Virology quiz part 4
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1. Reactivation of VZV is known to occur in persons receiving immunosuppressive therapy. Which of the following is the best antiviral for treating this infection?
2. An infant with microcephaly, jaundice, and hepatosplenomegaly was also small for gestation, and had thrombocytopenia. Radiology of the neonate’s head revealed intracranial calcifications. Which one of the following viruses most likely caused these congenital malformations?
a. Rubella virus
b. Respiratory syncytial virus
d. Mumps virus
3. A 32-year-old woman who had not received the usual pediatric vaccinations developed fever, headache, malaise, and ear pain accompanied by swelling of the parotid glands. One week later, her fever subsided but she developed pelvic pain and tenderness. With which virus was she infected?
b. Mumps virus
c. Rabies virus
d. Respiratory syncytial virus
e. Rubella virus
4. Worldwide 3 to 5 million cases of severe influenza illnesses and 250,000 to 500,000 deaths occur annually. Great effort is made annually to prepare influenza vaccines against circulating strains of Influenzavirus A and B. Yet, in some years, the vaccine is less effective in neutralizing the
virus even though the circulating strains are the same type as that from the previous year; that is, both are H1N1 or both are H2N3. Which of the following mechanisms is responsible for this problem?
a. Antigenic drift
b. Antigenic shift
d. Intramolecular recombination
e. Phenotypic mixing
5. A visitor from rural Mexico visited the United States and was admitted to a hospital after being diagnosed with probable rabies. Which of the following is the best representation of his prognosis?
a. He should survive without complications
b. He should survive but have seizures for life
c. He has a 50% chance of survival if aggressive therapy is instituted
d. Rabies is almost invariably fatal
6. Although vaccination with live, attenuated, or killed viral vaccines has been the most effective way of controlling viral disease in the population, common colds remain widespread because of the multiple serotypes identified. Which of the following viruses represents this problem?
b. Mumps virus
c. Rabies virus
d. Respiratory syncytial virus
7. A 3-year-old girl who was in day care presented with sudden onset of fever, nausea, vomiting, and anorexia. Her sclera were yellow and her abdomen was tender to palpation. Blood chemistries showed an AST of 640 U/L and ALT was 520 U/L. Previously, two other children had had similar symptoms. Which of the following tests would be most likely to reveal the etiology of her hepatitis?
a. Viral culture of stool
b. Test for hepatitis B surface antigen
c. Electron microscopy on stool specimen
d. Detection of rotavirus antigen
e. Anti-HAV IgM
8. In January, two school districts saw a sudden increase in absences. At the same time, sales of over-the-counter medications for fever, cough, and cold symptoms increased dramatically. To determine the etiology of this outbreak of respiratory illness, the public health department conducted a survey of local physicians to see what types of patients they were currently seeing most. The doctors all reported increased numbers of patients complaining of abrupt onset of high fever, severe headache, and myalgia followed by sore throat, dry cough, weakness, and severe fatigue. The patients were ill for 3 to 5 days, but many reported persistent malaise. What is the most likely diagnosis for this outbreak?
a. Common cold
b. Hand-foot-and-mouth disease
9. A vaccine against Morbillivirus (measles virus), introduced in 1963, has decreased the incidence of measles from an expected event in the life of every child to 50 to 200 cases per year in the United States. Which of the following best characterizes the vaccine that has dramatically reduced the incidence of this disease in the United States?
a. Inactivated virus
b. Live attenuated virus
c. Recombinant viral protein
d. Virus-specific immunoglobulin
e. Wild-type live virus
10. A newlywed couple was surprised to find that both experienced genital herpes lesions in their first year of marriage. Both were given an antiviral that is activated only in infected cells. Which of the following is the viral enzyme responsible for activation of the drug of choice for this infection?
a. DNA-dependent DNA polymerase
d. RNA-dependent RNA polymerase
e. Thymidine kinase
11. A neonate born to a woman with chronic hepatitis B infection is at great risk of contracting the virus and subsequently becoming a chronic carrier of HBV. Which of the following is the best approach to preventing the neonate becoming infected?
a. Give hepatitis B immunoglobulin (HBIg) at birth
b. Give HBIg at 6 months, when maternal antibodies have diminished
c. Immunize with recombinant HBV vaccine (rHBV) at birth
d. Immunize with rHBV at 1 year
e. Give HBIg and immunize with rHBV vaccine at birth
12. Twenty days after contact with an individual with an acute disease presentation, a 12-year-old girl has fever (low grade), malaise, and a rash composed of crops of vesicles that lasts 5 days. This common childhood disease is caused by which of the following viruses?
d. Measles virus
13. Over 400 military recruits undergoing basic training experienced an acute respiratory disease outbreak in their second month of camp. Most had high fever and sore throats with coughing; 27 developed pneumonia, five severe enough to require intensive care, and one died. Which of the following agents is the most likely cause of this outbreak?
14. Which of the following genetic disorders predisposes patients to widespread HPV infection and cutaneous squamous cell carcinoma?
a. Epidermodysplasia verruciformis
b. Familial adenomatous polyposis
c. Li–Fraumeni syndrome
e. Xeroderma pigmentosum
15. A 9-month-old girl, who has never been vaccinated, presents with a 3-day history of fever and watery, nonbloody diarrhea. On physical examination, she appears dehydrated. Which of the following describes the genome of the most likely infecting organism?
a. Double-stranded DNA
b. Single-stranded DNA
c. Segmented single-stranded minus-sense RNA
d. Nonsegmented single-stranded plus-sense RNA
e. Segmented double-stranded RNA
16. A 20-year-old college football player presented himself to the local emergency medicine department complaining of headache, fever, and malaise for 2 weeks and now a sore throat. The physician noted enlarged lymph nodes and hepatosplenomegaly. Laboratory tests found increased number of atypical lymphocytes and a reactive heterophile antibody test. The physician advised him not to play football until his symptoms had resolved. What is the best explanation for this advice?
a. To avert heat exhaustion
b. To avoid rupture of his spleen
c. To prevent malnutrition
d. To stave off an aplastic crisis
17. A humanitarian healthcare worker deployed in emergency to Darfur, Sudan, forgot to use insect repellant. Four days after being bitten several times by mosquitoes, he developed fever, chills, headache, back ache, and muscle aches. Two days later, he suffered a nosebleed and noticed his stools were black. The next day, he was jaundiced and vomited black material. Despite supportive care, he developed organ failure and died.
What was the cause of this patient’s death?
a. Dengue hemorrhagic shock
b. Hantavirus cardiopulmonary syndrome
c. Hemorrhagic fever with renal syndrome
e. Yellow fever
18. A patient who had not been vaccinated against influenza has hem-agglutination inhibition titers against influenzavirus A as follows: acute = 10, convalescent = 80. Which of the following is the correct conclusion concerning this patient?
a. No infection
b. Primary infection
c. Anamnestic response
d. Past infection
19. A 10-year-old boy in a malarial area of Africa was diagnosed with a poorly differentiated B-cell tumor of the jaw that was characterized by a translocation of the c-myc oncogene, t(8:14). The boy also has an elevated antibody titer to a specific viral early antigen with a restricted pattern of fluorescence. This disease is caused by which of the following?
a. Borrelia burgdorferi
b. Chlamydia trachomatis
d. Epstein–Barr virus
20. A 55-year-old Chinese man in southern China sought medical help due to a serious otitis media, which was related to obstruction of his Eustachian tubes. Medical examination and laboratory testing resulted in a diagnosis of NPC. Which of the following viruses may be detected by the PCR in a variety of cells of patients with this type of carcinoma?
a. Epstein–Barr virus
b. Measles virus
c. Mumps virus
d. Parvovirus B19
e. Rubella virus