Virology directed speci cally against which of the following

1. A pregnant woman developed u-like symptoms during structures?

her rst trimester of pregnancy. There was no history of a. Structural proteins
travel. Her baby was born with congenital infec on. b. Neuraminidase
Which of the following is the most likely congenital c. Envelope
syndrome to be considered with high incidence of d. Hemagglu nin
developmental defect and mental retarda on? 7. Which of the following agents is NOT considered as a
a. Epstein Barr Virus Human Cancer virus?
b. Zika Virus a. HHV 8
c. HSV 2 b. Adenovirus
d. Cytomegalovirus c. Retrovirus
2. A woman on her 32nd week AOG delivered a severely d. HCV
edematous fetus which did not survive. It was learned 8. Which of the following is NOT correct regarding measles
that she had fever and rash during the rst trimester. virus infec on?
Based on the appearance of the fetus, which of the a. Primary and secondary viremia occurs a er
following is associated with fetal death due to severe entry.
anemia? b. The natural hosts for the virus are monkey, dog
a. Parvovirus and mice.
b. CMV c. Mul nucleated giant cells with intranuclear
c. Varicella Zoster Virus inclusions are seen.
d. HSV d. Possess F protein.
3. A 7-year-old boy developed low grade fever, pain on 9. Which of the following is the dis nct clinical syndrome
swallowing and bilateral tender swelling of the associated with Respiratory Syncy al Virus infec on?
preauricular area. Which of the following is a possible a. Common colds
complica on seen among males in their pre-teens? b. Bronchioli s
a. Epididymi s c. Croup
b. Orchi s d. Pneumonia
c. Pancrea s 10. Which of the following is true regarding an genic shi ?
d. Meningi s a. An genic shi occurs alternately with an genic
4. A 45-year-old man who was bi en by a stray dog dri .
manifested with trismus which gradually progressed to b. It involves major an genic changes solely of the
hydrophobia and change in sensorium. Which of the HA an gen
following features of the e ologic agent will explain c. An genic shi occurs as a defensive response to
progression of neurologic symptoms in the absence of neutralizing an bodies
protec ve vaccina ons? d. An genic shi only occurs with in uenza A
a. Internal nucleocapsid 11. A 34-year-old musician presents with jaundice and poor
b. G glycoprotein appe te Laboratory work-up revealed elevated
c. Envelope epitopes transaminases. Hepa s B pro le revealed the following:
d. Bullet shaped capsid HBsAg posi ve, An -HBc IgM posi ve, An -HBs nega ve,
5. A 3-month-old baby developed watery stools with low- HBeAg posi ve. Which of the following re ects the
grade fever. Electron microscopy of the specimen showed current clinical condi on of the pa ent?
an RNA virus which has double-stranded genome and a. Chronic Hepa s B
double shelled capsid. Which of the following is the likely b. Acute Hepa s B, ac ve
agent? c. Hepa s B carrier
a. Coronavirus d. Acute Hepa s B, Immune
b. Norwalk virus 12. Which of the following is NOT correct regarding
c. Adenovirus replica on of Retroviruses?
d. Rotavirus a. Infec on by most Retrovirus members does not
6. A 54-year-old man developed fever, cough, cold, muscles lead to cell death.
aches and malaise. Viral in uenza was the impression of b. Retroviruses are the only viruses that possess
the general prac oner on consult. If neutralizing reverse transcriptase.
an body ters are to be requested, these would be

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 c.
d.
ANSWERS AND RATIONALE
1. D. Cytonegalovirus
Key Words: Congenital Infec on; high incidence of
developmental defect and mental retarda on
Cytomegalovirus (DNA)
- most common congenital infec on that almost always
accompanies a primary infec on in a pregnant woman.
- Infec ons are usually asymptoma c at birth, but
approximately 25% will develop deafness and
neurological problems.
- CMV can infect neonates during delivery through an
infected birth canal or via breas eeding, but infants
usually remain healthy.
- usually causes an asymptoma c infec on in children and
adults.
- It causes approximately 10% of mononucleosis cases that
are clinically similar to those caused by EBV except that
no heterophile an bodies are produced.
- Cytopathology: causes swelling of infected cells
(cytomegalic cells) and “owl’s eye” intranuclear inclusion
bodies.
- Replica on: replicates in epithelial cells of oropharynx,
but latently infects monocytes, macrophages, and
lymphocytes.
- Clinical disease:
o May depress immune response during ini al
infec on due to interac on of cells involved in
cellular immunity.
o Causes a heterophile-nega ve mononucleosis and is
a poten ally serious congenital infec on.
o Latent infec ons are usually reac vated to
asymptoma c disease, but reac va on in
immunosuppressed individuals can be serious (e.g.,
giant cell pneumonia in acquired immunode ciency
syndrome [AIDS] pa ents).
- Treatment: does not produce its own thymidine kinase,
but does produce a protein kinase that phosphorylates
ganciclovir, a nucleoside analog that when incorporated
into viral DNA inhibits replica on; cidofovir is
phosphorylated by cellular kinases and also inhibits viral
DNA replica on.
Epstein Barr Virus
- Pathobiology: can produc vely infect and abor vely
infect human B lymphocytes; abor ve infec on induces
B-cell prolifera on and poten al transforma on.
Reverse transcriptase makes DNA copy from - Virulence factors: uses complement receptor 3 (CS-21 or
genomic RNA. CR-2) as the cellular receptor.
HIV provirus integrates into host cell - Clinical disease:
chromosome. o Produces several dis nct an gens, including latent
membrane proteins (LMPs), nuclear an gens
(EBNAs), early an gens (EAs), a membrane an gen
(MA), and a viral capsid an gen (VCA).
o Usually causes clinically inapparent infec ons, but
may cause heterophile posi ve infec ous
mononucleosis and is associated with Burki ’s
lymphoma and nasopharyngeal carcinoma.
- Infec ous mononucleosis:
o This systemic disease of children and young adults
(some mes called the kissing disease)
o characterized by sore throat, fever, enlarged lymph
nodes and spleen, and some mes hepa s.
o Diagnosis:
▪ Associated with the produc on of atypical
reac ve T lymphocytes (Downey cells) and IgM
heterophile an bodies (IgM interacts with Paul-
Bunnell an gen on sheep, horse, or bovine
erythrocytes, causing agglu na on) and may be
iden ed by the
▪ (+) Monospot test.
- Burki ’s lymphoma and nasopharyngeal carcinoma is
characterized by cells that express EBV nuclear an gen
(EBNAs) and latent membrane protein (LMPs) and carry
mul ple copies of viral DNA.
Herpes simplex type 1 and 2 (HSV-1 and -2):
- HSV can be transferred to the fetus transplacentally from
the mother.
- Transmission at the me of delivery can cause a serious
disseminated disease
- can produce a conjunc vi s that may progress to a
kera s involving the forma on of a dendri c ulcer,
which, if untreated, can lead to visual impairment; it may
cause a neonatal conjunc vi s origina ng from an
infected birth canal.
- cause a clinically apparent primary infec on (e.g.,
gingivostoma s by HSV-1 in children and HSV-2 in
young adults) or recurrent infec on (e.g., cold sores).
- Progression to a severe, fatal encephali s (HSV-1) or
meningi s (HSV-2) can occur.
- Virus latently infects neurons and may be reac vated to
travel to peripheral ssue by physical or emo onal stress,
or immune suppression.
- Cytopathology: Cowdry type A inclusions
- Replica on: produce a viral-speci c thymidine kinase
necessary for DNA replica on; it is the target of several
an -herpes nucleoside analog drugs like acyclovir.
- Clinical disease:

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 o Latently infect neurons.

o Produce both acute and latent infec ons whose Varicella Zoster Virus
clinical lesions occur primarily on mucosal surfaces - causes a disease (chickenpox) characterized by fever and
(lip and genitals), but can cause encephali s and eye vesicular rash on the trunk, face, and scalp, which is
infec ons as well. usually benign and self-limi ng in healthy children but
- Diagnosis: cause vesicular lesions with an erythematous more severe in adults (poten al for pneumonia).
base that contain cytopathology visualized by a Tzanck - es mated to cause conjunc vi s in 4% of chickenpox
smear for rapid iden ca on of the virus. cases; it may reac vate in the ophthalmic branch of the
- Treatment: Infec ons may be treated with an virals that trigeminal nerve to cause herpes zoster ophthalmicus.
a ect the viral DNA polymerase (foscarnet, tri uridine, - latently infects neurons; the virus can reac vate to cause
or vidarabine) or stop DNA chain elonga on (acyclovir, herpes zoster or shingles later in life.
penciclovir, famciclovir, and valacyclovir), but none - Diagnosed clinically.
eliminate latent infec ons. - Preven on: may be prevented by vaccina on with the
live, a enuated Oka strain or treatment of high-risk or
TORCH infec on immunosuppressed individuals with VZIG.
- Toxoplasmosis
- Others (Gonorrhea, Syphilis) 3. B. Orchi s
- Rubella Key Words: Boy, low grade fever, pain on swallowing and
- Cytomegalovirus bilateral tender swelling of the preauricular area –
- Herpes Simplex MUMPS VIRUS

2. A. Parvovirus Mumps Virus

Key words: Edematous Fetus - o en associated with asymptoma c disease but can
cause a late winter or early spring disease characterized
Parvoviruses by sudden onset, fever, and paro s; it is some mes
- Descrip on: small, naked viruses with icosahedral accompanied by orchi s, pancrea s, and
capsids containing single-stranded DNA. meningoencephali s (50% have involvement, but only
- Clinical disease: includes one human virus (B19) that 10% have symptoms).
causes disease involving cytoly c replica on in erythroid - Central nervous system involvement (10–30% of cases)
precursor cells; causes several adverse consequences, o asep c meningi s (Males > Females)
including aplas c crisis, h disease, and fetal death. o Meningoencephali s
- Parvovirus B-19 can infect both mother and fetus during ▪ usually occurs 5–7 days a er in amma on of
epidemics, but the outcome is good for both, unless the the salivary gland
infec on of the fetus occurs during the rst 20 weeks of ▪ half of pa ents will not have clinical evidence of
pregnancy, when a severe anemia resul ng in death can paro s.
occur. o Meningi s is reported in up to 15% of cases and
encephali s in fewer than 0.3%.
- mortality rate is about 1%.
- The testes and ovaries may be a ected, especially a er
- puberty.
- 20–50% of men who are infected with mumps virus
develop orchi s (o en unilateral).
o Because of the lack of elas city of the tunica
albuginea, which does not allow the in amed tes s
to swell, the complica on is extremely painful.
o Atrophy of the tes s may occur as a result of
pressure necrosis but only rarely does sterility result.
- Mumps oophori s occurs in about 5% of women.
- Pancrea s is reported in about 4% of cases.
- Diagnosis: has a clinical diagnosis or ELISA for IgM.
- Preven on: Disease is prevented by vaccina on with the
live a enuated Jeryl Lynn strain or in combina on with

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 a enuated strains of measles and rubella viruses (MMR ▪ Grown in human MRC-5 diploid cell cultures
vaccine). (Pitman-Moore strain of virus) before
inac va on and used in ac ve immuniza on.
4. B. Glycoprotein ▪ Has been grown (Flury LEP strain) in primary
Key Words: Bi en by a Stray Dog; features of the chicken broblasts before inac va on and
e ologic agent inclusion in a PCEC (puri ed chick embryo cell
culture) vaccine used for postexposure
Rhabdoviruses vaccina on.
- General characteris cs: ▪ Has been a enuated by growth in a chick
o Descrip on: enveloped, bullet-shaped viruses with a embryo for use as an animal, not human,
helical nucleocapsid containing single-stranded, vaccine (Flury vaccine).
nega ve-sense RNA.
o Replica on: have a virion-associated transcriptase 5. D. Rotavirus
and replicate in the cytoplasm. Key Words: double-stranded genome; double shelled
o Classi ca on: includes the human pathogen rabies capsid
virus and the bovine pathogen vesicular stoma s
virus. Rotaviruses
- Rabies virus: - account for 50% to 80% of all cases of viral
o Replica on: has a virion-associated transcriptase or gastroenteri s, with more severe symptoms in neonates
replicase. and infants and asymptoma c infec ons in older children
o Cytopathology: produces speci c cytoplasmic and adults.
inclusion bodies, called Negri bodies, in infected - It also causes possible nosocomial disease and outbreaks
cells. in day care centers.
o Pathobiology: - When infec on occurs in malnourished children, the
▪ Uses acetylcholine receptors on muscle cells to mortality rate is 30%.
ini ate infec on. - Diagnosis: usually diagnosed by EIA for rotavirus an gens
▪ Has a predilec on for the hippocampus in the feces.
(Ammon’s horn cells). - Preven on: have been gene cally manipulated and
▪ Can travel throughout the nervous system in a enuated to prepare two live, oral vaccines.
nerve bers. o Rotarix vaccine contains a enuated subtypes G1, 3,
o Clinical disease: 4, and 9 human viruses.
▪ Produces disease a er inocula on by an animal o RotaTeq vaccine contains ve reassortment viruses
bite (zoono c disease) or, occasionally, with WC3 bovine parent and G1, G2, G3, G4, and PL
inhala on. human VP7 outer protein subtypes.
▪ Causes fatal disease unless the infected person Noroviruses (Norwalk and similar viruses)
previously received immuniza on or receives - cause gastroenteri s associated with contaminate water
postexposure prophylaxis consis ng of passive or shell sh and other food in adults and school-age
immuniza on with human rabies immune children.
globulin and immuniza on with a vaccine. - Infec ons occur most frequently in contained se ngs like
o Diagnosis: iden ed in suspected ssues by a direct schools, cruise ships, camps, hospitals, and so forth.
immuno uorescent test for viral an gens. - Noroviruses are the cause of winter vomi ng disease, a
▪ The G glycoprotein is a major factor in rabies disease involving school and family outbreaks.
virus neuroinvasiveness and pathogenicity.
▪ Avirulent mutants of rabies virus have been Adenovirus
selected using certain monoclonal an bodies - involved in respiratory tract infec ons but can cause a
against the viral glycoprotein. conjunc vi s known as pinkeye, which resolves
▪ A subs tu on at amino acid posi on 333 of the spontaneously in a few days.
glycoprotein results in loss of virulence,
- They can cause a serious epidemic keratoconjunc vi s,
indica ng some essen al role for that site of the
which may be transmi ed by contaminated
protein in disease pathogenesis.
ophthalmologic instruments.
o Treatment and preven on:

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 - second most common cause of gastroenteri s in Human herpesvirus type 8 (Kaposi’s sarcoma-associated
neonates and young children herpesvirus; HHVS or KSHV): - DNA
- Pathobiology: preferen ally infects B lymphocytes and
appears to be sexually transmi ed.
6. D. Hemagglu nin - Genome: contains more than 10 homologues of cellular
Key Words: fever, cough, cold, muscles aches and malaise genes (e.g., cyclin D, interleukin 6, and so forth) in its
– In uenza Virus genome.
- Clinical disease:
In uenza Virus o Associated with Kaposi’s sarcoma.
- a localized infec on of the respiratory tract with o Linked to some AIDS-associated B-cell lymphomas.
symptoms ranging from a mild rhinotrachei s to a fatal o Implicated in mul ple myeloma.
pneumonia.
- In healthy individuals, in uenza is usually not serious; in Retrovirus – also called oncoviruses; cause tumors of the
the elderly or in pa ents with a secondary bacterial re culoendothelial and hematopoie c systems (leukemias),
pneumonia, it may cause serious complica ons. connec ve ssues (sarcomas), or mammary gland.
- It may rarely progress to encephali s a few weeks
pos nfec on. HCV – Hepatocellular Carcinoma
- It is associated with Guillain-Barré syndrome (in uenza
virus types A and B) and Reye’s syndrome (in uenza virus 8. B. The natural hosts for the virus are monkey, dog and
type B). mice.
- Pandemics may result due to reassortment of the Key Words: measles virus infec on
hemagglu nin.
- Diagnosis: can be diagnosed by enzyme immunoassay Measles Virus
(EIA), direct immuno uorescence, or RT-PCR of - causes an infec on producing a maculopapular rash ( rst
respiratory secre ons or serologically. seen below the hairline and behind the ears) and
- Preven on: may be prevented by either an inac vated produces a high fever, cough, coryza, conjunc vi s, and
trivalent vaccine (whole, split, and subunit vaccines exist) Koplik spots on buccal mucosa (12 to 24 hours before the
or a live a enuated trivalent vaccine containing recent A/ rash).
H1N1 A/ H3N2, and B strains. - may cause complica ons including a pos nfec ous
- Treatment: may be prevented chemoprophylac cally and encephali s, giant cell pneumonia, atypical measles
treated (both A and B strains) by administra on of (disease in those previously vaccinated), and, a er many
zanamivir or oseltamivir (viral neuraminidase years, Subacute sclerosing panencephali s (SSPE).
inhibitors); amantadine and rimantadine (M2 ion - Temporary immunosuppression occurs due to
channel inhibitors) are no longer recommended for lymphocyte infec on.
treatment of in uenza A and are ine ec ve against - Diagnosis: has a clinical diagnosis.
in uenza B. - Preven on: may be prevented by vaccina on with the
live a enuated Enders-Edmonston strain by itself or in
7. B. Adenovirus combina on with a enuated strains of mumps and
Key Word: NOT considered as a Human Cancer virus rubella viruses (MMR vaccine).

9. B. Bronchioli s
Key Words: Respiratory Syncy al Virus infec on
Respiratory syncy al virus:
- Descrip on: exists in one serotype.
- Components: has only hemagglu nin ac vity (H
protein), no neuraminidase ac vity.
- Replica on: induces syncy a forma on during
replica on.
- Clinical disease: causes a poten ally serious
respiratory tract pathogen of infants.
- Diagnosis: diagnosed by enzyme immunoassay (EIA)
for viral an gens in nasopharyngeal washes.

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 - most important cause of lower respiratory tract

illness in infants and young children; cause of
bronchioli s and pneumonia in infants younger than
1 year

10. D. An genic shi only occurs with in uenza A 12. B. Retroviruses are the only viruses that possess reverse
Key Words: An genic shi transcriptase.
Key Words: Replica on of Retroviruses
An genic shi does not occur alternately with an genic dri .
It involves major an genic changes solely of the H and/or N Retroviruses
an gen - spherical, enveloped viruses (80–110 nm in diameter)
An genic shi is not defensive response to neutralizing - contains two copies of linear, posi ve-sense, single-
an bodies stranded RNA
- Infec on by most Retrovirus members does not lead to
cell death.
- Reverse transcriptase makes DNA copy from genomic
RNA ! DNA becomes circularized and integrated into
host chromosomal DNA
- HIV provirus integrates into host cell chromosome.
- Virion assembly occurs by budding on plasma
membranes.
- Hosts remain chronically infected.
- Retroviruses cause acquired immunode ciency syndrome
(AIDS) and make possible the iden ca on of cellular
oncogenes.

*Hepadnaviruses also possess reverse transcriptase

Hepadnaviruses
- Small (40–48 nm), enveloped viruses containing circular,
par ally double-stranded DNA molecules
11. B. Acute Hepa s B, ac ve
- Replica on involves repair of the single-stranded gap in
Key Words: HBsAg (+), An -HBc IgM (+), An -HBs (-),
the DNA, transcrip on of RNA, and reverse transcrip on
HBeAg (+).
of the RNA to make genomic DNA.
- Hepa s B virus can cause acute and chronic hepa s;
persistent infec ons are associated with a high risk of
developing liver cancer.

References:
- Dr. Bumblebee’s recording 😊
- Jawetz
- BRS Mirco

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