection gives more severe disease when the individual already has
A) cell mediated immune response to another serotype of Dengue
B) neutralizing antibody to another serotype of Dengue
C) non-neutralizing antibody to another serotype of Dengue
D) non-neutralizing antibody to yellow fever virus
Question 16 - Single Best Answer
Congenital CMV infection
A) is worst if contracted during the third trimester
B) presents with a slapped cheek rash
C) occurs only after primary infection of the mother with CMV
D) can be corrected by intrauterine blood transfusion
E) 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?
A) polio (Salk)
B) influenza A (FluMist)
C) HBV
D) rabies
E) vaccinia
Question 18 - Single Best Answer
Which of the following is NOT useful in laboratory diagnosis of papillomavirus infections?
A) cytology
B) PCR
C) immunofluorescence
D) electron microscopy
E) culture
Question 19 - Single Best Answer
Which of the following is TRUE for rotavirus
A) the cell killing action of virus on intestinal epithelium causes loss of electrolytes and prevents readsorption of water leading to watery diarrhea
B) infection, like that of Norwalk virus, causes serious disease in people of all ages
C) replication occurs within capsids in the nucleus
D) a live attenuated vaccine is licensed
E) 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
A) gp120, CD4 and CCR5
B) gp120, CD4 and CXCR4
C) gp41, CD4 and CXCR4
D) gp41, CD4 and CCR5
Question 22 - Single Best Answer
Hepatitis G virus and its infection are most like:
A) hepatitis A virus
B) hepatitis B virus
C) hepatitis C virus
D) hepatitis D virus
E) hepatitis E virus
Question 23 - Single Best Answer
Which of the following replication steps do all viruses have in common?
A) uptake by endocytosis
B) transcription by a cellular DNA dependent RNA polymerase
C) proteolytic processing of a polyprotein
D) translation of viral mRNA by cellular ribosomes
E) cell lysis
Question 24 - Single Best Answer
Respiratory syncytial virus infection:
A) causes more severe disease in adults
B) can be treated with amantidine
C) is restricted to the respiratory tract and causes bronchiolitis
D) induces good neutralizing antibody response
E) 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
A) if the mother had not handled cat litter
B) if the mother had not eaten raw beef
C) if the mother had received acyclovir at the time of the rash
D) if the mother had been vaccinated with the appropriate childhood vaccines
E) 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
A) CMI is dominant in the control of ectromelia infections
B) neutralizing antibody is dominant in the control of ectromelia infection
C) induction of IL-10 is critical in mounting a protective anti-ectromelia response
D) all of the above
E) none of the above
Question 27 - Single Best Answer
Adenoviruses can cause
A) acute respiratory disease
B) conjunctivitis
C) hemorrhagic cystitis
D) gastroenteritis
E) all of the above
Question 28 - Single Best Answer
Which of the following is TRUE:
A) acute hemorrhagic conjunctivitis is caused by enterovirus 70 and Coxsackievirus A24
B) pleurodynia with sudden onset of fever and severe thoracic pain is caused by Coxsackievirus A
C) herpangina with fever, sore throat, pain on swallowing and vesicular ulcerated lesions on the soft palate is caused by echovirus
D) 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?
A) red blood cells
B) endothelial cells
C) columnar epithelium
D) stratified epithelium
E) lymphocytes
Question 30 - Single Best Answer
The fact that Ebola has not yet resulted in a pandemic is probably based on the fact that
A) it kills its host before there is time to efficiently spread
B) most "out-breaks" have occurred in relatively remote areas
C) its natural reservoir may have only intermittent contact with humans
D) it may not spread efficiently from its natural reservoir to humans
E) all of the above
Question 31 - Single Best Answer
Which of the following viruses encodes its own DNA dependent DNA polymerase
A) adeno associated virus
B) BK polyomavirus
C) human papillomavirus
D) adenovirus
E) all of the above
Question 32 - Single Best Answer
Negri bodies are diagnostic for
A) measles infection
B) mumps infection
C) Eastern equine encephalitis
D) rubella infection
E) 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
A) dehydration
B) conjugated bilirubin
C) unconjugated bilirubin
D) blood
E) 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?
A) acute HBV infection
B) chronic HBV infection
C) previously vaccinated against HBV
D) superinfection with HDV
Question 35 - Single Best Answer
What is the most common outcome of a human polyomavirus infection?
A) inapparent infection
B) hemorrhagic cystitis
C) progressive multifocal leukoencaphalopathy
D) erythema infectiosum
E) hydrops fetalis
Question 36 - Single Best Answer
Hepatitis A and hepatitis E infections are similar in that
A) they both establish a chronic carrier state
B) they are both transmitted parenterally or sexually
C) most infections in children are more severe than in adults
D) they occur mostly in developed countries
E) 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?
A) the virus is spread mainly via respiratory droplets
B) the virus was acquired 2 weeks prior to the onset of the blisters
C) the disease can be controlled by antibody mediated immunity
D) 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
A) the fraction of defective or non infectious viruses produced during the infection
B) the mechanism of virus spread from cell to cell
C) the time during infection during which the virus genome is replicated
D) the number of virus particles produced per cell
E) all of the above
Question 39 - Single Best Answer
For rubella virus
A) 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
B) infection of children results in disease with neurological complications like postinfectious encephalitis
C) there are three serotypes of virus
D) the virus makes a fusion protein that mediates pH independent cell to cell spread
E) 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?
A) mumps IgM antibody
B) monospot test
C) Streptococcal antigen test
D) HBs Ag
E) denuded ciliated epithelium
Question 41 - Single Best Answer
HIV's tat and HSV's ICP4 proteins are both examples of a classic
A) promoter
B) enhancer
C) primase
D) protease
E) 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?
A) hepatitis E
B) eastern equine encephalitis
C) HIV 2
D) avian influenza
E) dengue
Question 43 - Single Best Answer
Which of the following is NOT a property of a killed-virus vaccine?
A) elicits cellular immune responses
B) elicits protective antibody responses
C) no chance of reverting to a virulent form
D) 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?
A) adenovirus
B) influenza virus
C) adeno associated virus
D) polyoma virus
E) poliovirus
Question 45 - Single Best Answer
Which of the following is NOT true of hepatitis C infection:
A) a significant portion of the infections are asymptomatic
B) chronic infections with the virus are common
C) chronic infection correlates with the development of hepatocellular carcinomas
D) good neutralizing antibody response occurs after infection
E) 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
A) the efficacy of the vaccine
B) better sanitation
C) an increase in the number of children in day care
D) less frequent travel to the Middle East
E) 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
A) develop fulminant disease
B) be clinically asymptomatic and become a chronic carrier
C) develop mild jaundice and then clear the infection
D) 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
A) occurs in normal individuals
B) occurs in immunocompromised individuals
C) has an associated rash
D) has a low mortality rate
E) 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?
A) nvCJD
B) spontaneous CJD
C) sporadic CJD
D) 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
A) measles rash
B) paralytic poliomyelitis
C) hepatitis A infection of the liver
D) measles encephalomyelitis
E) hepatitis C infection of the liver
Question 54 - Single Best Answer
A 2 year old child with RSV infection should be treated with
A) acyclovir
B) intravenous ribivarin
C) RSV hyper immune serum
D) RSV vaccine
E) humid air
Question 55 - Single Best Answer
In order for acyclovir to inhibit HSV DNA replication, this drug first must be
A) phosphorylated to a monophosphate by HSV-1 thymidine kinase
B) phosphorylated to a triphosphate by HSV-1 thymidine kinase
C) phosphorylated to a diphosphate by cellular thymidine kinase
D) 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
A) sex is safe except during outbreaks of lesions
B) if she gets pregnant her baby may be at risk
C) she should be tested for HIV
D) her disease cannot be transmitted by kissing
E) 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?
A) herpes simplex virus
B) influenza (H5N1)
C) influenza (H1N1)
D) CMV
E) HBV
Question 60 - Single Best Answer
Integration of papillomavirus DNA into the host chromosome
A) always occurs at the same place in the host chromosome virus
B) always occurs using the same breakpoint in the viral chromosome
C) is an obligatory part of the virus life cycle
D) can result in transcriptional upregulation of viral oncogenes
E) 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?
A) promoter
B) enhancer
C) junction of genome integration
D) initiation of transcription
E) transactivator
Question 63 - Single Best Answer
Which of the following is true of rabies virus infection:
A) rabies antibody can be detected in the sera two-three weeks following infection
B) the virus reaches the brain by viremia
C) 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
D) the virus first replicates in skin cells at the site of the infection
E) 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
A) it is a component of the Dane particle
B) it is a decoy antigen
C) it is the only protein component of the HBV vaccine
D) it forms filaments
E) it primes first strand synthesis from the pgRNA
Question 65 - Single Best Answer
Which of the following are relevant to antigenic drift in influenza?
A) interspecies transmission
B) segmented genome
C) virus coded RNA dependent RNA polymerase
D) nucleocapsid protein
E) 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?
A) hemagglutination
B) direct particle count
C) western blot
D) transformation assay
E) PCR
Question 68 - Single Best Answer
Congenital infection with parvovirus B19
A) can be diagnosed with ultrasound
B) can cause congestive heart failure in the fetus
C) attacks red-cell progenitors in the fetus
D) can be corrected with intrauterine transfusion
E) all of the above
Question 69 - Single Best Answer
Which virus infection is likely to have the shortest prodrome?
A) varicella (chickenpox)
B) measles
C) rabies
D) influenza
E) mumps
Question 70 - Single Best Answer
Which of the following enzymes is used for papillomavirus genome replication?
A) host DNA dependent DNA polymerase
B) virus coded DNA dependent DNA polymerase
C) host RNA dependent RNA polymerase
D) virus coded RNA dependent RNA polymerase
E) reverse transcriptase
Question 71 - Single Best Answer
Which of the following is NOT a complication of an influenza virus infection?
A) primary viral pneumonia
B) aplastic crisis
C) secondary bacterial infection
D) myositis and cardiac involvement
E) encephalitis
Question 72 - Single Best Answer
Prevention of perinatal transmission of HIV from the mother to her child is best done by
A) Caesarian section after labor has begun
B) treatment of the mother with antibody to HIV
C) treatment of the mother from the time of diagnosis with 3 antiviral medications
D) treatment of the baby after birth with antibody plus antiviral medication
E) 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
A) roseola
B) Kaposi's sarcoma
C) cervical carcinoma
D) infectious mononucleosis
E) 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.