CLINICALVIROLOGY

DIRECTIONS(Questions212275):SelecttheONEletteredanswerthatisBESTineach
question.
212.

WhichoneofthefollowingoutcomesisMOSTcommonfollowingaprimaryherpes
simplexvirusinfection?(A)Completeeradicationofvirusandvirusinfectedcells(B)
Persistentasymptomaticviremia(C)Establishmentoflatentinfection(D)Persistent
cytopathiceffectininfectedcells

213.

EachofthefollowingpathogensislikelytoestablishchronicorlatentinfectionEXCEPT:
(A)Cytomegalovirus
(B)HepatitisAvirus(C)HepatitisBvirus(D)Herpessimplexvirus
214.EachofthefollowingstatementsregardingpoliovirusanditsvaccineiscorrectEXCEPT:

(A)Poliovirusistransmittedbythefecaloralroute.

(B)Pathogenesisbypoliovirusprimarilyinvolvesthedeathofsensoryneurons.

(C)Thelive,attenuatedvaccinecontainsallthreeserotypesofpoliovirus.

(D)Anunimmunizedadulttravelingtocountrieswherethereisaknownriskofbeinginfected
withpoliovirusshouldreceivetheinactivatedvaccine.

215.

WhichoneofthefollowingstrategiesisMOSTlikelytoinducelastingintestinalmucosal
immunitytopoliovirus?(A)Parenteral(intramuscular)immunizationwithinactivatedvaccine
(B)Oraladministrationofpoliovirusimmuneglobulin(C)Parenteralimmunizationwithlive
vaccine(D)Oralimmunizationwithlivevaccine

216.

Eachofthefollowingclinicalsyndromesisassociatedwithinfectionbypicornaviruses
EXCEPT:(A)Myocarditis/pericarditis(B)Hepatitis(C)Mononucleosis(D)Meningitis

217.

EachofthefollowingstatementsconcerningrubellavaccineiscorrectEXCEPT:

(A)Thevaccinepreventsreinfection,therebylimitingthespreadofvirulentvirus.

(B)Theimmunogeninthevaccineiskilledrubellavirus.

(C)Thevaccineinducesantibodiesthatpreventdisseminationofthevirusbyneutralizing
itduringtheviremicstage.

(D)Theincidenceofbothchildhoodrubellaandcongenitalrubellasyndromehas

decreasedsignificantlysincetheadventofthevaccine.
218.

Eachofthefollowingstatementsconcerningtherabiesvaccineforuseinhumansiscorrect
EXCEPT:

(A)Thevaccinecontainslive,attenuatedrabiesvirus.

(B)Ifyourpatientisbittenbyawildanimal(e.g.,askunk)therabiesvaccineshouldbe
given.

(C)Whenthevaccineisusedforpostexposureprophylaxis,rabiesimmuneglobulinshould
alsobegiven.

(D)Thevirusinthevaccineisgrowninhumancellcultures,thusdecreasingtheriskof
allergicencephalomyelitis.
219.EachofthefollowingstatementsconcerninginfluenzaiscorrectEXCEPT:
(A)MajorepidemicsofthediseasearecausedbyinfluenzaAvirusesratherthaninfluenzaBand
Cviruses.
(B)LikelysourcesofnewantigensforinfluenzaAvirusesarethevirusesthatcauseinfluenzain
animals.
(C)Majorantigenicchanges(shifts)ofviralsurfaceproteinsareseenprimarilyininfluenzaA
virusesratherthanininfluenzaBandCviruses.
(D)Theantigenicchangesthatoccurwithantigenicdriftareduetoreassortmentofthemultiple
piecesoftheinfluenzavirusgenome.
220.Eachofthefollowingstatementsconcerningthepreventionandtreatmentofinfluenzais
correctEXCEPT:
.

(A)TheinactivatedinfluenzavaccinecontainsH1N1virus,whereasthelive,attenuated
influenzavaccinecontainsH3N2virus.

(B)Thevaccineisrecommendedtobegiveneachyearbecausetheantigenicityofthevirus
drifts.

(C)Oseltamivir(Tamiflu)iseffectiveagainstbothinfluenzaAandinfluenzaBviruses.

(D)Themainantigeninthevaccinethatinducesprotectiveantibodyisthehemagglutinin.
221.A6montholdchilddevelopsapersistentcoughandafever.

PhysicalexaminationandchestXraysuggestpneumonia.Whichoneofthefollowing
organismsisLEASTlikelytocausethisinfection?(A)Respiratorysyncytialvirus
(B)Adenovirus(C)Parainfluenzavirus(D)Rotavirus
222.A45yearoldmanwasattackedbyabobcatandbittenrepeatedlyaboutthefaceandneck.The
animalwasshotbyacompanionandbroughtbacktothepublichealthauthorities.Onceyou
decidetoimmunizeagainstrabiesvirus,howwouldyouproceed?
.

(A)Usehyperimmuneserumonly

(B)Useactiveimmunizationonly

(C)Usehyperimmuneserumandactiveimmunization

(D)Useactiveimmunizationandfollowthiswithhyperimmuneserumifadequateantibody
titersarenotobtainedinthepatientsserum
223.Eachofthefollowingstatementsconcerningmumpsiscorrect
EXCEPT:

(A)MumpsvirusisaparamyxovirusandhencehasasinglestrandedRNAgenome.

(B)Meningitisisarecognizedcomplicationofmumps.

(C)Mumpsorchitisinchildrenpriortopubertyoftencausessterility.

(D)Duringmumps,thevirusspreadsthroughthebloodstream(viremia)tovariousinternal
organs.
224.Eachofthefollowingstatementsconcerningrespiratorysyncytial
virus(RSV)iscorrectEXCEPT:(A)RSVhasasinglestrandedRNAgenome.
(B)RSVinducestheformationofmultinucleatedgiantcells.(C)RSVcausespneumoniaprimarilyin
children.(D)RSVinfectionscanbeeffectivelytreatedwithacyclovir.
PARTXIIUSMLE(NationalBoard)PracticeQuestions629
630PARTXIIUSMLE(NationalBoard)PracticeQuestions
225.Theprincipalreservoirfortheantigenicshiftvariantsofinfluenzavirusappearstobe:(A)
PeopleinisolatedcommunitiessuchastheArctic(B)Animals,specificallypigs,horses,andfowl
(C)Soil,especiallyinthetropics

(D)Sewage
226.

TheroleofaninfectiousagentinthepathogenesisofkuruwasBESTdemonstratedby
whichoneofthefollowingobservations?(A)A16foldriseinantibodytitertotheagent
wasobserved.(B)Theviralgenomewasisolatedfrominfectedneurons.(C)Electron
micrographsofthebrainsofinfectedindividualsdemonstratedintracellularstructures
resemblingparamyxovirusnucleocapsids.(D)Thediseasewasseriallytransmittedto
experimentalanimals.

227.

A64yearoldmanwithchroniclymphaticleukemiadevelopsprogressivedeteriorationof
mentalandneuromuscularfunction.Atautopsythebrainshowsenlargedoligodendrocytes
whosenucleicontainnaked,icosahedralvirusparticles.TheMOSTlikelydiagnosisis:(A)
Herpesencephalitis
(B)CreutzfeldtJakobdisease(C)Subacutesclerosingpanencephalitis(D)Progressivemultifocal
leukoencephalopathy(E)Rabies

228.

A20yearoldman,whoformanyyearshadreceiveddailyinjectionsofgrowthhormone
preparedfromhumanpituitaryglands,developsataxia,slurredspeech,anddementia.At
autopsythebrainshowswidespreadneuronaldegeneration,aspongyappearancedueto
manyvacuolesbetweenthecells,noinflammation,andnoevidenceofvirusparticles.The
MOSTlikelydiagnosisis:(A)Herpesencephalitis(B)CreutzfeldtJakobdisease(C)
Subacutesclerosingpanencephalitis(D)Progressivemultifocalleukoencephalopathy(E)
Rabies

229.

A24yearoldwomanhashadfeverandasorethroatforthepastweek.Moderatelysevere
pharyngitisandbilateralcervicallymphadenopathyareseenonphysicalexamination.
WhichoneofthefollowingvirusesisLEASTlikelytocausethispicture?(A)Norwalk
virus(Norovirus)(B)Adenovirus(C)Coxsackievirus(D)EpsteinBarrvirus

230.

ScrapieandkurupossessallofthefollowingcharacteristicsEXCEPT:(A)Ahistologic
pictureofspongiformencephalopathy(B)
Transmissibilitytoanimalsassociatedwithalongincubationperiod(C)Slowlyprogressive
deteriorationofbrainfunction(D)Prominentintranuclearinclusionsinoligodendrocytes

231.

Eachofthefollowingstatementsconcerningsubacutesclerosingpanencephalitisiscorrect
EXCEPT:(A)Immunosuppressionisafrequentpredisposingfactor.(B)
Aggregatesofhelicalnucleocapsidsarefoundininfectedcells.(C)Hightitersofmeasles
antibodyarefoundincerebrospinalfluid.(D)Slowlyprogressivedeteriorationofbrain
functionoccurs.
232.TheslowvirusdiseasethatMOSTclearlyhasimmunosuppressionasanimportantfactor
initspathogenesisis:(A)Progressivemultifocalleukoencephalopathy(B)Subacutesclerosing

panencephalitis
(C)CreutzfeldtJakobdisease
(D)Kuru233.A30yearoldmandevelopsfeverandjaundice.Heconsultsa
physician,whofindsthatbloodtestsforHBsantigenandantiHBsantibodyarenegative.
WhichoneofthefollowingadditionaltestsisMOSTusefultoestablishthatthehepatitiswas
indeedduetohepatitisBvirus?
(A)HBeantigen(B)AntiHBcantibody(C)AntiHBeantibody(D)Deltaantigen
234.WhichoneofthefollowingistheMOSTreasonableexplanationfortheabilityofhepatitis
Bvirustocausechronicinfection?(A)Infectiondoesnotelicittheproductionofantibody(B)
Theliverisanimmunologicallyshelteredsite
(C)ViralDNAcanpersistwithinthehostcell
(D)ManyhumansareimmunologicallytoleranttoHBsantigen235.Theroutinescreeningof
transfusedbloodforHBsantigenhasnoteliminatedtheproblemofposttransfusionhepatitis.For
whichoneofthefollowingviruseshasscreeningeliminateda
largenumberofcasesofposttransfusionhepatitis?(A)HepatitisAvirus(B)HepatitisCvirus(C)
Cytomegalovirus
(D)EpsteinBarrvirus236.A35yearoldmanaddictedtointravenousdrugshasbeenacar
rierofHBsantigenfor10years.Hesuddenlydevelopsacutefulminanthepatitisanddies
within10days.WhichoneofthefollowinglaboratorytestswouldcontributeMOSTtoa
diagnosis?(A)AntiHBsantibody
(B)HBeantigen(C)AntiHBcantibody(D)Antideltavirusantibody
237.WhichoneofthefollowingistheBESTevidenceonwhichtobaseadecisivediagnosisof
acutemumpsdisease?(A)Apositiveskintest(B)Afourfoldriseinantibodytitertomumpsantigen
(C)Ahistoryofexposuretoachildwithmumps
(D)Orchitisinyoungadultmale238.Varicellazostervirusandherpessimplexvirussharemany
char
acteristics.WhichoneofthefollowingcharacteristicsisNOTshared?(A)Inapparentdisease,
manifestedonlybyvirusshedding,is
common(B)Persistenceoflatentvirusafterrecoveryfromacutedisease(C)Vesicularrash(D)
Linear,doublestrandedDNAgenome

239.Herpessimplexvirusandcytomegalovirussharemanyfeatures.Whichoneofthefollowing
featuresisLEASTlikelytobeshared?(A)Importantcauseofmorbidityandmortalityinthe
newborn(B)Congenitalabnormalitiesduetotransplacentalpassage
(C)Importantcauseofseriousdiseaseinimmunosuppressedindividuals
(D)Mildorinapparentinfection
240.

Theeradicationofsmallpoxwasfacilitatedbyseveralfeaturesofthevirus.Whichoneof
thefollowingcontributedLEASTtoeradication?

(A)Ithasoneantigenictype.

(B)Inapparentinfectionisrare.

(C)Administrationoflivevaccinereliablyinducesimmunity.

(D)Itmultipliesinthecytoplasmofinfectedcells.
241.

WhichoneofthefollowingstatementsconcerninginfectiousmononucleosisistheMOST
accurate?

(A)Multinucleatedgiantcellsarefoundintheskinlesions.

(B)InfectedTlymphocytesareabundantinperipheralblood.

(C)Isolationofvirusisnecessarytoconfirmthediagnosis.

(D)Infectiousmononucleosisistransmittedbyvirusinsaliva.
242.

WhichoneofthefollowingstatementsaboutgenitalherpesisLEASTaccurate?

(A)Acyclovirreducesthenumberofrecurrentdiseaseepisodesbyeradicatinglatently
infectedcells.

(B)Genitalherpescanbetransmittedintheabsenceofapparentlesions.

(C)Multinucleatedgiantcellswithintranuclearinclusionsarefoundinthelesions.

(D)Initialdiseaseepisodesaregenerallymoreseverethanrecurrentepisodes.
243.

ThereareseveralinfluenzavaccinesadministeredintheUnitedStates.Regardingthese
vaccines,whichoneofthefollowingstatementsisLEASTaccurate?
(A)Oneofthevaccinescontainspurifiedpeptidesubunitsofneuraminidaseproducedin

yeast.
.

(B)Oneofthevaccinesisaninactivatedvaccineconsistingofformaldehydetreated
influenzavirions.

(C)Oneofthevaccinescontainsatemperaturesensitivemutantofinfluenzavirusthat
replicatesinthenosebutnotinthelungs.

(D)InfluenzavaccinescontaininfluenzaAandBstrainsbutnotCstrains.
244.

WhichofthefollowingistheMOSTcommonlowerrespiratorypathogenininfants?(A)
Respiratorysyncytialvirus(B)Adenovirus(C)Rhinovirus(D)Coxsackievirus

245.

WhichofthefollowingconditionsisLEASTlikelytobecausedbyadenoviruses?(A)
Conjunctivitis(B)Pneumonia(C)Pharyngitis(D)Glomerulonephritis

246.

Regardingtheserologicdiagnosisofinfectiousmononucleosis,whichoneofthefollowingis
CORRECT?

(A)AheterophilantibodyisformedthatreactswithacapsidproteinofEpsteinBarr
virus.

(B)Aheterophilantibodyisformedthatagglutinatessheeporhorseredbloodcells.

(C)AheterophilantigenoccursthatcrossreactswithProteusOX19strains.

(D)Aheterophilantigenoccursfollowinginfectionwithcytomegalovirus.
247.Herpessimplexvirustype1(HSV1)isdistinctfromHSV2inseveraldifferentways.
WhichoneofthefollowingistheLEASTaccuratestatement?
.

(A)HSV1causeslesionsabovetheumbilicusmorefrequentlythanHSV2does.

(B)InfectionbyHSV1isnotassociatedwithanytumorsinhumans.

(C)AntiserumtoHSV1neutralizesHSV1muchmoreeffectivelythanHSV2.

(D)HSV1causesfrequentrecurrences,whereasHSV2infectionrarelyrecurs.
248.Whichoneofthefollowingstatementsaboutthesrcgeneandsrc
proteinofRoussarcomavirusisINCORRECT?

(A)Thesrcgeneencodesaproteinwithepidermalgrowthfactoractivity.

(B)Thesrcproteinisaproteinkinasethatpreferentiallyphosphorylatestyrosineincellular
proteins.

(C)Thesrcproteinisrequiredtomaintainneoplastictransformationofinfectedcells.

(D)Theviralsrcgeneisderivedfromacellulargenefoundinallvertebratespecies.
249.Eachofthefollowingstatementssupportstheideathatcellular
protooncogenesparticipateinhumancarcinogenesisEXCEPT:

(A)ThecablgeneisrearrangedonthePhiladelphiachromosomeinmyeloidleukemiasand
encodesaproteinwithincreasedtyrosinekinaseactivity.

(B)TheNmycgeneisamplifiedasmuchas100foldinmanyadvancedcasesof
neuroblastoma.

(C)Thereceptorforplateletderivedgrowthfactorisatransmembraneproteinthatexhibits
tyrosinekinaseactivity.

(D)ThecHarasgeneismutatedatspecificcodonsinseveraltypesofhumancancer.
250.Eachofthefollowingstatementsconcerninghumanimmunode
ficiencyvirus(HIV)iscorrectEXCEPT:

(A)ScreeningtestsforantibodiesareusefultopreventtransmissionofHIVthroughtransfused
blood.

(B)TheopportunisticinfectionsseeninAIDSareprimarilytheresultofalossofcellmediated
immunity.

(C)Zidovudine(azidothymidine)inhibitstheRNAdependentDNApolymerase.

(D)ThepresenceofcirculatingantibodiesthatneutralizeHIVisevidencethatanindividualis
protectedagainstHIVinduceddisease.
251.Whichoneofthefollowingstatementsconcerningviralmeningi
tisandviralencephalitisisCORRECT?

(A)Herpessimplexvirustype2istheleadingcauseofviralmeningitis.

(B)Herpessimplexvirustype1isanimportantcauseofviralencephalitis.

(C)Thespinalfluidproteinisusuallydecreasedinviralmeningitis.

(D)ThediagnosisofviralmeningitiscanbemadebyusingtheIndiainkstainonasampleof
spinalfluid.
252.EachofthefollowingstatementsiscorrectEXCEPT:

(A)Coxsackievirusesareenterovirusesandcanreplicateinboththerespiratoryandgastrointestinal
tracts.

(B)Influenzaviruseshavemultipleserotypesbasedonhemagglutininandneuraminidase
proteinslocatedontheenvelopesurface.
PARTXIIUSMLE(NationalBoard)PracticeQuestions631
632
PARTXIIUSMLE(NationalBoard)PracticeQuestions
(C)FlavivirusesareRNAenvelopedvirusesthatreplicateinanimalsaswellashumans.
(D)AdenovirusesareRNAenvelopedvirusesthatareanimportantcauseofsexually
transmitteddisease.

253.

WhichoneofthefollowingstatementsconcerningthepreventionofviraldiseaseisCORRECT?

(A)Adenovirusvaccinecontainspurifiedpentonfibersandisusuallygiventochildrenin
conjunctionwithpoliovaccine.

(B)CoxsackievirusvaccinecontainslivevirusthatinducesIgA,whichprevents
reinfectionbyhomologousserotypes.

(C)Flavivirusimmunizationconsistsofhyperimmuneserumplusavaccineconsistingof
subunitscontainingthesurfaceglycoprotein.

(D)Oneoftheinfluenzavirusvaccinescontainskilledvirusthatinducesneutralizing
antibodydirectedagainstthehemagglutinin.
254.

EachofthefollowingstatementsconcerninghepatitisCvirus(HCV)andhepatitisDvirus
(HDV)iscorrectEXCEPT:

(A)HCVisanRNAvirusthatcausesposttransfusionhepatitis.

(B)HDVisadefectivevirusthatcanreplicateonlyinacellthatisalsoinfectedwith
hepatitisBvirus.

(C)HDVistransmittedprimarilybythefecaloralroute.

(D)PeopleinfectedwithHCVcommonlybecomechroniccarriersofHCVandare
predisposedtohepatocellularcarcinoma.
255.

EachofthefollowingstatementsconcerningmeaslesvirusiscorrectEXCEPT:

(A)MeaslesvirusisanenvelopedviruswithasinglestrandedRNAgenome.

(B)Oneoftheimportantcomplicationsofmeaslesisencephalitis.

(C)Theinitialsiteofmeaslesvirusreplicationistheupperrespiratorytract,fromwhich
itspreadsviathebloodtotheskin.

(D)Latentinfectionbymeaslesviruscanbeexplainedbytheintegrationofprovirusinto
thehostcellDNA.
256.

EachofthefollowingstatementsconcerningmeaslesvaccineiscorrectEXCEPT:

(A)Thevaccinecontainslive,attenuatedvirus.

(B)Thevaccineshouldnotbegivenatthesametimeasthemumpsvaccinebecausethe
immunesystemcannotrespondtotwoviralantigensgivenatthesametime.

(C)Virusinthevaccinecontainsonlyoneserotype.

(D)Thevaccineshouldnotbegivenpriorto15monthsofagebecausematernalantibodies
canpreventanimmuneresponse.
257.

EachofthefollowingstatementsconcerningrubellaiscorrectEXCEPT:

(A)Congenitalabnormalitiesoccurprimarilywhenapregnantwomanisinfectedduring
thefirsttrimester.

(B)Womenwhosaythattheyhaveneverhadrubellacan,nevertheless,haveneutralizing
antibodyintheirserum.

(C)Ina6yearoldchild,rubellaisamild,selflimiteddiseasewithfewcomplications.

(D)Acycloviriseffectiveinthetreatmentofcongenitalrubellasyndrome.
258.

EachofthefollowingstatementsconcerningrabiesandrabiesvirusiscorrectEXCEPT:

(A)ThevirushasalipoproteinenvelopeandsinglestrandedRNAasitsgenome.

(B)Thevirushasasingleantigenictype(serotype).

(C)IntheUnitedStates,dogsarethemostcommonreservoir.
(D)Theincubationperiodisusuallylong(severalweeks)ratherthanshort(severaldays).
259.

EachofthefollowingstatementsconcerningarbovirusesiscorrectEXCEPT:

(A)Thepathogenesisofdenguehemorrhagicshocksyndromeisassociatedwiththe
heterotypicanamnesticresponse.

(B)Wildbirdsarethereservoirforencephalitisvirusesbutnotforyellowfevervirus.

(C)Ticksarethemainmodeoftransmissionforbothencephalitisvirusesandyellow
fevervirus.

(D)Thereisalive,attenuatedvaccinethateffectivelypreventsyellowfever.
260.

EachofthefollowingstatementsconcerningrhinovirusesiscorrectEXCEPT:

(A)Rhinovirusesarepicornaviruses(i.e.,small,nonenvelopedviruseswithanRNA
genome).

(B)Rhinovirusesareanimportantcauseoflowerrespiratorytractinfections,especiallyin
patientswithchronicobstructivepulmonarydisease.

(C)Rhinovirusesdonotinfectthegastrointestinaltractbecausetheyareinactivatedbythe
acidpHinthestomach.

(D)Thereisnovaccineagainstrhinovirusesbecausetheyhavetoomanyantigenictypes.
261.

Eachofthefollowingstatementsconcerningherpessimplexvirustype2(HSV2)iscorrect
EXCEPT:

(A)PrimaryinfectionwithHSV2doesnotconferimmunitytoprimaryinfectionwith
HSV1.

(B)HSV2causesvesicularlesions,typicallyinthegenitalarea.

(C)HSV2cancausealterationsofthecellmembrane,leadingtocellfusionandthe
formationofmultinucleatedgiantcells.

(D)RecurrentdiseaseepisodesduetoreactivationoflatentHSV2areusuallymoresevere
thantheprimaryepisode.
262.

EachofthefollowingstatementsconcerningEpsteinBarrvirusiscorrectEXCEPT:

(A)Manyinfectionsaremildorinapparent.

(B)Theearlierinlifeprimaryinfectionisacquired,themorelikelythetypicalpictureof
infectiousmononucleosiswillbemanifest.

(C)Latentlyinfectedlymphocytesregularlypersistfollowinganacuteepisodeofinfection.

(D)Infectionconfersimmunityagainstsecondepisodesofinfectiousmononucleosis.
263.

EachofthefollowingstatementsregardingrotavirusesiscorrectEXCEPT:

(A)TherotavirusvaccinecontainsrecombinantRNApolymeraseastheimmunogen.

(B)Rotavirusesarealeadingcauseofdiarrheainyoungchildren.

(C)Rotavirusesaretransmittedprimarilybythefecaloralroute.

(D)Rotavirusesbelongtothereovirusfamily,whichhaveadoublestranded,segmented
RNAgenome.
264.

EachofthefollowingstatementsconcerningtheantigenicityofinfluenzaAvirusiscorrect
EXCEPT:

(A)Antigenicshifts,whichrepresentmajorchangesinantigenicity,occurinfrequently
andareduetothereassortmentofsegmentsoftheviralgenome.

(B)Antigenicshiftsaffectboththehemagglutininandtheneuraminidase.
(C)TheworldwideepidemicscausedbyinfluenzaAvirusareduetoantigenicshifts.
(D)Theproteininvolvedinantigenicdriftisprimarilytheinternalribonucleoprotein.
265.

EachofthefollowingstatementsconcerningadenovirusesiscorrectEXCEPT:

(A)AdenovirusesarecomposedofadoublestrandedDNAgenomeandacapsidwithout
anenvelope.

(B)Adenovirusescausebothsorethroatandpneumonia.

(C)Adenoviruseshaveonlyoneserologictype.

(D)Adenovirusesareimplicatedasacauseoftumorsinanimalsbutnothumans.
266.

Eachofthefollowingstatementsconcerningthepreventionofviralrespiratorytract
diseaseiscorrectEXCEPT:

(A)Topreventdiseasecausedbyadenoviruses,aliveentericcoatedvaccinethatcauses
asymptomaticentericinfectionisusedinthemilitary.

(B)TopreventdiseasecausedbyinfluenzaAvirus,aninactivatedvaccineisavailablefor
thecivilianpopulation.

(C)Thereisnovaccineavailableagainstrespiratorysyncytialvirus.

(D)Topreventdiseasecausedbyrhinoviruses,avaccinecontainingpurifiedcapsid
proteinsisused.
267.

EachofthefollowingstatementsconcerningherpesviruslatencyiscorrectEXCEPT:

(A)Exogenousstimulicancausereactivationofherpesvirusreplicationinlatentlyinfected
cells.

(B)Duringlatency,antiviralantibodyisnotdemonstrableintheseraofinfectedindividuals.

(C)Reactivationoflatentherpesvirusesaremorecommoninpatientswithimpairedcell
mediatedimmunitythaninimmunocompetentpatients.

(D)HerpesvirusgenomeDNApersistsinlatentlyinfectedcells.
268.

EachofthefollowingstatementsconcerningrhinovirusesiscorrectEXCEPT:

(A)Rhinovirusesarethemostcommoncauseofthecommoncold.

(B)Rhinovirusesgrowbetterat33Cthanat37C;hencetheytendtocausediseaseinthe
upperrespiratorytractratherthanthelowerrespiratorytract.

(C)Rhinovirusesaremembersofthepicornavirusesfamilyandhenceresemblepoliovirus
intheirstructureandreplication.

(D)Theimmunityprovidedbytherhinovirusvaccineisexcellentbecausethereisonly
oneserotype.
269.

WhichoneofthefollowingstatementsconcerningpoliovirusinfectionisCORRECT?

(A)Congenitalinfectionofthefetusisanimportantcomplication.

(B)Thevirusreplicatesextensivelyinthegastrointestinaltract.

(C)Askintestisavailabletodeterminepriorexposuretothevirus.

(D)Amantadineisaneffectivepreventiveagent.

270.

EachofthefollowingstatementsconcerningyellowfeveriscorrectEXCEPT:(A)Yellow
fevervirusistransmittedbytheAedesaegyptimosquitointheurbanformofyellowfever.
(B)Infectionbyyellowfeverviruscausessignificantdamagetohepatocytes.
(C)Nonhumanprimatesinthejungleareamajorreservoirofyellowfevervirus.
(D)Acyclovirisaneffectivetreatmentforyellowfever.

271.

WhichoneofthefollowingstatementsconcerningmumpsisCORRECT?

(A)Althoughthesalivaryglandsarethemostobvioussitesofinfection,thetestes,ovaries,
andpancreascanbeinvolvedaswell.

(B)Becausethereisnovaccineagainstmumps,passiveimmunizationistheonlymeans
ofpreventingthedisease.

(C)Thediagnosisofmumpsismadeonclinicalgroundsbecausetheviruscannotbe
grownincellcultureandserologictestsareinaccurate.

(D)Secondepisodesofmumpscanoccurbecausetherearetwoserotypesofthevirusand
protectionistypespecific.
272.

Manyoftheoncogenicretrovirusescarryoncogenescloselyrelatedtonormalcellular
genes,calledprotooncogenes.Whichoneofthefollowingstatementsconcerningproto
oncogenesisINCORRECT?

(A)Severalprotooncogeneshavebeenfoundinmutantforminhumancancersthatlack
evidenceforviraletiology.

(B)Severalviraloncogenesandtheirprogenitorprotooncogenesencodeproteinkinases
specificfortyrosine.

(C)Someprotooncogenesencodecellulargrowthfactorsandreceptorsforgrowth
factors.

(D)Protooncogenesarecloselyrelatedtotransposonsfoundinbacteria.
273.

Eachofthefollowingstatementsconcerninghumanimmunodeficiencyvirusiscorrect
EXCEPT:

(A)TheCD4proteinontheTcellsurfaceisoneofthereceptorsforthevirus.

(B)Thereisappreciableantigenicdiversityintheenvelopeglycoproteinofthevirus.

(C)Oneoftheviralgenescodesforaproteinthataugmentstheactivityoftheviral

transcriptionalpromoter.
.

(D)Amajorproblemwithtestingforantibodytothevirusisitscrossreactivitywith
humanTcelllymphomavirustypeI.
274.

Eachofthefollowingstatementsconcerninghumanimmunodeficiencyvirusiscorrect
EXCEPT:

(A)PatientsinfectedwithHIVtypicallyformantibodiesagainstboththeenvelopeglyco
proteins(gp120andgp41)andtheinternalgroupspecificantigen(p24).

(B)HIVprobablyaroseasanendogenousvirusofhumansbecauseHIVproviralDNAis
foundintheDNAofcertainnormalhumancells.

(C)TransmissionofHIVoccursprimarilybythetransferofbloodorsemeninadults,and
neonatescanbeinfectedatthetimeofdelivery.

(D)TheWesternblottestismorespecificforHIVinfectionthantheELISAis.
275.

EachofthefollowingstatementsconcerninghepatitisAvirus(HAV)iscorrectEXCEPT:

(A)ThehepatitisAvaccinecontainsinactivatedHAVastheimmunogen.

(B)HAVcommonlycausesasymptomaticinfectioninchildren.

(C)ThediagnosisofhepatitisAisusuallymadebyisolatingHAVincellculture.

(D)GammaglobulinisusedtopreventhepatitisAinexposedpersons.
PARTXIIUSMLE(NationalBoard)PracticeQuestions633
634PARTXIIUSMLE(NationalBoard)PracticeQuestionsAnswers(Questions212275)
281.Measlesvirus282.Respiratorysyncytialvirus283.Coxsackievirus284.Varicellazoster
virus
Questions285289
.

(A)Adenovirus

(B)Parainfluenzavirus

(C)Rhinovirus

(D)Coxsackievirus

(E)EpsteinBarrvirus

285.

Causesmyocarditisandpleurodynia

286.

Growsbetterat33Cthan37C

287.

Causestumorsinlaboratoryrodents

288.

Causescroupinyoungchildren

289.

Causesinfectiousmononucleosis
Questions290294

(A)HepatitisCvirus

(B)Cytomegalovirus

(C)Humanpapillomavirus

(D)Denguevirus

(E)St.Louisencephalitisvirus
290.Itisimplicatedasthecauseofcarcinomaofthecervix.291.Wildbirdsareanimportant
reservoir.292.Itisanimportantcauseofpneumoniainimmunocompromised
patients.293.DonatedbloodcontainingantibodytothisRNAvirusshouldnot
beusedfortransfusion.294.Itcausesahemorrhagicfeverthatcanbelifethreatening.
212.(C)213.(B)214.(B)215.(D)216.(C)217.(B)218.(A)219.(D)220.(A)221.(D)222.
(C)223.(C)224.(D)
225.(B)226.(D)227.(D)228.(B)229.(A)230.(D)231.(A)232.(A)233.(B)234.(C)235.
(B)236.(D)237.(B)
238.(A)239.(B)240.(D)241.(D)242.(A)243.(A)244.(A)245.(D)246.(B)247.(D)248.
(A)249.(C)250.(D)
251.(B)252.(D)253.(D)254.(C)255.(D)256.(B)257.(D)258.(C)259.(C)260.(B)261.
(D)262.(B)263.(A)
264.(D)265.(C)266.(D)267.(B)268.(D)269.(B)270.(D)271.(A)272.(D)273.(D)274.
(B)275.(C)

DIRECTIONS(Questions276294):SelecttheONEletteredoptionthatisMOSTclosely
associatedwiththenumbereditems.Eachletteredoptionmaybeselectedonce,morethanonce,
ornotatall.
Questions276279
(A)Yellowfevervirus(B)Rabiesvirus(C)Rotavirus(D)Rubellavirus
(E)Rhinovirus
276.

Diarrhea

277.

Jaundice

278.

Congenitalabnormalities

279.

Encephalitis
Questions280284

(A)Bronchiolitis

(B)Meningitis

(C)Pharyngitis

(D)Shingles

(E)Subacutesclerosingpanencephalitis
280.Adenovirus
Answers(Questions276294)
276.(C)277.(A)278.(D)279.(B)
280.(C)281.(E)282.(A)283.(B)
284.(D)285.(D)286.(C)287.(A)
288.(B)289.(E)290.(C)291.(E)
292.(B)293.(A)294.(D)