micro the best review(115 usmle level mcqs)
Virology
Questions
DIRECTIONS: Each question below contains five suggested responses.
Please choose the one best response to each question.
1. An HIV-positive patient asks you if you can tell him the chances of him
progressing to symptomatic AIDS. Which one of the following tests would
be most useful?
a. CD4 lymphocyte count
b. HIV antibody test
c. HIV RT PCR
d. Neopterin
e. HIV p24 antigen
2. Which of the following viruses causes an acute febrile rash and produces
disease in immunocompetent children but has been associated with
transient aplastic crises in persons with sickle cell disease?
a. Rubeola
b. Varicella-zoster
c. Parvovirus
d. Rubella
e. Herpes simplex
3. Infection with herpes simplex virus, a common human pathogen, is
best described by which of the following statements?
a. The CNS and visceral organs are usually involved
b. It rarely recurs in a host who has a high antibody titer
c. It can be reactivated by emotional disturbances or prolonged exposure to sunlight
d. Initial infection usually occurs by intestinal absorption of the virus
e. Infection with type 1 virus is most common
4. The latest and most effective therapy for AIDS patients includes azidothymidine
(AZT), dideoxyinosine (DDI), and saquinavir or similar
agents. Use of these three drugs would inhibit which of the following viral
processes?
a. RNase, DNase
b. gp120 formation
c. p24 antibody expression
d. All membrane synthesis
e. Reverse transcriptase, protease
5. An HIV-positive patient prior to being treated with AZT, DDI, and
saquinavir has a CD4 lymphocyte count and an HIV RNA viral load test
done. Results are as follows:
CD4: 50 CD4 lymphocytes per microliter
HIV RNA: 750,000 copies per ml
Which of the following statements best describes the above patient?
a. This patient is no longer in danger of opportunistic infection
b. The 5-year prognosis is excellent
c. The patient’s HIV screening test is most likely negative
d. The patient is not infectious
e. The viral load of 750,000 copies per ml suggests that the patient will respond
to triple therapy
6. This HIV-positive patient with a viral load of 750,000 copies of HIV
RNA/ml and a total CD4 count of 50 is at an increased risk for a number of
infectious diseases. For which of the following diseases is the patient at no
more added risk than an immunocompetent host?
a. Pneumocystic pneumonia
b. Mycobacterial disease
c. Kaposi’s sarcoma
d. Pneumococcal pneumonia
e. Herpes simplex virus
7. Infectious mononucleosis, a viral disorder that can be debilitating, is
characterized by which of the following statements?
a. It is most prevalent in children less than 14 years old
b. It is caused by a rhabdovirus
c. The causative pathogen is an Epstein-Barr virus
d. Affected persons respond to treatment with the production of heterophil antibodies
e. Ribavirin is the treatment of choice
8. A tube of monkey kidney cells is inoculated with nasopharyngeal secretions.
During the next 7 days, no cytopathic effects (CPEs) are observed.
On the eighth day, the tissue culture is infected accidentally with a picornavirus;
nevertheless, the culture does not develop CPEs. The most likely
explanation of this phenomenon is that
a. The nasopharyngeal secretions contained hemagglutinins
b. The nasopharyngeal secretions contained rubella virus
c. Picornavirus does not produce CPEs
d. Picornavirus does not replicate in monkey kidney cells
e. Monkey kidney cells are resistant to CPEs
9. The clinical picture of arbovirus infection fits one of three categories:
encephalitis, hemorrhagic fever, or fever with myalgia. One of the characteristics
of arboviruses is that they
a. Are transmitted by arthropod vectors
b. Are usually resistant to ether
c. Usually cause symptomatic infection in humans
d. Are closely related to parvoviruses
10. Which one of the following statements best describes interferon’s suspected
mode of action in producing resistance to viral infection?
a. It stimulates a cell-mediated immunity
b. It stimulates humoral immunity
c. Its direct antiviral action is related to the suppression of messenger RNA formation
d. Its action is related to the synthesis of a protein that inhibits translation or transcription
e. It alters the permeability of the cell membrane so that viruses cannot enter the
cell
11. Coronaviruses are recognized by club-shaped surface projections that
are 20 nm long and resemble solar coronas. These viruses are characterized
by their ability to
a. Infect infants more frequently than adults
b. Cause the common cold
c. Grow well in the usual cultured cell lines
d. Grow profusely at 50°C
e. Agglutinate human red blood cells
12. Delta hepatitis only occurs in patients who also have either acute or
chronic infection with hepatitis B virus. The delta agent is
a. An incomplete hepatitis B virus
b. Related to hepatitis A virus
c. A hepatitis B mutant
d. An incomplete RNA virus
e. Hepatitis C
13. Which of the following antiviral agents is a purine nucleoside analogue
that has shown promise with Lassa fever, influenza A and B, and respiratory
syncytial virus (RSV)?
a. Amantadine
b. Rimantadine
c. Vidarabine
d. Ribavirin
e. Acyclovir
14. Echoviruses are cytopathogenic human viruses that mainly infect the
a. Respiratory system
b. Central nervous system
c. Blood and lymphatic systems
d. Intestinal tract
e. Bladder and urinary tract
15. The most sensitive test for the diagnosis of herpes simplex (HSV)
meningitis in a newborn infant is
a. HSV IgG antibody
b. HSV polymerase chain reaction (PCR)
c. HSV culture
d. Tzanck smear
e. Cerebrospinal fluid (CSF) protein analysis
16. Acute hemorrhagic conjunctivitis (AHC) is a contagious ocular infection
characterized by pain, swelling of the eyelids, and subconjunctival
hemorrhages. AHC has been reported to be caused by which of the following
viruses?
a. Coronavirus
b. Reovirus
c. Rhinovirus
d. Enterovirus
e. Respiratory syncytial virus
17. Mumps virus accounts for 10 to 15% of all cases of aseptic meningitis
in the United States. Infection with mumps virus
a. Is apt to recur periodically in many affected persons
b. Will usually cause mumps orchitis in postpubertal males
c. Is maintained in a large canine reservoir
d. Usually produces severe systemic manifestations
e. Is preventable by immunization
18. The serum of a newborn infant reveals a 1:32 cytomegalovirus (CMV)
titer. The child is clinically asymptomatic. Which of the following courses
of action would be advisable?
a. Repeat the CMV titer immediately
b. Wait 6 months and obtain another titer on the baby
c. Obtain a CMV titer from all siblings
d. Obtain an anti-CMV IgM titer from the mother
e. Obtain an anti-CMV IgM titer from the baby
19. A 3-year-old child presents at the physician’s office with symptoms of
coryza, conjunctivitis, low-grade fever, and Koplik’s spots. The causative
agent of this disease belongs to which group of viruses?
a. Adenovirus
b. Herpesvirus
c. Picornavirus
d. Orthomyxovirus
e. Paramyxovirus
20. One of the most common sexually transmitted diseases that may lead
to cervical carcinoma is caused by which of the following viruses?
a. Cytomegalovirus
b. Papillomavirus
c. Epstein-Barr virus
d. Herpes simplex virus
e. Adenovirus
21. Which virus is the leading cause of the croup syndrome in young children
and, when infecting mammalian cells in culture, will hemabsorb red
blood cells?
a. Group B coxsackievirus
b. Rotavirus
c. Parainfluenza virus
d. Adenovirus
e. Rhinovirus
22. Hepatitis E, a recently characterized hepatitis virus, is best described
by which of the following statements?
a. It is not a threat to the blood supply
b. It is a major cause of blood-borne hepatitis
c. It is prevalent in North America
d. It is a single-stranded DNA virus
e. The disease resembles hepatitis C
23. Meningitis is characterized by the acute onset of fever and stiff neck.
Aseptic meningitis may be caused by a variety of microbial agents. During
the initial 24 h of the course of aseptic meningitis, an affected person’s cerebrospinal
fluid is characterized by
a. Decreased protein content
b. Elevated glucose concentration
c. Lymphocytosis
d. Polymorphonuclear leukocytosis
e. Eosinophilia
24. Infection with hepatitis D virus (HDV; delta agent) can occur simultaneously
with infection with hepatitis B virus (HBV) or in a carrier of hepatitis
B virus because HDV is a defective virus that requires HBV for its
replicative function. What serologic test can be used to determine whether
a patient with HDV is an HBV carrier?
a. HBsAg
b. HBc IgM
c. HBeAg
d. HBs IgM
e. HBs IgG
25. A nurse develops clinical symptoms consistent with hepatitis. She
recalls sticking herself with a needle approximately 4 months before after
drawing blood from a patient. Serologic tests for HBsAg, antibodies to
HBsAg, and hepatitis A virus (HAV) are all negative; however, she is positive
for IgM core antibody. The nurse
a. Does not have hepatitis B
b. Has hepatitis A
c. Is in the late stages of hepatitis B infection
d. Is in the “window” (after the disappearance of HBsAg and before the appearance
of anti-HBsAg)
e. Has hepatitis C
26. Eastern equine encephalitis virus is associated with a high fatality rate.
Control of the disease could be possible by eradication of
a. Horses
b. Birds
c. Mosquitoes
d. Fleas
e. Ticks
27. Adults who have had varicella as children occasionally suffer a recurrent
form of the disease, shingles. The agent causing these diseases is a
member of which of the following viral families?
a. Herpesvirus
b. Poxvirus
c. Adenovirus
d. Myxovirus
e. Paramyxovirus
28. Rhinovirus is primarily transmitted by
a. Droplet aerosolization
b. Sexual activity
c. Fecal-oral route
d. Fomites
e. Vertical transmission from mother to child
29. German measles virus (rubella), a common cause of exanthems in
children, is best described by which of the following statements?
a. Measles (rubeola) and German measles (rubella) are caused by the same virus
b. Incubation time is approximately 3 to 4 weeks
c. Vesicular rashes are characteristic
d. Onset is abrupt with cough, coryza, and fever
e. Specific antibody in the serum does not prevent disease
30. The presence of Negri inclusion bodies in host cells is characteristic of
a. Mumps
b. Infectious mononucleosis
c. Congenital rubella
d. Aseptic meningitis
e. Rabies
31. Kuru is a fatal disease of certain New Guinea natives and is characterized
by tremors and ataxia; Creutzfeldt-Jakob disease (CJD) is characterized
by both ataxia and dementia. These diseases are thought to be caused
by
a. Slow viruses
b. Cell wall–deficient bacteria
c. Environmental toxins
d. Prions
e. Flagellates
32. According to recommendations issued by the U.S. Public Health Service,
which of the following statements regarding vaccination against
smallpox is true?
a. Pregnant women should be vaccinated in the first trimester
b. Persons who have eczema should be vaccinated soon after diagnosis
c. Persons who have immune deficiencies should be vaccinated every 5 years
d. Persons traveling abroad need not be vaccinated
e. Children should be vaccinated before they begin school
33. Hepatitis D virus (delta agent) is a defective virus that can replicate
only in cells already infected with which of the following viruses?
a. Hepatitis A virus
b. Epstein-Barr virus
c. Hepatitis G virus
d. Hepatitis B virus
e. HIV
34. A patient presents with keratoconjunctivitis. The differential diagnosis
should include infection with which of the following viruses?
a. Parvovirus
b. Adenovirus
c. Epstein-Barr virus
d. Respiratory syncytial virus
e. Varicella-zoster virus
35. A hospital worker is found to have hepatitis B surface antigen. Subsequent
tests reveal the presence of e antigen as well. The worker most likely
a. Is infective and has active hepatitis
b. Is infective but does not have active hepatitis
c. Is not infective
d. Is evincing a biologic false-positive test for hepatitis
e. Has both hepatitis B and C
36. Alphavirus causes which one of the following viral diseases?
a. Marburg virus disease
b. St. Louis encephalitis
c. Western equine encephalitis
d. Dengue
e. Yellow fever
37. Several antiviral compounds have been developed during the last
decade. One such compound is ribavirin, a synthetic nucleoside structurally
related to guanosine. Ribavirin therapy has been successfully used
against
a. Respiratory syncytial virus
b. Herpes simplex virus
c. Hepatitis B
d. Group A coxsackievirus
e. Parvovirus
38. An immunocompromised person with history of seizures had an MRI
that revealed a temporal lobe lesion. Brain biopsy results showed multinucleated
giant cells with intranuclear inclusions. The most probable cause of
the lesion is
a. Hepatitis C virus
b. Herpes simplex virus
c. Listeria monocytogenes
d. Coxsackievirus
e. Parvovirus
39. Which of the following procedures or clinical signs is most specific for
the diagnosis of infectious mononucleosis caused by the Epstein-Barr
virus?
a. Laboratory diagnosis is based on the presence of “atypical lymphocytes” and
EBV-specific antibody
b. Growth in tissue culture cells
c. Heterophile antibodies in serum
d. Lymphadenopathy and splenomegaly on physical examination
e. B-cell lymphocyte proliferation
40. An infant, seen in the ER, presents with a fever and persistent cough.
Physical examination and a chest x-ray suggest pneumonia. Which of the
following is most likely the cause of this infection?
a. Rotavirus
b. Adenovirus
c. Coxsackievirus
d. Respiratory syncytial virus
e. Rhinovirus
41. Which one of the following groups of people may be at increased risk
for HIV infection?
a. Members of a household in which there is a person who is HIV-positive
b. Receptionists at a hospital
c. Factory workers whose coworkers are HIV-positive
d. Foreign service employees who are hospitalized in Zaire for bleeding ulcers
e. Homosexual females
42. An obstetrician sees a pregnant patient who was exposed to rubella
virus in the eighteenth week of pregnancy. She does not remember getting
a rubella vaccination. The best immediate course of action is to
a. Terminate the pregnancy
b. Order a rubella antibody titer to determine immune status
c. Reassure the patient because rubella is not a problem until after the thirtieth
week
d. Administer rubella immune globulin
e. Administer rubella vaccine
43. Mad Cow Disease has been highly publicized in Great Britain. This
disease, which is similar to scrapie, is caused by
a. A prion
b. A virus
c. Rickettsiae
d. An autoimmune reaction
e. A bacterium with a defective cell wall
44. A patient has all the gastrointestinal symptoms of infection with
hepatitis A virus (HAV), yet all the tests for HAV-IgG and HAV-IgM are nonreactive.
A possible cause of this infection is
a. Hepatitis B surface antigen
b. Hepatitis C
c. Hepatitis D
d. Hepatitis E
e. Rotavirus
45. A 70-year-old nursing home patient refused the influenza vaccine and
subsequently developed influenza. She died of acute pneumonia 1 week
after contracting the “flu.” The most common cause of acute postinfluenzal
pneumonia is
a. Legionella
b. Listeria
c. Staphylococcus aureus
d. Klebsiella
e. Escherichia coli
46. Which of the following viruses is primarily transmitted by the fecaloral
route?
a. St. Louis encephalitis virus
b. Colorado tick fever virus
c. Coxsackievirus
d. Yellow fever virus
e. Dengue fever virus
47. Hantavirus is an emerging pathogen that is best described by which of
the following statements?
a. Influenza-like symptoms are followed rapidly by acute respiratory failure
b. Hemolysis is common in infected patients
c. It is acquired by inhalation of aerosols of the urine and feces of deer
d. Transmission from human to human is common
e. There is effective antiviral therapy available
48. Erythema infectiosum (fifth disease), a self-limited disease of children,
is caused by
a. Measles
b. Parvovirus
c. Rubella
d. Human herpesvirus type 6
e. Norwalk virus
49. Which one of the following viruses may be human tumor virus?
a. Epstein-Barr virus (EBV)
b. HIV
c. Papillomavirus
d. Varicella-zoster virus (VZV)
e. Herpes simplex virus, type 2 (HSV)
50. Parvovirus infection, the cause of a mild exanthem in children, is
characterized by
a. Epidemic acute respiratory disease
b. Gastroenteritis
c. Whooping cough–like disease
d. Keratoconjunctivitis
e. Acute hemolytic anemia
51. Cytomegalovirus (CMV) infection is common. Which one of the following
statements best characterizes CMV?
a. It can be transmitted across the placental barrier
b. While a common infection, CMV is almost always symptomatic
c. The CMV can be cultured from red blood cells of infected patients
d. Unlike other viral infections, CMV is not activated by immunosuppressive therapy
e. There is no specific therapy for CMV
52. Human rotaviruses are characterized by which of the following statements?
a. They produce an infection that is primarily seen in adults
b. They produce cytopathic effects in many conventional tissue culture systems
c. They are lipid-containing RNA viruses possessing a double-shelled capsid
d. They can be sensitively and rapidly detected in stools by the enzyme-linked
immunosorbent assay (ELISA) technique
e. They have been implicated as a major etiologic agent of infantile respiratory disease
53. Subacute sclerosing panencephalitis virus (SSPE) is best described by
which of the following statements?
a. It is a progressive disease involving both white and gray matter
b. It is a late CNS manifestation of mumps
c. It is a common event occurring in 1 of 300,000 cases of mumps
d. Viral DNA can be demonstrated in brain cells
e. Demyelination is characteristic
54. Rotavirus is a double-stranded RNA virus with a double-walled capsid.
Which one of the following statements best describes rotavirus?
a. There are no related animal viruses
b. It is a major cause of neonatal diarrhea
c. It is readily cultured from the stool of infected persons
d. Maternal antibody does not appear to be protective
e. Early breast-feeding offers no protection to neonates against it
55. Paramyxoviruses are most commonly associated with which of the following
diseases?
a. Fifth disease
b. Rubella
c. Croup
d. Tonsillitis
e. Otitis media
56. Human papillomavirus is most commonly associated with
a. Rectal polyps
b. Prostate cancer
c. Condyloma acuminatum
d. Hepatic carcinoma
e. Carcinoma of the lung
57. Reverse transcriptase is an enzyme unique to the retroviruses. Which
one of the following is a function of the enzyme reverse transcriptase?
a. DNase activity
b. RNA-dependent RNA polymerase activity
c. RNA isomerase activity
d. RNA-dependent DNA polymerase activity
e. Integration activity
58. St. Louis encephalitis, a viral infection, was first recognized as an
entity in 1933. Which of the following best describes SLE?
a. It is transmitted to humans by the bite of an infected tick
b. It is caused by a togavirus
c. It is the major arboviral cause of central nervous system infection in the United
States
d. It may present initially with symptoms similar to influenza
e. Laboratory diagnosis is routinely made by cultural methods
59. There is considerable overlap of signs and symptoms seen in congenital
and perinatal infections. In a neonate with “classic” symptoms of congenital
cytomegalovirus (CMV) infection, which one of the following tests
would be most useful in establishing a diagnosis?
a. CMV IgG titer on neonate’s serum at birth
b. CMV IgG titer on mother’s serum at birth of infant
c. CMV IgM titer on neonate’s serum at birth and at 1 month of age
d. Total IgM on neonate’s serum at birth
e. Culture of mother’s urine
60. Interferon, a protein that inhibits viral replication, is produced by cells
in tissue culture when the cells are stimulated with which of the following?
a. Botulinum toxin
b. Synthetic polypeptides
c. Viruses
d. Chlamydiae
e. Gram-positive bacteria
61. Which one of the following statements best describes the cytopathic
effects of viruses on host cells?
a. Usually morphological in nature
b. Often associated with changes in mitochondrial membranes
c. Pathognomonic for an infecting virus
d. Rarely fatal to the host cell
e. Can only be seen with an electron microscope
62. A 17-year-old girl presents with cervical lymphadenopathy, fever, and
pharyngitis. Infectious mononucleosis is suspected. The most rapid and
clinically useful test to make this diagnosis is
a. IgM antibody to viral core antigen (VCA)
b. IgG antibody to VCA
c. Antibody to Epstein-Barr nuclear antigen (EBNA)
d. Culture
e. C reactive protein (CRP)
63. Which one of the following viruses would be most likely to establish a
latent infection?
a. Adenovirus
b. Measles virus
c. Influenza virus
d. Parvovirus
e. Coxsackievirus group B
64. A regimen that includes appropriately administered gamma globulin
may be contraindicated in which one of the following diseases?
a. Hepatitis A
b. Hepatitis B
c. Rabies
d. Poliomyelitis
e. Infectious mononucleosis
65. Atypical lymphocytosis is most likely to be found in which one of the
following diseases?
a. Encephalitis caused by herpes simplex virus (HSV)
b. Mononucleosis induced by Epstein-Barr virus
c. Parvovirus infection
d. Chronic hepatitis C
e. Rotavirus gastroenteritis
66. A patient has arthralgia, a rash, lymphadenopathy, pneumonia but no
fever. Which of the following diseases is most likely based on these symptoms?
a. Dengue fever
b. St. Louis encephalitis
c. Infectious mononucleosis
d. Hepatitis
e. HIV infection
67. Hepatitis C (HCV) is usually a clinically mild disease, with only minimal
elevation of liver enzymes. Hospitalization is unusual. Which one of
the following statements best characterizes HCV?
a. Few cases progress to chronic liver disease
b. It often occurs in posttransfusion patients
c. HBV but not HCV infections occur in IV drug abusers
d. It is a DNA virus
e. Blood products are not tested for antibody to HCV
68. Which of the following markers is usually the first viral marker
detected after hepatitis B infection?
a. HBeAg
b. HBsAg
c. HBcAg
d. Anti-HBc
e. HbeAb
69. Which of the following may be the only detectable serological marker
during the early convalescent phase of HBV infection (window phase)?
a. HBeAg
b. HBsAg
c. HBcAg
d. Anti-HBc
e. HbeAb
70. Which one of the following markers is closely associated with HBV
infectivity and DNA polymerase activity?
a. HBeAg
b. HBsAg
c. HBcAg
d. Anti-HBc
e. HBeAb
71. Which of the following is found within the nuclei of infected hepatocytes
and not usually in the peripheral circulation?
a. HBeAg
b. HBsAg
c. HBcAg
d. Anti-HBc
e. HbeAb
72. Which one of the following viruses is the leading cause of congenital
malformations?
a. Rabies
b. Rhinovirus
c. Cytomegalovirus
d. Respiratory syncytial virus
e. Mumps
73. Orchitis, which may cause sterility, is a possible manifestation of
which of the following?
a. Rabies
b. Rhinovirus
c. Cytomegalovirus
d. Respiratory syncytial virus
e. Mumps
74. Which of the following is a leading cause of pneumonia primarily in
infants?
a. Rabies
b. Rhinovirus
c. Cytomegalovirus
d. Respiratory syncytial virus
e. Mumps
75. Which of the following causes a fatal encephalitis for which a vaccine
is available?
a. Rabies
b. Rhinovirus
c. Cytomegalovirus
d. Respiratory syncytial virus
e. Mumps
76. Traditional vaccination for the common cold is virtually impossible
because there are multiple serotypes of which one of the following viruses?
a. Rabies
b. Rhinovirus
c. Cytomegalovirus
d. Respiratory syncytial virus
e. Mumps
77. Which of the following is available and effective for hepatitis A?
a. Acyclovir
b. Killed virus vaccine
c. Inactivated virus vaccine
d. Live virus vaccine
e. Recombinant viral vaccine
78. Patients should be vaccinated annually for influenza with which of the
following vaccines?
a. Immune serum globulin
b. Killed virus vaccine
c. Inactivated virus vaccine
d. Live virus vaccine
e. Recombinant viral vaccine
79. The vaccine for measles is best characterized as a
a. Bacterin
b. Killed virus vaccine
c. Inactivated virus vaccine
d. Live virus vaccine
e. Recombinant viral vaccine
80. Which one of the following would be the treatment of choice for HSV
infection?
a. Acyclovir
b. Killed virus vaccine
c. Herpes immune globulin
d. Azythromycin
e. Recombinant viral vaccine
81. Which of the following best describes the presently available vaccine
for hepatitis B?
a. Synthetic peptide vaccine
b. Killed virus vaccine
c. Inactivated virus vaccine
d. Live virus vaccine
e. Recombinant viral vaccine
82. Chicken pox is a common disease of childhood. It is caused by which
of the following viruses?
a. Cytomegalovirus
b. Rotavirus
c. Varicella-zoster virus
d. Adenovirus
e. Papillomavirus
83. Excluding influenza, which one of the following viruses is a common
cause of acute respiratory disease?
a. Cytomegalovirus
b. Rotavirus
c. Varicella-zoster virus
d. Adenovirus
e. Papillomavirus
84. Human warts are not only cosmetically unsightly but may lead to cancer
of the cervix. They are caused by which one of the following viruses?
a. Cytomegalovirus
b. Rotavirus
c. Varicella-zoster virus
d. Adenovirus
e. Papillomavirus
85. A vaccine is available for one of the most common causes of infantile
gastroenteritis. However, it has recently been recalled. The virus is
a. Cytomegalovirus
b. Rotavirus
c. Varicella-zoster virus
d. Adenovirus
e. Papillomavirus
86. A child has mononucleosis-like symptoms yet the test for mononucleosis
and the EBV titers are negative. One of the causes of heterophilenegative
mononucleosis is
a. Cytomegalovirus
b. Herpes simplex virus
c. Varicella-zoster virus
d. Adenovirus
e. Coxsackievirus
24 Microbiology
87. Malaise and fatigue with increased “atypical” lymphocytes and a reactive
heterophil antibody test is most commonly caused by
a. Toxoplasma
b. Borrelia burgdorferi
c. Epstein-Barr virus
d. Parvovirus
e. Rubella virus
88. Lethargy, malaise, and fatigue are observed in a patient 2 weeks after
eating raw hamburger at a restaurant. The most likely infectious cause is
a. Toxoplasma
b. Cytomegalovirus
c. E. coli
d. Salmonella
e. Clostridium
89. Burkitt’s lymphoma is characterized by elevated “early antigen” tests
with a restricted pattern of fluorescence. This disease is caused by
a. Cytomegalovirus
b. B. burgdorferi
c. Epstein-Barr virus
d. Lymphogranuloma venereum
e. Herpes simplex virus
90. This virus may be detected by the polymerase chain reaction (PCR) in
a variety of cells of patients with nasopharyngeal carcinoma.
a. Measles
b. Mumps
c. Rubella
d. Parvovirus
e. Epstein-Barr virus
91. This virus causes a mononucleosis-like syndrome caused by a latent
herpesvirus; it is often a congenital infection. Large amounts of the virus
are excreted in the urine; thus, urine becomes the fluid of choice for diagnosis
of this disease.
a. Epstein-Barr virus
b. Cytomegalovirus
c. HHV-6
d. Parvovirus
e. Norwalk virus
Questions 92–96
Assume you are asked by a resident what the most appropriate specimen is
for the detection of a particular virus.
92. Human papillomavirus
a. Cervical tissue
b. Synovial fluid
c. Blood
d. Skin
93. Cytomegalovirus
a. Cervical tissue
b. Synovial fluid
c. Blood
d. Skin
e. Cerebrospinal fluid
94. Enterovirus
a. Cervical tissue
b. Synovial fluid
c. Blood
d. Skin
e. Cerebrospinal fluid
95. Varicella-zoster virus (VZV)
a. Cervical tissue
b. Synovial fluid
c. Blood
d. Skin
e. Cerebrospinal fluid
96. Adenovirus 40/41
a. Cervical tissue
b. Synovial fluid
c. Blood
d. Stool
e. Cerebrospinal fluid
97. Which of the following is transmitted by the fecal-oral route; can be
acquired from shellfish; and often causes acute jaundice, diarrhea, and liver
function abnormalities?
a. Rotavirus
b. Adenovirus 40/41
c. Norwalk virus
d. Astrovirus
e. Hepatitis A virus
98. Which of the following is the second most common cause of pediatric
gastroenteritis? Unlike other similar viruses, this virus causes only gastroenteritis.
a. Rotavirus
b. Adenovirus 40/41
c. Norwalk virus
d. Astrovirus
e. Hepatitis A virus
99. Which of the following is the most common cause of pediatric gastroenteritis?
It is difficult to grow in cell culture but can be detected easily
by immunologic methods (ELISA).
a. Rotavirus
b. Adenovirus 40/41
c. Norwalk virus
d. Astrovirus
e. Hepatitis A virus
100. Which of the following is a common cause of epidemic gastroenteritis,
particularly aboard cruise ships and in summer camps? It may be
detected by ELISA methods or electron microscopy.
a. Rotavirus
b. Adenovirus 40/41
c. Norwalk virus
d. Astrovirus
e. Hepatitis A virus
101. Which of the following is a cause of mild gastroenteritis? It can be
transmitted by the fecal-oral route but not by food consumption.
a. Rotavirus
b. Adenovirus 40/41
c. Norwalk virus
d. Astrovirus
e. Hepatitis A virus
102. IgM antibody to the viral particle is the method of choice for laboratory
diagnosis of which one of the following hepatitis viruses?
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
e. Hepatitis E
103. This virus belongs to the family of flaviviruses and its reservoir is
strictly human. Transmission is blood-borne so the blood supply is routinely
screened for this virus.
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
e. Hepatitis E
104. Vaccination for this hepatic disease is with viral surface antigen and
usually provides immunity.
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
e. Hepatitis E
105. This hepatitis virus is a calicivirus. The reservoir is in pigs, and
humans acquire it via the fecal-oral route.
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
e. Hepatitis E
106. This hepatitis virus is a defective virus in that it cannot replicate
independently without the presence of hepatitis B virus.
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
e. Hepatitis E
107. Which of the following is the causative agent of a variety of cutaneous
warts (plantar, common, and flat) and is associated with cervical neoplasia?
a. Human papillomavirus
b. West Nile virus
c. Tick-borne encephalitis virus
d. Polyomavirus
e. Subacute sclerosing panencephalitis virus (SSPE)
108. Recently appearing in the United States, this virus is carried by birds,
transmitted by mosquitoes, and infects humans and horses.
a. Human papillomavirus
b. West Nile virus
c. Tick-borne encephalitis virus
d. Polyomavirus
e. SSPE
109. Which of the following viruses causes progressive multifocal
leukoencephalopathy (PML), a disease causing demyelination in the central
nervous system?
a. Human papillomavirus
b. West Nile virus
c. Tick-borne encephalitis virus
d. Polyomavirus
e. SSPE
110. This virus is transmitted by the same arthropod that transmits
babesiosis and ehrlichiosis.
a. Human papillomavirus
b. West Nile virus
c. Tick-borne encephalitis virus
d. Polyomavirus
e. SSPE
111. This virus is a single-stranded RNA orthomyxovirus. Annual vaccination
is necessary because of antigenic drift and shift.
a. Measles virus
b. Influenza virus
c. Respiratory syncytial virus
d. Parainfluenza virus
e. Adenovirus
112. This virus is a single-stranded RNA paramyxovirus. The rash known
as Koplik’s spots is pathognomonic.
a. Measles virus
b. Influenza virus
c. Respiratory syncytial virus
d. Parainfluenza virus
e. Adenovirus
113. This virus is the leading cause of bronchiolitis and communityacquired
pneumonia in infants.
a. Measles virus
b. Influenza virus
c. Respiratory syncytial virus
d. Parainfluenza virus
e. Adenovirus
114. This is a paramyxovirus and causes the syndrome known as croup.
a. Measles virus
b. Influenza virus
c. Respiratory syncytial virus
d. Parainfluenza virus
e. Adenovirus
115. This is a double-stranded DNA virus. It is responsible for 15% of
pediatric respiratory infections and 10 to 15% of acute diarrhea in children.
a. Measles virus
b. Influenza virus
c. Respiratory syncytial virus
d. Parainfluenza virus
e. Adenovirus
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Originally Posted by sunny kothiwala
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