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Socrative Questions Exam 2

Terms in this set (48)

Novel viruses emerged from China have resulted in a severe acute respiratory syndrome (SARS) resulting millions of deaths. All of the following are true except:

A. It was due to a new Paramyxoviridae family virus now known as Human metapneumovirus
B. the causitive virus could be recovered from the respiratory tract, urine and feces
C. It was due to a Coronavirus. This family of viruses can infect Camels via bats then species jump to produce in humans, Middle East Respiratory Syndrome (MERS)
D. The 2002-2003 SARS event was terminated by aggressive quarantine. SARS-CoV2 the agent of the 2019 to current pandemic will require aggressive worldwide vaccination to control
A. It was due to a new Paramyxoviridae family virus now known as Human metapneumovirus
Quasispecies are:

A. In general are the result of high misread rates commonly seen in DNA virus like Herpes making treatment difficult
B. Commonly seen in Poxviruses
C. are the main reason why polio vaccines are now killed (Salk) rather than inactivated (Sabin)
D. Are not associated with reverse transcription
C. are the main reason why polio vaccines are now killed (Salk) rather than inactivated (Sabin)
Influenza is an 8 segmented ssRNA virus.

A. Like most RNA viruses it replicates in the cytoplasm
B. Like most RNA viruses it has a polymerase that is not prone to misreads, resulting rare genetic drift of the transmembrane proteins neuraminadase hemagglutinin and M2 membrane antigenic sites
C. Neuraminadase destroys cell receptor binding of hemagglutinin to the cell surface allowing the budded virus to be released
D. is a naked non enveloped virus that incorporates into the host cell nucleus
C. Neuraminadase destroys cell receptor binding of hemagglutinin to the cell surface allowing the budded virus to be released
Antigenic shift is due to RNA polymerase misreads and antigenic drift is due to genetic recombination and reassortment.

True or False?
False
Vaccines based on class slides and discussion; Which statement is true?

A. Influenza vaccines can be either inactivated or attenuated. They are formulated based on year round surveillance by the WHO, with twice a year meetings to determine seasonal winter composition for either the Northern or Southern hemispheres.
B. Influenza nasal mist a live attenuated vaccine is safe because they can not replicate in the nasal passages only the body at normal temperature.
C. The Salk vaccine is used in areas where cultural habit preclude routine vaccination. This vaccine results in significant fecal oral spread via school children and resultant "herd immunity".
D. Live attenuated vaccines like influenza are recommended for immunosuppressed, elderly and pregnant people to encourage a stronger immune response.
A. Influenza vaccines can be either inactivated or attenuated. They are formulated based on year round surveillance by the WHO, with twice a year meetings to determine seasonal winter composition for either the Northern or Southern hemispheres.
Tamiflu (oseltamvir) is a hemagglutinin inhibitor

True or False?
False
The Paramyxoviridae family includes several respiratory viruses. Which is not true?

A. RSV a member of this family cause life threaten bronchiolar swelling in infants. Prior vaccine development resulted in "immunopotentiation".
B. Influenza C a 7 genome -sense RNA virus resulting in severe epidemics. It is part of this family.
C. This viral family is - sense RNA single stranded making it Baltimore class V
D. Human Metapneumovirus is relatively newly recognized virus producing a disease syndrome similar to RSV. It is from the Paramyxovirdae family.
B. Influenza C a 7 genome -sense RNA virus resulting in severe epidemics. It is part of this family.
20 year NKU student goes to Puerto Vallarta for Fall break. They "party" including lot of 2carbon beverages. They return the same color as pineapple juice in their Piña Coladas, with dark urine, light stool and yellow eyes.

A. They have the first signs of exposure to polio a fecal oral virus associated with 3rd world poverty
B. They have presumptive Hepatitis B from a "D" rated bar
C. They have Presumptive Hepatitis C
D. They have Norwalk virus
E. They have presumptive Hepatitis A
E. They have presumptive Hepatitis A
You are the NKY physician. Case 1 has just left your office aside from good hand washing "before having lunch" what would you do?

A. Isolate the student until he is no longer yellow, ie. restrict him from classes.
B. Give him the Hepatitis A vaccine and recommend the Hepatitis B and C vaccines.
C. Give his roommates and close contacts a gamma-globulin shot and Hepatitis A vaccination
D. Monitor him for long term consequences including cirrhosis of the liver
C. Give his roommates and close contacts a gamma-globulin shot and Hepatitis A vaccination
You are a pediatrician. Most of your day is spent with well baby and child care mixed with anxious parent syndrome. Vaccination is a major part of your practice, including a vaccine to prevent the #1 cause of diarrhea in infants and children. A 1 year old appears in your office with abdominal pain, is not making stool and vomiting along with fever.

A. This is most likely constipation
B. This is a side effect of the MMR vaccine referred as AMS
C. This a potential side effect of the Rotavirus vaccine called intussusception (bowel pulled into bowel)
D. This is a known side effect to exposure of the Sabin polio vaccine via the fecal oral route.
C. This a potential side effect of the Rotavirus vaccine called intussusception (bowel pulled into bowel)
A NKU student is going to volunteer in a refugee camp in North Eastern Nigeria. Polio boaster is recommended. You recommend the oral Sabin vaccine over the Salk vaccine because it is a live DNA based (low risk of false misreads) and will help provide herd immunity and is safer vaccine for the vaccinee than the Salk.

True or False?
False
You are a volunteer working for the Bill and Melinda Gates foundation in refugee camp in Pakistan taking care of children with polio. All of the following are reasonable mitigation options for the camp except:

A. Masks to prevent aerosls with the virus
B. Teaching good hand washing hygiene
C. consider use of the Sabin vaccine over the Salk vaccine for "herd immunity"
D. Improve waste sanitation
E. Take a booster Salk vaccine prior to working in the camps
A. Masks to prevent aerosls with the virus
A NKU elderly professor develops muscle weakness, and loss of prior involve limb 30 years after having polio. This is because polio is a lentivirus with prolonged latency.

True or False?
False
Mucosal IgA a localized specific antibody response to polio vaccine is seen after immunization with the Sabin (oral) but not the Salk (killed IM shot)

True or False?
True
Norwalk virus is a Caliciviridae family of small non-enveloped RNA viruses that causes diarrhea on cruises and is the most common cause of viral gastroenteritis in the world.

True or False
True
An 18 year college student finds a bat in her dorm room. She is bitten in her successful attempt to return it to nature. What would you not recommend?

A. Rhabdoviridae are rod-shaped negative-sense, non-segmented, single-stranded RNA viruses (Baltimore V) that cause rabies. She should be observed for signs of this virus before considering treatment.
B. She should have the wound cleaned with 20% soap and water/or a quaternary ammonium compounds, plus receive human rabies immune globulin instilled into the wound and systemically along with HDCV for rabies
C. She is be told that bats are epizootic for rabies
D. In the United States the Human Diploid Cell Vaccine is non neuro in origin and the HIG is non equestrian making the likelihood of a reaction less likely
A. Rhabdoviridae are rod-shaped negative-sense, non-segmented, single-stranded RNA viruses (Baltimore V) that cause rabies. She should be observed for signs of this virus before considering treatment.
A 20 year old veterinary student is a spelunker is concerned his rabies risks. All of the following statements are true except:

A. 2% of bats have rabies
B. rabies virus can be aerosolize in bat urine
C. PEP (pre-exposure prophylaxis to rabies) offers no protection
D. If he had PEP he will still need vaccination and appropriate wound care but not have to receive HRIG (human rabies immune globulin).
C. PEP (pre-exposure prophylaxis to rabies) offers no protection
A NKU student on the swimming team, is referred by a health office to you a new virologist. They have a negative screen for acterial source of an exudative pharyngitis, associated with conjunctivitis, and fever. No h/o esophagitis or chest pain and not sexually active. Pending RT-PCR your most likely diagnosis is:

A. EBV infection a common Herpes virus contagious in college students. It is noted that she has no atypical lymphocytes
B. Herpes simplex pharyngitis with keratoconjunctivitis
C. Pharyngocjunctival fever due adenovirus infection. This is highly contagious
D. Mumps virus pharyngitis and conjunctivitis
C. Pharyngocjunctival fever due adenovirus infection. This is highly contagious
Adenovirus select for host CAR and can be adapted to "carry" trans genes

True or False?
True
Vladimir Putinovich, a scientist from the Ukraine, cleared to work on Variola at the CDC. He becomes ill with a high fever and followed by a vesicular rash. You are asked to diagnosis and treat him. Which statement is clearly incorrect?

A. You would anticipate that his rash is centrifugal spread, including mucous membranes and not occurring in crops.
B. Variola is stored at the CDC and in Russia. The disease limited only to humans.
C. The disease is highly contagious and lethal spread via respiratory or direct contact with the vesicles
D. You would consider tecovirimat that inhibits p37, a protein in all orthopoxviruses that mediates the formation and egress of enveloped virions, plus brincidofovir a nucleotide analog useful in dsDNA virus including Adeno-virus
E. Refer him back to the Ukraine for treatment for treatment of his Baltimore class VII virus
E. Refer him back to the Ukraine for treatment for treatment of his Baltimore class VII virus
Vaccination for Variola (smallpox) - which is true?

A. uses a monkey pox derivative
B. can result in "vaccinia" a diseminated lethal case of vaccinia virus in severely immunocompromised individuals
C. Is one of the components of the pediatric vaccinations (PTD) or pox, tetanus, distemper vaccine
D. Variolation uses the vaccinia virus
B. can result in "vaccinia" a diseminated lethal case of vaccinia virus in severely immunocompromised individuals
Rotavirus

A. DS RNA viruses requiring reverse transcriptorase to replicate
B. result in severe life threatening diarrhea due to NSP4 effect on intentional villi with destruction and malabsorption of sugars resulting in an osmotic diarrhea
C. spreads by respiratory droplets
D. limited to infants and children
B. result in severe life threatening diarrhea due to NSP4 effect on intentional villi with destruction and malabsorption of sugars resulting in an osmotic diarrhea
Regarding the virus family Calcivirdae all of the following are true except:

A. are single-stranded, positive-sense RNA genome making it a Baltimore class IV (making a - RNA to mRNA)
B. Norwalk virus is a member of this family and cause 699 million illnesses and 219,000 deaths annually worldwide
C. Incubation periods are generally 24 to 48 hours, spread via diarrhea and vomitus, rarely airborne
D. Sea food handlers, are not associated with epidemics of this family of virus
E. HBGA a precursor to human blood types-especially type O located on the small intestinal mucosal is an associated Calicivirus binding site. Breast milk has this precursor binding the virus and limited spread to infants
D. Sea food handlers, are not associated with epidemics of this family of virus
Interferons (IFNs) are important modulators of immune, inflammatory, and antiviral functions, as well as cell survival and proliferation. They exert signals through the activation of the JAK-STAT pathway that mediates rapid induction of IFN-stimulated genes or ISGs

True or False?
True
Mumps involves all of the following except:

A. Mumps virus is a member of the Paramyxoviridae family
B. is an enveloped - sense RNA virus, a Baltimore class V
C. can cause inflammation of the parotid gland, pancreas, testes and CNS (aseptic meningitis). Before widespread vaccination, mumps was the most common cause of acquired sensorineural hearing loss in children
D. Inactivated vax is protective and part of the MMR
D. Inactivated vax is protective and part of the MMR
Measles Virus includes all of the following except:

A. Vaccine is a live attenuated vax which is protective and part of the MMR
B. SSPE is a slowly progressive disorder characterized by seizures, deterioration of cognitive and motor function, myoclonic movements, and death. It occurs 5 to 15 years after initial measles infection, which usually occurs in children younger than 2 years
C. Koplik spots found next to the 2nd molar make the clinical diagnosis
D. Increase the immune response to PPD and PHA testing
D. Increase the immune response to PPD and PHA testing
Kaposi's sarcoma is highly associated with this Herpetic virus in AIDS patients

A. HHV6
B. EBV
C. HSV 1
D. HHV8
D. HHV8
Burkett's lymphoma, and Hodgkin's disease are cancer associated with this Herpes virus

A. HHV6
B. EVB
C. HSV 1
D. CMV
B. EVB
A 30 year nursing student doing oral care on ventilator patients without gloves now has a very tender finger, referred to as a "whitlow"

A. HSV 1
B. EVB
C. CMV
D. VZV
A. HSV 1
Exanthem subitum or roseola, a self limiting Herpes class ___ virus is a pediatric exanthema (rash) preceded by high fever which cause of febrile seizures in infants

A. HHV5 or CMV
B. HHV4 or EBV
C. HHV3 or VZV
D. HHV6 or Herpes lymphotropic virus
D. HHV6 or Herpes lymphotropic virus
This common Herpes virus can be latent for years with age, waning immunity, or immunosuppression it traveled down, retrograde, the involved sensory nerve

A. HSV 1
B. EBV
C. VZV
D. HHV 7
VZV
A student develops severe pharyngitis. This develops a few days after a first kissing date. An enlarged spleen is detected. Ampicillin is given without a culture resulting in a diffuse skin rash. This picture is due to T cells activated in response to infected B lymphocytes by this Herpes virus. It is known to be "heterophile antibody positive.

A. EBV
B. HSV2
C. HHV7
D. VZV
A. EBV
A student who was considering taking virology, and currently has HSV-2, read on FB that this virus can cause meningitis

True or False?
True
This is a brain removed at autopsy of a patient with a treatable viral encephalitis

A. VZV
B. EBV
C. CMV or HHV5
D. HSV1
D. HSV1
This is a Tzank prep (essentially a Pap smear) from the Cervix or skin. It shows viral inclusions and multi-nucleated cells. This cytology can be helpful in diagnosing all the following Herpes virus except:

A. HSV
B. VZV
C. CMV
D. Rabies
D. Rabies
CMV is associated with all of the following except:

A. retinitis in T cell suppressed patients
B. birth defects especially the developing brain in first naive pregnant women
C. can cause hepatitis
D. is airborne spread
D. is airborne spread
All of the following are true about Hepatitis A except:

A. It can be a chronic disease relapsing over the course of years resulting in cirrhosis of the liver and or primary hepatoma (cancer of the liver)
B. It can be spread fecal-orally, via blood products such as factor VIII for hemophiliacs, and vertically in pregnancy
C. it can be transmitted via food handlers, contaminated fruits and vegetables, ice, shellfish, and has a higher incidence in homeless people. MSM are also seen to have higher incidence of HAV
D. It is a non-enveloped + RNA virus of the picornaviridae, Baltimore class IV
A. It can be a chronic disease relapsing over the course of years resulting in cirrhosis of the liver and or primary hepatoma (cancer of the liver)
You and a friend go South of the border for Fall break. Your friend is now a early Fall pumpkin color with cola urine. Lab tests confirm with an IgM to HAV. Your best choice is:

A. Consider routine pooled Gamma globulin (noting that HAV antibody levels having been decreasing in recent years)
B. HAV inactivated vaccine
C. continue to work in the school's dining room as a server since you are not jaundice and feel well
D. Have a few drinks with your infectious disease physician and see if you can get some free advice
B. HAV inactivated vaccine
Hepatitis B: all of the following are correct except:

A. HBV is a small enveloped (from ER) DNA virus, partially double-stranded DNA genome is maintained in a circular conformation
B. It is Baltimore class VII requiring reverse transcription to replicate
C. HBV infection results in the production of large quantities of subviral spherical and filamentous HVsAg particles (Dane), which are devoid of HBV DNA useful both as immune decoys and for vaccine development
D. Highly infectious with over 200 million infections worldwide, spread via the fecal oral route
D. Highly infectious with over 200 million infections worldwide, spread via the fecal oral route
EBV vaccination is a recombinant vaccine containing HBsAg. It produces an immune (antibody) response identical to those who acquired natural immunity to the virus.

True or False?
False
Hepatitis C virus is an enveloped, positive-strand RNA virus of the Flaviviridae family, the same family as Dengue and Yellow fever viruses, Hepacivirus. It can produce cirrhosis and cancer of the liver. It is primarily transmitted by contact with blood or serum.

True or False?
True
All of the following are correct statements about Hepatitis C except:

A. HCV sequences assigned to different genotypes may have less than 50% nucleotide sequence identity of which there are 7 proven
B. HCV is associated with a high level of virion turnover, absence of proofreading it's RNA polymerase, results the generation of viral mutations. Multiple HCV variants can be recovered from the plasma and liver of an infected individuals
C. Untreated 70% of infected people will have chronic potentially progressive disease resulting in liver fibrosis (cirrhosis) and primary liver cancer (hepatoma)
D. Heterosexual transmission is the primary route of acquiring the virus
E. Sofosbuvir is an RNA chain terminator prodrug with broad pangenotypic activity.
D. Heterosexual transmission is the primary route of acquiring the
Efforts to develop and HCV vaccine are complicated by the extensive antigenic diversity existing among different HCV genotypes, in addition to the absence of solid immunity following natural infections

True or False?
True
HBV and HCV can be associated with extra hepatic disease including lymphoma, kidney disease and skin diseases

True or False?
True
All of the following are true about the Delta agent except:

A. HDV is an enveloped virus with a small single-stranded, - sensed circular RNA genome
B. No proofreading ability of the RNA polymerases, so the mutation rate is high, i.e. produces quasispecies
C. Requires the Hepatitis C virus capsid to allow this viroid become functional
D. Cirrhosis occurs in 60% to 80% of chronic hepatitis D patients within 5 to 10 years. Some people develop a fulminant hepatitis
C. Requires the Hepatitis C virus capsid to allow this viroid become functional
All of the following are true about Hepatitis E except:

A. HEV is a small, icosahedral, non-enveloped single-stranded RNA virus with a positive-sense genome
B. 20 million infections annually occur worldwide. 3.3 million of these cases are symptomatic 44,000 deaths
C. Usually self limiting similar clinically to hepatitis A (rarely chronic). Can be severe in pregnant and immunocompromised patients
D. Humans are the only reservoir, spread fecal orally
D. Humans are the only reservoir, spread fecal orally
Metastable is a critical concept in viral packaging, delivery and uncoating. Key points include all of the following except:

A. Has obtained the minimum free energy conformation of the viral particles
B. The viral capsid sub-units are not covalently bonded
C. potential energy is used for disassembly
D. Binding to receptor site can change the virion stability (configuration)
E. The virus is stable in protecting the genome with its capsid and unstable in disassembling on fusion with the appropriate host i.e. "metastable"
A. Has obtained the minimum free energy conformation of the viral particles
Which fo the following are characteristics of icosahedral symmetry in viral capsids:

A. a solid with 20 faces, each equilateral triangle
B. Formation of a closed shell with 60 identical subunits
C. Fivefold, threefold and twofold axis of symmetry
D. the T number describes the number of facets per icosahedral face
E. All of the above
E. All of the above
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