1. The retrovirus responsible for causing acquired A.

HeLa cells
immune deficiency syndrome is a member of B. HEp-2 cells
the family C. Human fibroblast cells
A. Orthomyxoviridae D. Primary monkey kidney (PMK) cells
B. Paramyxoviridae 9. Which of the following viruses is
C. Retroviridae predominantly associated with respiratory
D. Flaviviridae disease and epidemics of keratoconjunctivitis?
2. The appearance of Koplik spots in the oral A. Adenovirus
mucosa of patients is characteristic of infection B. Molluscum contagiosum virus
with what viral agent? C. Norwalk virus
A. Hepatitis D. Rotavirus
B. Measles 10. A 25-year-old patient presented with multiple
C. Rabies vesicles around the mouth. Material from the
D. Smallpox lesions was obtained by needle aspiration and
3. Characteristics of this DNA hepatitis virus inoculated to MRC-5 cells. After 1 day, the
include infections spread by contaminated cytopathic effect included foci of "ballooned"
body fluids, 50- to 180-day incubation period, and lysed cells. These observations suggest
and chronic infections. infection with
A. HAV A. Adenovirus
B. HBV B. Cytomegalovirus
C. HCV C. Epstein-Barr virus
D. HEV D. Herpes simplex virus
4. Which of the following has been declared 11. The Sabin polio vaccine uses which of the
eradicated by the World Health Organization? following?
A. Smallpox A. Formalin-inactivated viruses
B. Human T cell lymphotropic virus B. Attenuated viruses
C. Hepatitis G virus C. Recombinant viral antigens
D. Eastern equine encephalitis D. DNA
5. Rotavirus is the most common etiologic agent 12. Which of the following is caused by a herpes
of virus?
A. Acute nonbacterial encephalitis in children A. Cold sores
B. Acute nonbacterial gastroenteritis in infants B. Hemorrhagic fever
and young children C. Polio
C. Chronic nonbacterial pharyngitis in children D. Rabies
and young adults 13. Which of the following is not a general
D. Chronic nonbacterial retinitis in children characteristic of a virus?
6. Kaposi sarcoma is associated with infection by A. Obligate intracellular parasite
A. Adenovirus B. Does not produce ATP
B. Cytomegalo virus C. Genome is surrounded by a protein coat
C. Hepatitis E virus D. Can self-replicate in the appropriate host cell
D. Human herpes virus 8 14. The viral disease shingles, which causes
7. The molecular receptor of the virus causing extreme tenderness along the dorsal nerve
acquired immune deficiency syndrome is roots and a vesicular eruption, has the same
A. CD 4 etiologic agent as
B. CDS A. Rubeola
C. Fc receptor B. Vaccinia
D. Complement receptor C. Varicella
8. The type of cell culture that best supports the D. Variola
growth of cytomegalovirus is
15. The etiologic agents of many common colds C. HCV
are RNA viruses that grow better at 33°C than D. HGV
at 37°C. These viruses are 23. Enteroviruses are most often associated with
A. Adenoviruses A. Acute nonspecific febrile syndrome
B. Orthomyxoviruses B. Bronchitis and pneumonia
C. Paramyxoviruses C. Lower respiratory tract infections
D. Rhinoviruses D. Upper respiratory tract infections
16. Influenza A virus undergoes recombination 24. The "core window" refers to the time
events that produce new strains; this is A. During hepatitis B virus infection when anti-
referred to as HBc IgM is the only serologic marker
A. Antigenic drift B. During hepatitis B virus infection when HBc is
B. Antigenic shift the only serologic marker
C. Reactivation C. During hepatitis A virus infection when HAc is
D. Viral latency the only serologic marker
17. Negri bodies may be found in brain tissue of D. During hepatitis C virus infection when the
humans or animals infected with virus is latent
A. Adenovirus 25. Human herpesviruses 6 and 7 are associated
B. Filovirus with a childhood disease called
C. Measles virus A. Chickenpox
D. Rabies virus B. Measles
18. Molluscum contagiosum virus is a member of C. Roseola
the D. Zoster
A. Adenoviruses 26. A baby was admitted to the hospital in
B. Herpes viruses February for dehydration due to severe
C. Papovaviruses diarrhea. Cultures for bacterial pathogens
D. Pox viruses revealed normal fecal flora at 24 hours. Which
19. A clinical specimen is received in viral transport of the following additional tests would be most
medium for viral isolation. The specimen appropriate given the case history?
cannot be processed for 72 hours. At what A. Heterophile antibody test
temperature should it be stored? B. Rotavirus antigen assay of stool specimen
A. -80°C C. McCoy cell inoculation for cytomegalovirus
B. -20°C (CMV)
C. 4°C D. Urine microscopic analysis for presence of
D. 22°C CMV cellular inclusion bodies
20. Arboviruses 27. Rhabdovirus is most noted for causing
A. Only infect humans infections of the
B. Often cause hepatitis A. Central nervous system
C. Typically infect lymphocytes B. Gastrointestinal tract
D. Are transmitted by arthropods C. Lower respiratory tract
21. Mumps is characterized by an infection of the D. Upper respiratory tract
A. Central nervous system 28. Jaundice is a common clinical symptom of
B. Parotid glands which of the following viral diseases?
C. Pancreas A. Hepatitis A
D. Thymus B. Infectious mononucleosis
22. Which of the following hepatitis viruses is C. Rabies
typically transmitted by the fecal-oral D. Varicella
pathway? 29. An 18-year-old male presents to his family
A. HAV physician complaining of sore throat and
B. HBV fatigue. The patient is found to have a fever
 and swollen cervical lymph nodes. A complete 37. The tubular cells of the human kidney shed
blood count and differential reveal which of the following viruses for prolonged
lymphocytosis and many reactive (atypical) periods?
lymphocytes. The physician should suspect an A. Adenovirus
infection caused by B. Cytomegalovirus
A. Adenoviruses C. Epstein-Barr virus
B. Epstein-Barr virus D. Rubella virus
C. Parainfluenza virus 38. The togavims known to produce fetal defects is
D. Varicella-zoster virus A. Influenza
30. The poliovirus, an RNA virus, is a(n) B. Rotavirus
A. Adenovirus C. Rubella
B. Coxsackie virus D. Varicella
C. Enterovirus 39. An 8-week-old infant was admitted to the
D. Rhinovirus hospital with symptoms of low birth weight,
31. The virus that causes hepatitis B is jaundice, and neurologic defects. Intranuclear
characterized as a inclusions were found in epithelial cells from
A. Defective DNA virus requiring delta virus to the urine. The most likely diagnosis in this case
complete its replication cycle would be infection by
B. DNA virus utilizing reverse transcriptase A. Cytomegalovirus
C. Nonenveloped DNA virus B. Epstein-Barr virus
D. Single-stranded RNA virus C. Herpes simplex virus
32. Hepatitis C virus infections D. Rubella virus
A. Are commonly diagnosed during the acute 40. The most common cause of cervical cancer is
stage A. Cytomegalovirus
B. Are uncommon in the U.S. B. Enterovirus
C. Are most often acquired by contact with C. Molluscum contagiosum
blood D. Papilloma virus
D. Seldom results in chronic infection 41. Select the statement that is correct concerning
33. Characteristic cytopathic effect associated with the influenza A viruses.
respiratory syncytial virus is A. Humans are the only animal hosts for
A. Giant multinucleated cells influenza A viruses.
B. Basophilic intranuclear inclusions B. Pandemics are characteristically produced by
C. Eosinophilic cytoplasmic inclusions influenza A.
D. Shrunken cells with multilobed nuclei C. The incidence of infection peaks in the
34. The virus associated with warts is summer months.
A. Flavivirus D. They are DNA viruses.
B. Morbillivirus 42. An example of a virus associated with latent
C. Mumps virus infections is
D. Papillomavirus A. Influenza
35. RNA-dependent DNA polymerase is also called B. Rotavirus
A. Gyrase C. Rubella
B. Neuraminidase D. Varicella-zoster
C. Reverse transcriptase 43. The use of cell cultures has enabled virologists
D. Transaminase to isolate and identify many clinically
36. Coxsackie viruses are associated with important viruses. However, because some
A. Gastrointestinal disease viruses cannot be grown in cell cultures, these
B. Hepatitis agents are best diagnosed by serologic testing.
C. Myocarditis Such an agent is
D. The common cold A. Cytomegalovirus
 B. Hepatitis C virus C. Genital herpes
C. Herpes simplex virus 2 D. Thrush
D. Respiratory syncytial virus
44. 47. Although there have been no natural cases
of this serious disease in about 30 years, which 51. Classification of viruses is made by:
of the following is considered a potential A. Complement fixation serology
bioterrorism disease B. Electron microscopy
A. Dengue C. Nucleic acid composition
B. Ebola hemorrhagic fever D. Cellular inclusion bodies
C. Shingles 52. Which virus is the most common etiological
D. Smallpox agent of viral respiratory diseases in infants
45. Which of the following is not a step involved in and children?
virus replication? A. Respiratory syncytial virus (RSV)
A. Attachment B. Measles virus
B. Mitosis C. Coxsackie A virus
C. Penetration D. Coxsackie B virus
D. Release 53. The most common viral syndrome of
46. 44. Which of the following is associated with pericarditis, myocarditis, and pleurodynia (pain
the rubella virus? upon breathing) is caused by:
A. It is a DNA virus A. Herpes simplex virus
B. It is a member of the same taxonomic family B. Respiratory syncytial virus
as measles virus. C. Epstein-Barr virus
C. It is known to produce defects in fetuses D. Coxsackie B virus
during the early stages of pregnancy. 54. Which of the following viruses is implicated
D. It is transmitted by an arthropod vector. along with Epstein-Barr virus as a cause of
47. Which of the following opportunistic diseases infectious mononucleosis?
is not closely associated with acquired immune A. Cytomegalovirus (CMV)
deficiency syndrome? B. Coxsackie A virus
A. Cryptococcosis C. Coxsackie B virus
B. Cryptosporidiosis D. Hepatitis B virus
C. Malaria 55. The most common causes of viral pneumonia
D. Mycobacteriosis in adults are:
48. Poliovirus is a member of the family A. Influenza and adenovirus
A. Flaviviridae B. Hepatitis A and B viruses
B. Paramyxoviridae C. Coxsackie A and B viruses
C. Picornaviridae D. Herpes simplex and CMV
D. Reoviridae 56. Which virus belonging to the Reoviridae group
49. Which of the following has not been causes gastroenteritis in infants and young
successfully used to detect viruses in clinical children but an
specimen? A. Coxsackie B virus
A. Cytopathic effect B. Rotavirus
B. Enzyme-linked immunosorbent assay C. Respiratory syncytial virus
C. growth on selective agar media D. Rhabdovirus
D. immunofluorescence 57. A very small, single-stranded DNA virus that
50. Which of the following diseases in not causes a febrile illness with a rash and is called
associated with herpes simplex virus? the fifth childhood disease after rubeola,
A.Cold sores rubella, varicella, and roseola is:
B. Encephalitis A. Rotavirus
B. Adenovirus type 40
 C. Coxsackie A virus D. Isolate the virus from the saliva of both the
D. Parvovirus B19 animals and the patient
58. Hepatitis B virus can be transmitted by: 64. A 65-year-old woman was admitted to the
A. Acupuncture hospital with acute respiratory distress, fever,
B. Tattoos myalgia, and headache. Influenza A or B was
C. Sexual contact suspected after ruling out bacterial
D. All of these options pneumonia. Which of the following methods
59. Which virus has been implicated in adult could be used to confirm influenza infection?
gastroenteritis resulting from ingestion of A. Influenza virus culture in Madin-Darby canine
contaminated food (especially shellfish) and kidney
water? B. Hemagglutination-inhibition test for
A. Norwalk-like viruses antibodies in the patient's serum
B. Rotavirus C. Direct examination of nasal epithelium for
C. Hepatitis C virus virus using fluorescent antibody stain
D. Coronavirus D. All of these options
60. Which virus is associated with venereal and 65. The most rapid definitive diagnosis of a genital
respiratory tract warts and produces lesions of herpes simplex (HSV-2) infection in a 20-year-
skin and mucous membranes? old man is made by which method?
A. Polyomavirus A. Direct immunofluorescence test for viral
B. Poxvirus antigen in vesicle fluid
C. Adenovirus B. Titer of serum and seminal fluid for
D. Papillomavirus antibodies to herpes simplex
61. A clinical test used for the detection and C. Detection of antiherpes simplex in seminal
identification of viral infections other than fluid
culture is: D. Cell culture of vesicle fluid
A. Hemagglutination 66. A 20-year-old female college student
B. Hemadsorption complained of a sore throat and extreme
C. Viral antigen detection fatigue. The physician noted lymphadenopathy
D. All of these options and ordered a rapid test for infectious
62. Which technique is used for the confirmation mononucleosis antibodies that was negative.
of infection with human immunodeficiency Bacterial cultures were negative, as were
virus (HIV-1)? serological tests for influenza A and B, HIV-1,
A. Western blot (immunoblot) assay CMV, hepatitis B, and antistreptolysin O. What
B. Enzyme-linked immunosorbent assay (ELISA) would be the next line of viral testing to
C. Complement fixation establish a diagnosis?
D. p24 Antigen testing A. Herpes simplex
63. A 13-year-old boy was admitted to the hospital B. Rubella
with a diagnosis of viral encephalitis. History C. Epstein-Barr
revealed that the boy harbored wild raccoons D. West Nile
from nearby woods. What is the best method 67. A 60-year-old male gardener from New York
to determine if the boy has contracted rabies? State was hospitalized with flulike symptoms
A. Remove the brainstems from all of the and eventually diagnosed with encephalitis.
raccoons and examine for cytopathic effects While working in his garden, he noticed several
B. Request immunofluorescent test for antibody dead birds around his bird feeder. The region
on the saliva from all of the raccoons was known to be heavily infested with
C. Request immunofluorescent test for antigen mosquitoes. What is the most likely cause of
in cutaneous nerves obtained by nuchal biopsy his illness?
of the patient A. West Nile virus
B. Epstein-Barr virus
 C. Parvovirus
D. Hantavirus
68. A 30-year-old male patient who was a
contractor and building inspector in the
southwestern United States complained of
difficulty breathing and was admitted to the
hospital with severe respiratory disease. The
physician noted a high fever and cough. Two
days before, the patient had inspected an old
warehouse, abandoned and infested with
rodents. The patient was given intravenous
antibiotics, but 2 days into therapy the
pneumonia worsened and he developed
pulmonary edema. Which organism should be
suspected of causing his illness?
A. Hantavirus
B. Rotavirus
C. West Nile virus
D. Norwalk-like virus
69. A 3-year-old female was admitted to the
hospital following a 2-day visit with relatives
over the Christmas holidays. Vomiting and
diarrhea left the child severely dehydrated. No
other members of the family were affected. All
bacterial cultures proved negative. A stool
sample should be tested for which virus?
A. CMV
B. EBV
C. Hepatitis D
D. Rotavirus
70. A 25-year-old male patient was diagnosed with
HIV-1 by enzyme immunoassay, testing positive
twice, and the diagnosis was confirmed by
Western blot testing. Which laboratory test
should be performed prior to initiating antiviral
therapy?
A. Quantitative plasma virus concentration (viral
load testing)
B. Quantitation of CD4 lymphocytes
C. Phenotype/genotype resistance testing
D. All of these options
71. A 6-month-old male infant was hospitalized
with a respiratory infection. He was diagnosed
with apnea and bronchiolitis. Further testing
revealed congenital heart disease. Bacterial
cultures were negative for Streptococcus
pneumoniae and Haemophilus influenzae.
What further testing should be done?
A. Respiratory syncytial virus (RSV)
B. Rotavirus
C. Norwalk virus
D. HIV
72. A young male hunter encountered a fox in his
path during a walk in the woods. The fox was
staggering but appeared nonthreatening. The
man tried to avoid contact but was attacked
and bitten on the leg. The bite broke the skin
but was not deep. Wildlife officials were
unable to locate the fox for testing. What
procedure should take place next for the
hunter?
A. Spinal tap with CSF testing for rabies virus
B. Administration of hyperimmune antirabies
globulin and rabies vaccine
C. Biopsy of the wound site
D. Throat culture and blood culture
73. A 40-year-old female experienced a respiratory
infection after returning home from a visit to
her homeland of China. A rapid onset of
pneumonia in the lower respiratory area
prompted the physician to place her in
isolation. She was diagnosed presumptively
with severe acute respiratory syndrome (SARS)
and placed on a respirator. What type of
testing should be done next to diagnose this
disease?
A. Molecular technique and cell culture
B. Latex agglutination test
C. Blood culture
D. Complement fixation
74. A pregnant 25-year-old female with genital
lesions delivered a premature newborn with
complications. The baby tested negative for
bacterial infection (cultures of blood and
urine). Antigen testing of the baby's urine
proved negative for group B streptococci and
Streptococcus pneumoniae. The mother tested
negative for bacterial sexually transmitted
diseases and for group B streptococci. The
baby was treated with acyclovir and failed to
survive. What was the most likely cause of
death?
A. CMV
B. Human immunodeficiency virus
C. Respiratory syncytial virus
D. Herpes simplex virus
75. A young father of two small children
complained of a rash on the torso of his body.
 The children had been diagnosed with
chickenpox and confined to their home. The
father had experienced chickenpox as a child
and knew he did not have the same rash as his
children. What is the most likely cause of the
father's rash?
A. Herpes simplex 1 virus
B. Varicella-zoster virus
C. Herpes simplex 2 virus
D. Epstein-Barr virus
76. The organs of a 65-year-old male were donated
soon after a fatal auto accident. Three
recipients of his corneas and kidneys died
within weeks after receiving his organs. Which
of the following viruses most likely caused the
death of these recipients?
A. HIV
B. Rabies
C. Norwalk-like
D. Rotavirus
77. While on a 7-day cruise to Vancouver and
Alaska, a number of passengers reported to
the ship's medical staff complaining of
vomiting and diarrhea. Which is the most likely
virus to have infected these mainly adult
passengers?
A. Rotavirus
B. Parainfluenza
C. Respiratory syncytial
D. Norwalk or Norwalk-like viruses
78. A patient tested positive for HIV-1 infection
using a reverse transcriptase-polymerase chain
reaction (RT-PCR) method. However, 1 week
later a second blood sample was collected and
sent to a reference lab that performed a
confirmatory test by Western blot. The
Western blot test was negative. What best
explains these results?
A. The samples for RT-PCR and Western blot
were not from the same patient
B. RT-PCR is more sensitive for early detection
C. The RT-PCR result was falsely positive
D. The RT-PCR test detected HIV-2 and the
Western blot is specific for HIV-1
79. A pregnant women was seen by her
obstetrician with signs of flulike illness during
her second trimester. NAT tests were ordered
for Toxoplasma gondii, rubella,
cytomegalovirus, and herpes simplex 1 and 2.
All test results were negative. However, after
delivery, the newborn exhibited signs of an
infection and failed to survive. Which virus
causes a 90% transplacental infection rate
when found in the mother?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis D
D. Hepatitis G
80. An immunocompromised patient was admitted
to the hospital with a diagnosis of hemorrhagic
cystitis. Which combination of virus and
specimen would be most appropriate to
diagnose a viral cause of this disorder?
A. BK virus—urine
B. Human papilloma virus—skin
C. Hepatitis B virus—serum
D. Epstein-Barr virus—serum
81. Which of the following groups RNA viruses are
common causes of viral meningitis?
A. Rhinoviruses
B. Caliciviruses
C. Hepatitis C virus
D. Flaviviruses
E. Enteroviruses
82. An ornithologist was on a 3-month trip to
study several species of birds living in a rain
forest in South America. On the 10th day of her
trip, she was bitten on the hand by an
unusually aggressive bat. The scientist applied
a topical antibiotic ointment and continued her
research. Four weeks later, the scientist lost
feeling in her hand. She shortly began
experiencing high fever, periods of rigidity,
difficulty in swallowing liquids, drooling, and
disorientation. Death followed rapidly. A
postmortem biopsy of her brain showed the
presence of Negri bodies. These symptoms are
consistent with:
A. California encephalitis virus.
B. Hantaan virus.
C. Ebola virus.
D. rabies virus.
E. lymphocytic choriomeningitis virus.
83. The answer is C. A marked antigenic change in
the N (neuraminidase) protein, the H
(hemagglutinin) protein, or both is termed
antigenic shift. In antigenic drift, there is also an
antigenic change in one or both of these
 proteins, but the change is much less significant.
With antigenic drift, although the H protein
does change antigenically, H1 remains H1, for
example.
84. From 1918 until 1956, the only subtype of
influenza observed in humans was H1N1. In
1957, H1N1 was replaced by H2N2. This is an
example of:
A. viral interference.
B. phenotypic mixing.
C. antigenic shift.
D. antigenic drift.
E. viral transformation.
85. The typical clinical syndrome associated with
rotavirus infection is:
A. acute gastroenteritis of young adults.
B. acute bronchiolitis of infants.
C. acute hepatitis.
D. nausea, vomiting, and diarrhea in infants and
young children.
E. acute paralytic syndrome.
86. Appropriate treatment of rotavirus infection
includes which of the following?
A. Fluid and electrolyte replacement
B. Antiviral drugs targeting membrane fusion
C. Metronidazole
D. Antiviral drugs targeting reverse transcriptase
E. Antiviral drugs targeting proteolytic
processing
87. Amantadine inhibits
(A) Influenza A and B virus hemagglutinin
binding activity
(B) Influenza A virus M2 protein activity
(C) Influenza A and B virus neuraminidase
activity
(D) Influenza B virus RNA-dependent RNA
polymerase activity
88. Negri bodies are associated with
(A) Cytomegalovirus infections
(B) Herpes simplex virus infections
(C) Rabies virus infections
(D) Rubella virus infections
89. A killed virus vaccine is
(A) Jeryl Lynn mumps vaccine
(B) Enders measles vaccine
(C) Salk poliovirus vaccine
(D) Oka varicella-zoster vaccine
90. Viruses whose genomes have a messenger
(positive-sense) polarity are
(A) Adenoviruses
(B) Papovaviruses
(C) Paramyxoviruses
(D) Polioviruses
91. A 23-year-old medical student on the Caribbean
island of Dominica presents at the Student
Health Clinic complaining of an increasingly
severe headache and back and bone pain.
Yesterday she was nauseated and vomited
several times during the night. She has a
39.5°C/103°F fever, which appeared suddenly,
and a generalized rash that blanches under
pressure. She had been hiking in the rainforest 1
week earlier and was particularly bothered by
mosquitoes at that time. The most likely
infectious agent causing her symptoms is
(A) Dengue virus
(B) LCM virus
(C) West Nile virus
(D) Yellow fever virus
92. A 4-year-old girl is brought to your rural clinic
office by her mother who states the child has a
runny nose, barking cough, and a sorethroat.
Your examination indicates respiration is
labored. None of her three siblings is sick. The
most probable viral cause of her symptoms is
(A) Adenovirus
(B) Influenza virus
(C) Parainfluenza virus
(D) RSV
93. A 64-year-old man living on a farm in southern
Minnesota is brought on July 15 to the
emergency room by his brother. The brother
said the man had a 2-day history of fever,
headache, and some vomiting, but today he
appeared confused. He is confused by some of
the simple questions you ask him. His spinal tap
is clear with 75% PMNs and a head CT is normal.
The most likely cause of his symptoms is
(A) California encephalitis virus
(B) Enterovirus
(C) HSV
(D) West Nile virus
94. A mother brings her 18-month-old son to your
office. She was called by her day care center
who reported he had vomited twice during the
morning and had diarrhea as well. She noted he
had a slight fever the past 2 days and had not
 been very hungry. The most likely cause of his
illness is
(A) Adenovirus
(B) Astrovirus
(C) Norovirus
(D) Rotavirus
95. On September 17, a 22-year-old male college
student appears at the Student Health Clinic
complaining of moderate headache, nausea,
and vomiting. His temperature is 38.5°C/101°F
and his physical examination shows stiffness in
the neck. What is the most likely viral cause of
the symptoms?
(A) CMV
(B) Enterovirus
(C) EBV
(D) HSV type 1
96. An outbreak of Calicivirus occurs in a home for
disabled adults. What is an important
characteristic of this virus group that influences
the occurrence of disease outbreaks and their
control and prevention?
(A) Long-term immunity after infection or
vaccination
(B) Low infectious dose required for infection
(C) Susceptibility of the virus to chlorine
cleaning agents
(D) Susceptibility of the virus to desiccation
(E) Transmission by inhalation of aerosolized
virus particles
97. Amantadine is a drug used to reduce the ill
effects of an influenza virus A infection;
however, increasing levels of resistance have
limited its usefulness. Resistant strains of
influenza A contain single amino acid
substitutions in the M2 protein. With which
aspect of the virus replication cycle is this
protein involved?
(A) Attachment
(B) Genome replication
(C) Penetration
(D) Release
(E) Uncoating
98. A 66-year-old man was bitten on the right index
finger by a bat while in his bed. He washed the
wound but did not seek medical care for the
bite. Five weeks later, he went to the emergency
room complaining of headache, malaise,
drowsiness, pain, and weakness in his right
hand. From his history of the bat bite, he was
immediately treated with rabies prophylaxis.
What was he given?
(A) Interferon-α plus rabies immune globulin
(B) Rabies immune globulin
(C) Rabies immune globulin plus rabies vaccine
(D) Rabies vaccine plus interferon-α
(E) Ribavirin plus interferon-α
99. A 66-year-old man was bitten on the right index
finger by a bat while in his bed. He washed the
wound but did not seek medical care for the
bite. Five weeks later, he went to the emergency
room complaining of headache, malaise,
drowsiness, pain, and weakness in his right
hand. From his history of the bat bite, he was
immediately treated with rabies prophylaxis.
Why was the man given rabies prophylaxis?
(A) Interferon enhances the efficacy of rabies
vaccine
(B) Prophylaxis with antiviral drugs and
interferon blocks viral replication
(C) Rabies prophylaxis reduces the person-to-
person spread of rabies
(D) The immune globulin provides immediate
but short-lived protection and the vaccine
generates long-lasting neutralizing antibodies
(E) The vaccine generates antibody directed
against host viral receptors preventing migration
of rabies virus into the CNS
100. In January, a 66-year-old woman
presents a fever of 102 °F, chills, back pain,
headache, and marked fatigue. Her physician
prescribes oseltamivir and she rapidly recovers.
With which etiologic agent was she infected?
(A) Coronavirus
(B) Influenzavirus
(C) Parainfl uenza virus
(D) Respiratory syncytial virus
(E) Varicella-zoster virus
101. What is the mechanism of action of
oseltamivir?
(A) Directly prevents replication of the viral
genome
(B) Prevents the release of mature virions from
the infected host cell
(C) Inhibits the uncoating of the virus
(D) Inhibits the translocation of the viral
genome to the nucleus
 (E) Binds directly to the virus RNA polymerase
active site
101. A 28-year-old man was clinically
diagnosed with the flu after presenting to his
physician with a fever of 102 °F, severe myalgia,
fatigue, and rhinorrhea of 12 h duration. The
physician had read local health department
reports that said both AH1N1 and B viruses
were circulating in the area. Which medication
did she most likely prescribe?
(A) Amantadine
(B) Foscarnet
(C) Ribavirin
(D) Ritonavir
(E) Zanamivir
102. A 2-year-old girl was brought to the
emergency department by frantic parents with a
3-day history of coldlike illness and a 1-day
history of diffi culty breathing and an unusual,
barklike cough. Physical exam revealed a fever
of 38 °C, tachypnea, and tachycardia and stridor.
A chest radiograph revealed narrowing of the
upper airways (a steeple sign); however, lungs
were free of infiltrates. A rapid antigen
detection test on respiratory secretions was
positive for parainfluenza virus. What is the
clinical diagnosis?
(A) Bronchitis
(B) Bronchiolitis
(C) Croup
(D) Epiglottitis
(E) Pneumonia
103. A 21-year-old college student
contracted mumps infection as did several other
students at the college. He had received a single
dose of the measles, mumps, rubella (MMR)
vaccine at 15 months of age. What is the most
likely reason that he became infected despite
having been vaccinated?
(A) Early vaccines only contained one of the four
strains of mumps virus
(B) Early versions of the mumps vaccine were
heat inactivated and induced immune
suppression in some recipients
(C) Fifteen months of age is too early to receive
the MMR vaccine
(D) Mumps virus rapidly undergoes antigenic
variation
(E) Some individuals who receive a single dose
of mumps vaccine do not respond adequately
104. A 3-year-old child presents with a 3-day
history of cough, a profusely runny nose, and
conjunctivitis, and a 1-day history of 40°C fever,
and a blotchy, erythematous, maculopapular
rash that began on his face and is now
appearing on his chest. The child is toxic
appearing. His history is significant for a lack of
most childhood vaccines due to family religious
beliefs. Which is the most likely diagnosis?
(A) Echovirus summer rash
(B) Measles
(C) Mumps
(D) Rubella
(E) Varicella
105. A 3-year-old child presents with a 3-day
history of cough, a profusely runny nose, and
conjunctivitis, and a 1-day history of 40°C fever,
and a blotchy, erythematous, maculopapular
rash that began on his face and is now
appearing on his chest. The child is toxic
appearing. His history is significant for a lack of
most childhood vaccines due to family religious
beliefs. The child in the above case recovered
uneventfully, was re-exposed to the same agent
a year later, but did not become ill. What
prevented the child from becoming infected on
subsequent encounter with the agent?
(A) Activated macrophages
(B) Interferon-α
(C) Naïve cytotoxic T cells specific for the agent
(D) Neutralizing IgG antibodies specific for the
agent
(E) NK cells
106. A 9-month-old child is hospitalized with
viral pneumonia. Which virus is the most likely
cause?
(A) Adenovirus
(B) Influenza virus
(C) Parainfluenza virus
(D) Respiratory syncytial virus
(E) Varicella-zoster virus
107. An infant is born prematurely in
February. Concerned about the risk of serious
infection with respiratory syncytial virus, he is
treated with the monoclonal antibody
palivizumab before being released from the
 hospital. What is the viral target of this
monoclonal antibody?
(A) Capsid protein
(B) Fusion protein
(C) Hemagglutinin protein
(D) Neuraminidase protein
(E) Matrix protein
108. An 8-year-old boy attending 4-week
summer camp presented in August with a 3-day
history of fever, sore throat and conjunctivitis.
Seven other children and two camp counselors
developed similar symptoms over the next few
days. All described a gritty feeling in their eyes.
A similar outbreak had occurred at the camp in
July. The cause of the outbreak of fever, sore
throat, and conjunctivitis was found to be a
virus traced to the camp's underchlorinated,
turbid swimming pool. Which virus is the cause
of this outbreak?
(A) Adenovirus
(B) Influenza virus
(C) Parainfluenza virus
(D) Respiratory syncytial virus
(E) Rotavirus
109. A previously healthy 56-year-old woman
in Florida dies of eastern equine encephalitis
virus. Viral activity had been detected at that
time by the local health department in which
reservoir and vector species, respectively?
(A) Birds; mosquitoes
(B) Cattle; soft bodied ticks
(C) Foxes; hard bodies ticks
(D) Horses; mosquitoes
(E) Rats; fleas
110. A 43-year-old man is hospitalized after
presenting to the emergency department with
fever, chest pain, and shortness of breath after
mild exertion. Physical exam reveals tachycardia
out of proportion with his fever. He reports a
flulike illness 2 weeks previously. A biopsy, taken
after the patient began to show signs of heart
failure, reveals mononuclear infiltration in the
myocardial tissue. Reverse transcriptase PCR
identified a viral cause. What is the most likely
etiological agent causing this man's condition?
(A) Adenovirus type 7
(B) Coxsackievirus B
(C) Influenza virus
(D) Measles virus
(E) Parvovirus B19
111. A 36-year-old woman is preparing for an
adventure trip down the Amazon River in Brazil
by receiving recommended vaccinations.
Against which arbovirus should she be
vaccinated?
(A) Arenavirus
(B) Dengue virus
(C) Venezuelan equine encephalitis virus
(D) West Nile virus
(E) Yellow fever virus
112. Which vaccine is made from reassorted
bovine and human viruses?
(A) Hepatitis A vaccine
(B) Influenza vaccine
(C) Mad cow disease vaccine
(D) Poliovirus vaccine
(E) Rotavirus vaccine
113. A 34-year-old man, an avid hiker from
New Jersey, presents with a fever, fatigue,
headache, malaise, myalgia, and arthralgia. The
patient reported that the fever had first
occurred 1 week ago and lasted for 3 days, then
resolved for 3 days, and returned, at which time
he sought medical attention. His history is
significant for a recent hiking trip in Utah during
which he experienced a tick bite. Which tick-
borne viral disease might this man have
contracted in his hiking trip?
(A) Colorado tick fever
(B) Lyme disease
(C) Relapsing fever
(D) Rocky Mountain spotted fever
(E) Tick-borne encephalitis
114. An outbreak of a hemorrhagic virus
occurs in a village in Uganda, Africa. Clinical
manifestations included hemoptysis, bleeding
from the eyes, skin, and gastrointestinal tract.
The mortality rate exceeded 70%. The virus
appeared to be transmitted in the village by
contact with the blood and bodily secretions of
affected individuals; thus, infection rates were
highest among those caring for the sick. Which
viral disease was involved in this outbreak?
(A) Dengue hemorrhagic fever
(B) Ebola
(C) Hantavirus pulmonary syndrome
(D) West Nile fever
(E) Yellow fever
115. A 67-year-old male in Minnesota is
hospitalized in August with fever, lethargy, and
disorientation. Cerebral spinal fluid analysis
reveals a WBC count of 100 with 65%
mononuclear cells, elevated protein, and
normal glucose. IgM antibodies to the most
common arbovirus in the United States are
found in his serum. With which virus is he
infected?
(A) Eastern equine encephalitis virus
(B) LaCrosse virus
(C) St Louis encephalitis virus
(D) Western equine encephalitis virus
(E) West Nile virus
116. In 2003, a previously unknown viral
disease arose in China and spread to five
countries around the world, causing thousands
of cases with about a 10% overall mortality rate.
The disease was attributed to a novel
Coronavirus. What human disease did this
newly described Coronavirus cause?
(A) Aseptic meningitis
(B) Bird flu
(C) Hantavirus pulmonary syndrome
(D) Meningoencephalitis
(E) Severe acute respiratory syndrome
117. Four days after returning to the United
States from a trip to the Caribbean, a 34-year-
old man presents with fever that had been as
high as 39 °C two days previously but had
returned to normal, severe headache, and
severe pain behind the eyes, in the joints, and in
the muscles. Physical exam reveals a macular
rash seen on the trunk and extremities,
hepatomegaly, petechiae on mucous
membranes of the mouth and induced on the
arm following a tourniquet test. Laboratory
tests reveal a white blood cell count of 6,720
with 30% neutrophils, 50% lymphocytes, 16%
monocytes, and 4% atypical lymphocytes and
65,000 platelets. IgM to which virus was found
in his serum?
(A) Dengue virus
(B) Ebola virus
(C) Epstein-Barr virus
(D) Hepatitis A virus
(E) Parvovirus B-19
118. Four days after returning to the United
States from a trip to the Caribbean, a 34-year-
old man presents with fever that had been as
high as 39 °C two days previously but had
returned to normal, severe headache, and
severe pain behind the eyes, in the joints, and in
the muscles. Physical exam reveals a macular
rash seen on the trunk and extremities,
hepatomegaly, petechiae on mucous
membranes of the mouth and induced on the
arm following a tourniquet test. Laboratory
tests reveal a white blood cell count of 6,720
with 30% neutrophils, 50% lymphocytes, 16%
monocytes, and 4% atypical lymphocytes and
65,000 platelets. Which method is best for
prevention of this infection?
(A) Avoiding places with poor public hygiene
when visiting endemic areas
(B) Drinking only bottled water
(C) Taking prophylactic ribavirin
(D) Use of insect repellent
(E) Vaccination
119. The 6-week-old infant shown in the
photograph is brought to the emergency
department with poor feeding, irritability, and
rapid breathing. Studies reveal
hepatosplenomegaly, bilateral deafness, and
patent ductus arteriosus. The infant's mother,
an undocumented immigrant, reported
experiencing fever and joint pain that lasted a
few days during her second month of
pregnancy. The maternal illness is determined
to be related to the infant's condition. What is
the most likely diagnosis for the infant?
(A) Congenital cytomegalovirus
(B) Congenital rubella syndrome
(C) Congenital varicella
(D) Neonatal enterovirus infection
(E) Neonatal herpes
120. A 65-year-old woman refuses to be
vaccinated against influenza virus because she
was vaccinated the previous year. What changes
in the virus necessitate annual vaccination?
(A) Acquisition of new genes through
coinfection of cells with parainfluenza viruses
(B) Antigenic changes in the viral matrix protein
(C) Changes in the level of expression of the
envelope fusion proteins
(D) Mutations in the genes for the envelope
glycoproteins
 (E) Reassortment of RNA strands between
animal and human strains
121. Why do polio eradication programs in
developing countries utilize the oral polio
vaccine (OPV) rather than the inactivated polio
vaccine (IPV)?
(A) Persons immunized with IPV can still become
infected with and shed wild-type virus.
(B) The vaccine strain of IPV can be shed from
the feces and cause disease in susceptible
individuals.
(C) The IPV cannot be used in immune deficient
patients.
(D) The IPV does not contain all strains of
poliovirus.
(E) Vaccine-induced cases of paralytic polio have
occurred with IPV.
122. A 14-month-old girl presents with a low-
grade fever and rash on her hands and feet as
seen in the accompanying photographs.
Vesicular lesions were also present on the
tongue, palate, and buccal mucosa. The lesions
resolved spontaneously within 1 week. What is
the most likely etiology of this infection?
(A) Adenovirus
(B) Coxsackievirus
(C) Cytomegalovirus
(D) Papillomavirus
(E) Rotavirus
123. A 2-year old boy is brought to a
pediatrician's office by his parents. They report
that the child had a low-grade fever five days
ago, along with a cough and eye discharge. An
eruption is seen on his face, trunk and hands,
and his parents say it started about 2 days ago
on his face (similar to Figure A). Oral
examination is unremarkable. Which of the
following is a complication of this patient's
condition?
A. Mitral valve disease
B. Glomerulonephritis
C. Hearing loss
D. Encephalitis
E. Recurrent dermatomal rash
124. A small outbreak of hepatitis A infection
is reported by epidemiological services. Which
of the following treatments is most likely to
destroy the virus in the contaminated products?
A. Drying
B. Treating with 20% diethyl ether
C. Treating with acid (pH = 1.0)
D. Heating to 60°C for an hour
E. Boiling for 1 minute
125. A 25-year-old male with a several
month history of fluctuating levels of alanine
aminotransferase (ALT) and aspartate
aminotransferase (AST) is found to have high
titers of lgG directed against hepatitis C
envelope protein. These antibodies do not
confer effective immunity against the infection
because:
A. The antibodies do not have neutralizing
properties
B. Envelope proteins vary their antigenic
structure
C. Envelope proteins have low immunogenicity
D. Envelope proteins are lost after recurrent
replications
E. Envelope proteins are sequestered within the
hepatocytes
126. An 18-month-old male is seen on an
outpatient basis for fever, runny nose, and sore
throat. Two days later, he is brought to the
emergency department with persistent fever,
brassy cough and difficult breathing. Physical
examination reveals stridor. Which of the
following pathogens is most likely responsible
for this patient's condition?
A. Rhinovirus
B. Paramyxovirus
C. Togavirus
D. Parvovirus
E. Calicivirus
127. A 22-year-old male is found to have
serum anti-HAV lgG antibodies although he
denies any vaccination against hepatitis. The
laboratory finding most likely indicates:
A. An anicteric viral infection in the past
B. An icteric illness in the childhood
C. Chronic viral hepatitis
D. Asymptomatic viral carrier state
E. Reinfection with hepatitis A virus
F. Immunity against hepatitis 0 infection
128. HCV strains isolated from a single
individual demonstrate significant variability.
This genetic instability of HCV is attributed in
large part to its RNA-dependent RNA-
polymerase, which lacks:
 A. Nucleotide specificity
B. 3' — 5' exonuclease activity
C. 5' — 3' exonuclease activity
D. Ligase activity
E. Glycosylase activity
F. Primase activity
129. A 34-year-old Caucasian nurse with
recent onset of malaise is found to have the
following set of laboratory findings:
This patient most likely:
A. Had oysters at a local restaurant
B. Consumed boiled eggs
C. Had a recent tattoo
D. Had an accidental needlestick
E. Had an unprotected sexual intercourse
130. During the first trimester of pregnancy a
22-year-old immigrant from the Middle East
develops a low-grade fever and maculopapular
rash. Over 48 hours the rash spreads from her
face and chest to her trunk and extremities.
Physical .examination also detects post auricular
lymphadenopathy. The mother is at risk for
which of the following immediate complications
(from the first column) and the fetus is at risk
for which of the following congenital defects
(from the second column)?
A. Mother: polyarthralgia; infant: deafness
B. Mother: deafness; infant: bowlegs
C. Mother: polyarthralgia; infant:
macrocephaly
D. Mother: meningitis; infant: malformed
teeth
E. Mother: pneumonia; infant: cataracts
131. Naked RNA molecules are isolated from
viral particles in the nasal exudate of a 23-year-
old male. After introduction into human cells,
the naked RNA molecules induce viral protein
synthesis and viral genome replication. The
patient is most likely infected with:
A. Influenza virus type A
B. Respiratory syncytial virus
C. Rotavirus
D. HIV
E. Rhinovirus
132. A child who was complaining of sore
throat and breathing problems was tested for
the presence of antibodies to several of the
common respiratory viral pathogens. Laboratory
tests of the patient's serum revealed the
presence of anti-G and anti-F antibodies. Which
virus do you suspect as the etiologic agent of
this child's illness?
A) Adenovirus
B) Influenza virus
C) Herpesvirus
D) RSV
E) Parainfluenza virus
133. The factor facilitating the re-emergence
of measles in select communities on the West
Coast is which of the following?
A) governmental instability
B) inadequate rate of immunization
C) increased injection drug abuse
D) microbial adaptation
E) the spread of HIV infection
134. A 10-year-old boy was sent home from
school due to pain on both sides of the parotid
area while eating lunch. The swelling of the
glands increased in 2 to 3 days while he
remained home. He complained of a headache
and had a low-grade fever. This child had not
received all the required vaccinations. The
teacher reported that one of the other students
in the classroom had had similar complaints
three weeks earlier. The disease is diagnosed as
which of the following?
a. Measles
b. Common cold
c. Influenza
d. Mumps
e. Infectious mononucleosis
135. Human influenza virus is known to
participate in genetic reassortment when
exposed to animal orthomyxoviruses. Which of
the following viruses is most likely to undergo a
similar process?
A. Poliovirus
B. Human papilloma virus
C. Rotavirus
D. Measles virus
E. Hepatitis C virus
136. An infant born to a 27-year-old
immigrant is evaluated for hearing loss. Physical
examination demonstrates white pupils and a
continuous machinery murmur over the left
infraclavicular area. Which of the following
prenatal interventions would have most likely
prevented this infant's condition?
 A. Live attenuated vaccine D. Paramyxovirus
B. Viral component vaccine E. Parvovirus
C. Killed vaccine 141. A 32-year-old male presents to the
D. Toxoid vaccine emergency department with progressive fatigue
E. Viral enzyme inhibitor drug malaise and lymphadenopathy. When tested for
F. Cellular receptor inhibitor drug HIV infection, his blood samples are positive for
G. Interferons viral protein p24. The protein detected in this
H. Prenatal vitamins patient is a product of which of the following
137. After exposure to mutagens, several viral genes?
strains of enveloped RNA viruses isolated from A. pol
the nasal exudate of experimental animals B. env
acquire the ability to infect human epithelial C. gag
cells. Which of the following viral-encoded D. nef
proteins is most likely to have mutated in this E. rev
circumstance? F. tat
A. Surface glycoprotein 142. A virus-encoded polypeptide detected
B. Capsid protein in infected human cells has a specific protease
C. RNA polymerase activity essential for generating several
D. Endonuclease functional viral proteins from a large precursor
E. Protease polypeptide. Which of the following viruses is
138. Picornaviruses are small RNA-containing most likely studied in the experiment?
viruses. Which of the following picornaviruses A. Measles virus
are the most acid-labile? B. Rabies virus
A. Coxsackie A C. Influenza virus type A
B. Echovirus D. Rotavirus
C. Poliovirus E. Echovirus
D. Rhinovirus 143. A newborn male presents to the
E. Hepatitis A virus emergency room with a fever and the
139. A 4-year-old Asian immigrant is brought oropharyngeal findings shown in Figure A. The
to clinic with high fever nasal discharge patient's mother reports that he also has
lacrimation and dry cough. Physical examination chronic diarrhea, and laboratory workup shows
reveals several blue-white spots on his buccal lymphocytopenia. During a careful review of the
mucosa. Over the next several days, which of social history, you learn that the mother has a
the following is most likely to develop? history of IV drug abuse and commercial sex
A. Bronchiolitis work. She was prescribed prenatal medications,
B. Parotitis but failed to take one of them as directed.
C. Profuse diarrhea Which of the following may have helped
D. Skin rash prevent this patient's condition?
E. Jaundice A. Folic acid
140. An 8-year-old Middle Eastern immigrant B. Acyclovir
is brought to clinic with low-grade fever and a C. Zidovudine
skin rash that started on his face and spread D. Ribavirin
down his body. Physical examination reveals E. Zanamivir
post-auricular tenderness. Which of the 144. A 23-year-old male with a homozygous
following is the most likely cause of this CCR5 mutation is found to be immune to HIV
patient's disease? infection. The patient's CCR5 mutation
A. Herpesvirus interferes with the function of which viral
B. Togavirus protein?
C. Reovirus A. Reverse transcriptase
 B. gp120
C. gp41
D. p24
E. pp17
145. A scientist performed an experiment to
produce hybrid viruses by mixing two different
serotypes of influenza virus, H1N1 and H2N2, in
a respiratory epithelium cell line. Several days
later, the scientist collected the media and
analyzed the viral progeny. She found the
following serotypes of virus: H1N1, H2N2,
H1N2, and H2N1. Which of the following terms
best explains the appearance of new serotypes?
A. Recombination
B. Reassortment
C. Complementation
D. Phenotypic mixing
E. Transformation
146. A 20-year-old man comes to your clinic
complaining of anorexia (loss of appetite),
weight loss and fatigue for about 2 weeks. On
exam you find he is mildly jaundiced and his
abdomen is tender in the right upper quadrant.
On further questioning, you discover he
traveled outside of the United States and ate
from local food stands. Serology could likely be
positive for which of the following?
A) IgM to Hepatitis A antigen
B) IgG to Hepatitis B core antigen
C) Hepatitis C surface antigen
D) Hepatitis B surface antigen
E) IgM to Hepatitis D antigen
147. During an experimental study, an
investigator develops a new member of the
class of non-nucleoside reverse transcriptase
inhibitors. This new drug most likely inhibits HIV
infection through which of the following
mechanisms?
(A) Binding to reverse transcriptase
(B) Binding to RNase H
(C) Blockade of integration
(D) Incorporation into viral DNA
(E) Phosphorylation of nucleoside
trisphosphates
148. A 3-year-old girl is brought to the
emergency department by her father because
of a persistent cough for 2 weeks. She
sometimes vomits following a paroxysm of
coughing. While she is not coughing, she
appears well. She has not yet received any
routine childhood vaccinations. Her
temperature is 37°C (98.6°F). Physical
examination shows petechiae over the sclera
and face. Which of the following is the most
likely diagnosis?
(A) Diphtheria
(B) Influenza
(C) Pertussis
(D) Plague
(E) Tularemia
149. An 8-month-old girl is brought to the
emergency department because of a 1-day
history of rapid breathing. Her temperature is
38.4°C (101.1°F), pulse is 160/min, respirations
are 60/min, and blood pressure is 100/68 mm
Hg. Bilateral expiratory wheezing and crackles
are heard on auscultation. A chest x-ray shows
areas of atelectasis and hyperinflation. Which of
the following is the most likely causal virus?
(A) Measles virus
(B) Respiratory syncytial virus
(C) Rhinovirus
(D) Rotavirus
(E) Varicella-zoster virus
102. 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
103. 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
104. 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 sun-light
d. Initial infection usually occurs by intestinal
absorption of the virus
e. Infection with type 1 virus is most common
105. The latest and most effective therapy
for AIDS patients includes azi-dothymidine
(AZT), dideoxyinosine (DDI), and saquinavir or
similaragents. Use of these three drugs would
inhibit which of the following viralprocesses?
a. RNase, DNase
b. gp120 formation
c. p24 antibody expression
d. All membrane synthesis
e. Reverse transcriptase, protease
106. 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
107. 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
108. Infectious mononucleosis, a viral
disorder that can be debilitating, ischaracterized
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
109. 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
110. 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
111. 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
112. 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
113. 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 119.
d. An incomplete RNA virus
e. Hepatitis C
114. 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 120.
115. 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
116. The most sensitive test for the diagnosis
of herpes simplex (HSV) meningitis in a
newborn infant is 121.
a. HSV IgG antibody
b. HSV polymerase chain reaction (PCR)
c. HSV culture
d. Tzanck smear
e. Cerebrospinal fluid (CSF) protein analysis
117. Acute hemorrhagic conjunctivitis (AHC)
is a contagious ocular infection characterized by
pain, swelling of the eyelids, and
subconjunctival hemorrhages. AHC has been 122.
reported to be caused by which of the following
viruses?
a. Coronavirus
b. Reovirus
c. Rhinovirus
d. Enterovirus
e. Respiratory syncytial virus
118. 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
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
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
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
Which virus is the leading cause of the
croup syndrome in young children and, when
infecting mammalian cells in culture, will
hemabsorb redblood cells?
a. Group B coxsackievirus
b. Rotavirus
c. Parainfluenza virus
d. Adenovirus
e. Rhinovirus
123. Hepatitis E, a recently characterized 128. Control of the disease could be possible
hepatitis virus, is best described by which of the by eradication of
following statements? a. Horses
a. It is not a threat to the blood supply b. Birds
b. It is a major cause of blood-borne hepatitis c. Mosquitoes
c. It is prevalent in North America d. Fleas
d. It is a single-stranded DNA virus e. Ticks
e. The disease resembles hepatitis C 129. Adults who have had varicella as
124. Meningitis is characterized by the acute children occasionally suffer a recurrent form of
onset of fever and stiff neck. Aseptic meningitis the disease, shingles. The agent causing these
may be caused by a variety of microbial agents. diseases is a member of which of the following
During the initial 24 h of the course of aseptic viral families?
meningitis, an affected person's cerebrospinal a. Herpesvirus
fluid is characterized by b. Poxvirus
a. Decreased protein content c. Adenovirus
b. Elevated glucose concentration d. Myxovirus
c. Lymphocytosis e. Paramyxovirus
d. Polymorphonuclear leukocytosis 130. Rhinovirus is primarily transmitted by
e. Eosinophilia a. Droplet aerosolization
125. Infection with hepatitis D virus (HDV; b. Sexual activity
delta agent) can occur simultaneously with c. Fecal-oral route
infection with hepatitis B virus (HBV) or in a d. Fomites
carrier of hepatitis B virus because HDV is a e. Vertical transmission from mother to child
defective virus that requires HBV for its 131. German measles virus (rubella), a
replicative function. What serologic test can be common cause of exanthems in children, is best
used to determine whether a patient with HDV described by which of the following statements?
is an HBV carrier? a. Measles (rubeola) and German measles
a. HBsAg (rubella) are caused by the same virus
b. HBc IgM b. Incubation time is approximately 3 to 4 weeks
c. HBeAg c. Vesicular rashes are characteristic
d. HBs IgM d. Onset is abrupt with cough, coryza, and fever
e. HBs IgG e. Specific antibody in the serum does not
126. A nurse develops clinical symptoms prevent disease
consistent with hepatitis. She recalls sticking 132. The presence of Negri inclusion bodies
herself with a needle approximately 4 months in host cells is characteristic of
before after drawing blood from a patient. a. Mumps
Serologic tests for HBsAg, antibodies to HBsAg, b. Infectious mononucleosis
and hepatitis A virus (HAV) are all negative; c. Congenital rubella
however, she is positive for IgM core antibody. d. Aseptic meningitis
The nurse e. Rabies
a. Does not have hepatitis B 133. Kuru is a fatal disease of certain New
b. Has hepatitis A Guinea natives and is characterized by tremors
c. Is in the late stages of hepatitis B infection and ataxia; Creutzfeldt-Jakob disease (CJD) is
d. Is in the "window" (after the disappearance characterized by both ataxia and dementia.
of HBsAg and before the appearance of anti- These diseases are thought to be caused by
HBsAg) a. Slow viruses
e. Has hepatitis C b. Cell wall-deficient bacteria
127. Eastern equine encephalitis virus is c. Environmental toxins
associated with a high fatality rate. d. Prions
 e. Flagellates e. Yellow fever
134. According to recommendations issued 139. . Several antiviral compounds have been
by the U.S. Public Health Service, which of the developed during the last decade. One such
following statements regarding vaccination compound is ribavirin, a synthetic nucleoside
against smallpox is true? structurally related to guanosine. Ribavirin
a. Pregnant women should be vaccinated in the therapy has been successfully used against
first trimester a. Respiratory syncytial virus
b. Persons who have eczema should be b. Herpes simplex virus
vaccinated soon after diagnosis c. Hepatitis B
c. Persons who have immune deficiencies d. Group A coxsackievirus
should be vaccinated every 5 years e. Parvovirus
d. Persons traveling abroad need not be 140. An immunocompromised person with
vaccinated history of seizures had an MRI that revealed a
e. Children should be vaccinated before they temporal lobe lesion. Brain biopsy results
begin school showed multinucleated giant cells with
135. Hepatitis D virus (delta agent) is a intranuclear inclusions. The most probable
defective virus that can replicate only in cells cause of the lesion is
already infected with which of the following a. Hepatitis C virus
viruses? b. Herpes simplex virus
a. Hepatitis A virus c. Listeria monocytogenes
b. Epstein-Barr virus d. Coxsackievirus
c. Hepatitis G virus e. Parvovirus
d. Hepatitis B virus 141. Which of the following procedures or
e. HIV clinical signs is most specific for the diagnosis of
136. A patient presents with infectious mononucleosis caused by the Epstein-
keratoconjunctivitis. The differential diagnosis Barr virus?
should include infection with which of the a. Laboratory diagnosis is based on the presence
following viruses? of "atypical lymphocytes" and EBV-specific
a. Parvovirus antibody
b. Adenovirus b. Growth in tissue culture cells
c. Epstein-Barr virus c. Heterophile antibodies in serum
d. Respiratory syncytial virus d. Lymphadenopathy and splenomegaly on
e. Varicella-zoster virus physical examination
137. A hospital worker is found to have e. B-cell lymphocyte proliferation
hepatitis B surface antigen. Subsequent tests 142. An infant, seen in the ER, presents with
reveal the presence of e antigen as well. The a fever and persistent cough. Physical
worker most likely examination and a chest x-ray suggest
a. Is infective and has active hepatitis pneumonia. Which of the following is most
b. Is infective but does not have active hepatitis likely the cause of this infection?
c. Is not infective a. Rotavirus
d. Is evincing a biologic false-positive test for b. Adenovirus
hepatitis c. Coxsackievirus
e. Has both hepatitis B and C d. Respiratory syncytial virus
138. Alphavirus causes which one of the e. Rhinovirus
following viral diseases? 143. Which one of the following groups of
a. Marburg virus disease people may be at increased risk for HIV
b. St. Louis encephalitis infection?
c. Western equine encephalitis a. Members of a household in which there is a
d. Dengue 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
144. 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
145. 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
146. 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 non-reactive. A possible cause of this
infection is
a. Hepatitis B surface antigen
b. Hepatitis C
c. Hepatitis D
d. Hepatitis E
e. Rotavirus
147. 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
148. Which of the following viruses is
primarily transmitted by the fecal-oral route?
a. St. Louis encephalitis virus
b. Colorado tick fever virus
c. Coxsackievirus
d. Yellow fever virus
e. Dengue fever virus
149. 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
150. 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
151. 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)
152. 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
153. 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
154. 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
155. 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
156. 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
157. Paramyxoviruses are most commonly
associated with which of the following diseases?
a. Fifth disease
b. Rubella
c. Croup
d. Tonsillitis
e. Otitis media
158. Human papillomavirus is most
commonly associated with
a. Rectal polyps
b. Prostate cancer
c. Condyloma acuminatum
d. Hepatic carcinoma
e. Carcinoma of the lung
159. 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
160. 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
161. 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
162. 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
163. 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 169. Hepatitis C (HCV) is usually a clinically
d. Rarely fatal to the host cell mild disease, with only minimal elevation of
e. Can only be seen with an electron microscope liver enzymes. Hospitalization is unusual. Which
164. A 17-year-old girl presents with cervical one of the following statements best
lymphadenopathy, fever, and pharyngitis. characterizes HCV?
Infectious mononucleosis is suspected. The a. Few cases progress to chronic liver disease
most rapid and clinically useful test to make this b. It often occurs in posttransfusion patients
diagnosis is c. HBV but not HCV infections occur in IV drug
a. IgM antibody to viral core antigen (VCA) abusers
b. IgG antibody to VCA d. It is a DNA virus
c. Antibody to Epstein-Barr nuclear antigen e. Blood products are not tested for antibody to
(EBNA) HCV
d. Culture 170. Which of the following markers is
e. C reactive protein (CRP) usually the first viral marker detected after
165. Which one of the following viruses hepatitis B infection?
would be most likely to establish a latent a. HBeAg
infection? b. HBsAg
a. Adenovirus c. HBcAg
b. Measles virus d. Anti-HBc
c. Influenza virus e. HbeAb
d. Parvovirus 171. Which of the following may be the only
e. Coxsackievirus group B detectable serological marker during the early
166. A regimen that includes appropriately convalescent phase of HBV infection (window
administered gamma globulin may be phase)?
contraindicated in which one of the following a. HBeAg
diseases? b. HBsAg
a. Hepatitis A c. HBcAg
b. Hepatitis B d. Anti-HBc
c. Rabies e. HbeAb
d. Poliomyelitis 172. Which one of the following markers is
e. Infectious mononucleosis closely associated with HBV infectivity and DNA
167. Atypical lymphocytosis is most likely to polymerase activity?
be found in which one of the following a. HBeAg
diseases? b. HBsAg
a. Encephalitis caused by herpes simplex virus c. HBcAg
(HSV) d. Anti-HBc
b. Mononucleosis induced by Epstein-Barr virus e. HBeAb
c. Parvovirus infection 173. Which of the following is found within
d. Chronic hepatitis C the nuclei of infected hepatocytes and not
e. Rotavirus gastroenteritis usually in the peripheral circulation?
168. A patient has arthralgia, a rash, a. HBeAg
lymphadenopathy, pneumonia but no fever. b. HBsAg
Which of the following diseases is most likely c. HBcAg
based on these symptoms? d. Anti-HBc
a. Dengue fever e. HbeAb
b. St. Louis encephalitis 174. Which one of the following viruses is
c. Infectious mononucleosis the leading cause of congenital malformations?
d. Hepatitis a. Rabies
e. HIV infection b. Rhinovirus
 c. Cytomegalovirus 181. The vaccine for measles is best
d. Respiratory syncytial virus characterized as a
e. Mumps a. Bacterin
175. Orchitis, which may cause sterility, is a b. Killed virus vaccine
possible manifestation of which of the c. Inactivated virus vaccine
following? d. Live virus vaccine
a. Rabies e. Recombinant viral vaccine
b. Rhinovirus 182. Which one of the following would be
c. Cytomegalovirus the treatment of choice for HSV infection?
d. Respiratory syncytial virus a. Acyclovir
e. Mumps b. Killed virus vaccine
176. Which of the following is a leading c. Herpes immune globulin
cause of pneumonia primarily in infants? d. Azythromycin
a. Rabies e. Recombinant viral vaccine
b. Rhinovirus 183. Which of the following best describes
c. Cytomegalovirus the presently available vaccine for hepatitis B?
d. Respiratory syncytial virus a. Synthetic peptide vaccine
e. Mumps b. Killed virus vaccine
177. Which of the following causes a fatal c. Inactivated virus vaccine
encephalitis for which a vaccine is available? d. Live virus vaccine
a. Rabies e. Recombinant viral vaccine
b. Rhinovirus 184. Chicken pox is a common disease of
c. Cytomegalovirus childhood. It is caused by which of the following
d. Respiratory syncytial virus viruses?
e. Mumps a. Cytomegalovirus
178. Traditional vaccination for the common b. Rotavirus
cold is virtually impossible because there are c. Varicella-zoster virus
multiple serotypes of which one of the following d. Adenovirus
viruses? e. Papillomavirus
a. Rabies 185. Excluding influenza, which one of the
b. Rhinovirus following viruses is a common cause of acute
c. Cytomegalovirus respiratory disease?
d. Respiratory syncytial virus a. Cytomegalovirus
e. Mumps b. Rotavirus
179. Which of the following is available and c. Varicella-zoster virus
effective for hepatitis A? d. Adenovirus
a. Acyclovir e. Papillomavirus
b. Killed virus vaccine 186. Human warts are not only cosmetically
c. Inactivated virus vaccine unsightly but may lead to cancer of the cervix.
d. Live virus vaccine They are caused by which one of the following
e. Recombinant viral vaccine viruses?
180. Patients should be vaccinated annually a. Cytomegalovirus
for influenza with which of the following b. Rotavirus
vaccines? c. Varicella-zoster virus
a. Immune serum globulin d. Adenovirus
b. Killed virus vaccine e. Papillomavirus
c. Inactivated virus vaccine 187. A vaccine is available for one of the
d. Live virus vaccine most common causes of infantile
e. Recombinant viral vaccine
 gastroenteritis. However, it has recently been c. Rubella
recalled. The virus is d. Parvovirus
a. Cytomegalovirus e. Epstein-Barr virus
b. Rotavirus 193. This virus causes a mononucleosis-like
c. Varicella-zoster virus syndrome caused by a latent herpesvirus; it is
d. Adenovirus often a congenital infection. Large amounts of
e. Papillomavirus the virus are excreted in the urine; thus, urine
188. A child has mononucleosis-like becomes the fluid of choice for diagnosis of this
symptoms yet the test for mononucleosis and disease.
the EBV titers are negative. One of the causes of a. Epstein-Barr virus
heterophile-negative mononucleosis is b. Cytomegalovirus
a. Cytomegalovirus c. HHV-6
b. Herpes simplex virus d. Parvovirus
c. Varicella-zoster virus e. Norwalk virus
d. Adenovirus 194. Human papillomavirus
e. Coxsackievirus a. Cervical tissue
189. Malaise and fatigue with increased b. Synovial fluid
"atypical" lymphocytes and a reactive c. Blood
heterophil antibody test is most commonly d. Skin
caused by 195. Cytomegalovirus
a. Toxoplasma a. Cervical tissue
b. Borrelia burgdorferi b. Synovial fluid
c. Epstein-Barr virus c. Blood
d. Parvovirus d. Skin
e. Rubella virus e. Cerebrospinal fluid
190. Lethargy, malaise, and fatigue are 196. Enterovirus
observed in a patient 2 weeks after eating raw a. Cervical tissue
hamburger at a restaurant. The most likely b. Synovial fluid
infectious cause is c. Blood
a. Toxoplasma d. Skin
b. Cytomegalovirus e. Cerebrospinal fluid
c. E. coli 197. Varicella-zoster virus (VZV)
d. Salmonella a. Cervical tissue
e. Clostridium b. Synovial fluid
191. Burkitt's lymphoma is characterized by c. Blood
elevated "early antigen" tests with a restricted d. Skin
pattern of fluorescence. This disease is caused e. Cerebrospinal fluid
by 198. Assume you are asked by a resident
a. Cytomegalovirus what the most appropriate specimen is for the
b. B. burgdorferi detection of a particular virus. Adenovirus
c. Epstein-Barr virus 40/41:
d. Lymphogranuloma venereum a. Cervical tissue
e. Herpes simplex virus b. Synovial fluid
192. This virus may be detected by the c. Blood
polymerase chain reaction (PCR) in a variety of d. Stool
cells of patients with nasopharyngeal e. Cerebrospinal fluid
carcinoma. 199. Which of the following is transmitted by
a. Measles the fecal-oral route; can be acquired from
b. Mumps
 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
200. 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
201. 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
202. 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