Virology quiz part 3
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|1. A 32-year-old gay male went to his community STD clinic, where it was found that he had perianal condyloma accuminatum. Physical removal was recommended due to the size of the sessions along with immunomodulatory therapy. Which of the following drugs was most likely selected?
e. Trichloroacetic acid
|2. A 7-year-old girl with sickle cell anemia was brought to her physician by her parents who reported that she seemed to be extremely fatigued and pale-looking. They stated that several of her classmates had recently had rashes and bright red cheeks. On examination, the doctor did not see a rash, but observed that her conjunctiva, gums, and nail beds were pale and that she had tachycardia. A CBC revealed that her hemoglobin level had fallen by 2 g/dL from her last result 3 months ago; her reticulocyte count was 0.05%. From which of the following is this child suffering?
a. Aplastic crisis from parvovirus B19 infection
b. Pericarditis caused by Coxsackievirus B
c. Gastroenteritis with bleeding caused by Norovirus
d. Exacerbated anemia from Coltivirus infection
e. Hemorrhagic cystitis caused by BK polyomavirus
|3. An infant who appeared healthy at birth developed sensorineural hearing loss within the first year of life. Viral culture on urine from this child is positive for a relatively slow-growing virus (3 weeks). With which virus was this infant most likely infected at birth?
b. HSV type 2
c. Rubella virus
d. Measles virus
|4. A 6-month-old infant has had watery diarrhea for 5 days; he vomited a couple of times. The stools have no blood or pus. He is dehydrated. He has not been outside of Cincinnati, but two other toddlers who visited for a day are also sick. What is the most likely cause of this child’s diarrhea?
d. Salmonella enterica
e. Staphylococcus aureus enterotoxin
|5. Subacute sclerosing panencephalitis (SSPE) begins with mild changes in personality, behavior and memory, and seizures. The process is progressive and ends with dementia and death. Infection with which virus precedes SSPE?
a. Epstein–Barr virus
c. JC polyomavirus
d. Measles virus
e. Mumps virus
|6. A couple who had been hiking in Utah in May developed fever, myalgias, headache, and pain behind their eyes. The fever was present for 3 days, subsided, and then recurred, lasting 3 days. Their doctor recommended antipyretic therapy and told them they should not donate blood for 6 months. With which virus was this couple most likely infected?
b. Coxsackievirus B
c. Dengue virus
d. Sin Nombre hantavirus
e. Western equine encephalitis virus
|7. An outbreak of disease caused by a virus occurred in Uganda, Africa. Clinical manifestations included hemoptysis and bleeding from the eyes, skin, and gastrointestinal (GI) tract. The mortality rate exceeded 70%. The virus appeared to be transmitted in the village by contact with the blood and bodily secretions of effected individuals; thus, infections rates were higher among those caring for the sick. Which viral disease occurred in this outbreak?
a. Dengue hemorrhagic fever
b. Ebola hemorrhagic fever
c. Hantavirus pulmonary syndrome
d. West Nile encephalitis
e. Yellow fever
|8. A transplant patient who had serologic evidence of previous Epstein–Barr virus infection was taking high levels of immunosuppressive medications. He presents with generalized lymphadenopathy, fever, night sweats, weight loss, abdominal pain, and tonsillitis. The dosage of immunosuppressive drugs given to the patient is decreased, and the lymphadenopathy regresses. Which of the following is the best diagnosis for this patient?
a. Burkitt lymphoma
b. Hodgkin lymphoma
c. Infectious mononucleosis
d. Lymphoproliferative disorder
e. Nasopharyngeal carcinoma (NPC)
|9. An infant is born to an HIV-positive mother who did not receive anti-retroviral therapy during her pregnancy. The mother’s HIV viral load, tested just before delivery, was 15,000 copies/mL. Both mother and baby tested positive for HIV antibodies by rapid testing. Since this infant is at risk of vertical transmission of HIV from her mother, the pediatrician decided to treat her prophylactically with a reverse transcriptase inhibitor. Which of the following is the most appropriate choice for prophylaxis?
|10. A 25-year-old woman from East Texas donated blood in late July. The next day, she called the Blood Center reporting sudden onset of fever, malaise, myalgia, and backache. The staff at the Blood Center notified the woman 3 days later that her blood had tested positive for an arthropodborne virus. With which virus was this young woman infected?
b. St. Louis encephalitis virus
c. Dengue virus
|11. A 25-year-old graduate student presents to the local clinic with fever, malaise, lymphadenopathy, and pharyngitis. His spleen is not enlarged and although there is a predominance of lymphocytes reported in his peripheral smear, the heterophile antibody test is negative. What is the most likely etiology of this student’s infection?
c. Epstein–Barr virus
d. Parvovirus B19
e. Hepatitis C virus (HCV)
|12. A middle-aged man with a long history of multiple operations and blood transfusions was diagnosed with chronic hepatitis C. He was then treated with pegylated interferon-α (IFN-α) and weight-dosed ribavirin. How does IFN-α affect HCV?
a. Blocks viral envelope fusion with host cell membrane
b. Directly inhibits the viral RNA polymerase
c. Induces the antiviral state in host cells to prevent HCV replication
d. Inhibits the viral protease
e. Interferes with guanosine-dependent processes within the cell
|13. A 35-year-old man presents with symptoms of jaundice, right upper quadrant pain, and vomiting. His ALT is elevated. He is diagnosed with HAV infection after eating at a restaurant where others were also infected. Which of the following should be done to protect his 68-year-old father and his 6-month-old son?
a. Administer IFN-α to both
b. Give each one dose of γ-globulin
c. Immunize both with one dose of hepatitis A vaccine
d. Quarantine household contacts and observe
e. No treatment is necessary
|14. Latent infection of neurons occurs with which of the following viruses?
b. Epstein–Barr virus
d. Measles virus
e. Rabies virus
|15. On November 6, a patient had the onset of an illness characterized by fever, chills, headache, cough, and chest pain. The illness lasted 1 week. On December 5, she had another illness very similar to the first, which lasted 6 days. She had no influenza immunization during this period. Her hemagglutination inhibition antibody titers to nH1N1 influenza virus were as follows:
November 6: 10 November 30: 10 December 20: 160
There was no laboratory error. Which of the following is the best conclusion from these data?
a. The patient was ill with influenza on November 6
b. The patient was ill with influenza on December 5
c. The patient was ill with influenza on December 20
d. It is impossible to relate either illness with the nH1N1 influenza virus
|16. Recently, a new dsDNA nonenveloped virus has been associated with a human cancer. The viral genome was found to be integrated into the host chromosome of cells in an aggressive skin cancer, Merkel cell carcinoma. To which genus does this new virus belong?
|17. A tourist who recently returned from a Caribbean cruise suddenly develops fever, headache, pain behind her eyes, severe joint, bone, and muscle pain, and a maculopapular rash. The ship had made numerous stops at various islands to allow exploratory trips. The tourist reported significant encounter with mosquitoes at one of the stops. Which of the following is the most likely diagnosis?
b. Hemorrhagic fever with renal syndrome
c. Hepatitis C
e. Yellow fever
|18. A 30-year-old female who had a history of serious illness requiring surgery and infusion of multiple blood products developed fever, nausea, and jaundice. Her condition has continued for 2 years as a clinically mild disease with fluctuating levels of bilirubin and liver enzymes. Recent blood chemistry testing showed her serum aspartate aminotransferase (AST) to be 352 U/L, ALT 512 U/L, and total bilirubin 4.5 mg/dL. Which of the following best characterizes the virus most likely causing her illness?
a. DNA virus belonging to the Hepadnaviridae
b. ss(+)RNA virus belonging to the Hepeviridae
c. ss(+)RNA virus belonging to the Picornaviridae
d. ss(+)RNA virus belonging to the Flaviviridae
e. ss(-)RNA virus known as Deltavirus
|19. An IV-drug user discovered that a friend with whom he shared needles for injections was diagnosed with viral hepatitis. He had his blood drawn at the local public health clinic and tested for HBV. Which of the following markers is usually the first viral marker detected after infection with HBV?
d. HBeAg IgG
e. HBcAg IGM
|20. A 55-year-old woman who had immigrated 30 years ago to the United States from Dominica in the Caribbean presented with cutaneous lesions and hepatosplenomegaly. She was hypercalcemic, had lymphocytosis, and bone lesions were demonstrated on x-ray. Peripheral smear showed cloverleaf lymphocytes, consistent with acute T-cell leukemia (CD4+ lymphocytes), in which a provirus was found. Which virus is most likely responsible for her disease?