Download Life 4 Exam Questions

Version one questions:
On flow cytometric analysis of a sample of fetal thymus, certain population of cells is identified that is positive for both CD4 and CD8 cell
surface antigens. These cells are best characterized as which of the following cells?
Mature helper T lymphocytes
Rotavirus and Norwalk virus are distinctly different viruses.
However, they share which one of the following characteristics?
(A) Fecal–oral mode of transmission.
(B) They mainly cause disease in infants and young children.
(C) They induce generally mild disease in young children.
(D) Infection patterns show no seasonal variation.
(E) A double-stranded RNA genome
A 32-year-old woman with AIDS is admitted with new-onset seizures. The CT scan of the head reveals multiple ring-enhancing lesions of the
brain most likely caused by Toxoplasma Gondi. What CD4 T Cell count does this patient most likely have?
CD4 < 100
A 23-year-old immigrant gives birth to a term newborn at home. The infant’s father cuts the umbilical cord with a kitchen knife.
One week later, the infant develops rigidity and spasms. This child’s condition could most likely have been prevented by which
of the following? (Immune)
A.
B.
C.
D.
Infant vaccination at the time of birth
Maternal vaccination during pregnancy
Multivitamins during pregnancy
Peripartum antibiotics to the mother
E. Proper infant nutrition after birth
8. Which of the following viruses
causes a mononucleosis-like
syndrome and is excreted in the
urine?
(A) Cytomegalovirus
(B) Epstein-Barr virus
(C) Human herpesvirus 6
(D) Varicella-zoster virus
Bone marrow transplantation in immunocompromised patients presents which major problem? (Immune)
A.
B.
C.
D.
Potentially lethal graft-versus-host disease
High risk of T-cell leukemia
Inability to use a live donor
Delayed hypersensitivity
A 35-year-old African American female is being evaluated for exertional dyspnea and dry cough. She has a hi
stow of intravenous dug use and multiple sexual partners. Chest x-ray shows bilateral hilar adenopathy and
pulmonary infiltrates. Serum angiotensin converting enzyme levels and calcium levels are elevated. PPD testing is negative.
Bronchoscopy is arranged to help determine the diagnosis. Which of the following cell types is most likely to predominate in
this patient’s bronchoalveolar lavage fluid? (Immune)
A. Eosinophils
B. Neutrophils
C.
D.
E.
F.
CD4+ lymphocytes
CD8+ lymphocytes
CD22+ lymphocytes
Mast cells
A 4-year-old Caucasian boy is evaluated for difficulty walking. Past medical history includes frequent respiratory infections.
Cultured cells from this patient demonstrate a high rate of radiation-induced genetic mutation. This patient is most
likely to experience which of the following? (Immune)
A.
B.
C.
D.
E.
F.
Neurofibrillary tangles in neocortex
Cerebellar atrophy
Loss of neurons in the substantia nigra
Atrophy of caudate nucleus
Posterior column degeneration
Presence of Lewy bodies
anal itching.
A 4-year-old girl is brought to the physician’s office by her mother because of
The mother has noticed her
daughter scratching and rubbing her anal area frequently for the past few days. The child attends day care. Examination of her
perianal area reveals some erythema and excoriation from scratching. You perform a microscopic examination of a sample collected
by touching the perianal region with a piece of clear cellophane tape. What is the most likely diagnosis of this girl? (C. Micro)
A.
B.
C.
D.
Ascaris lumbricoides
Enterobius vermicularis
Dracunculus medinensis
Onchocerca volvulus
Which of the following is the correct interpretation of HBV serologic markers’ dynamics shown in the graph below? (C.
Micro)
A.
B.
C.
D.
E.
The patient had Acute Hepatitis B that progressed to chronic Hepatitis with high infectivity
The patient has an exacerbation of chronic Hepatitis B
The patient successfully recovered
The patient was vaccinated against HBV previously
The patient had Acute Hepatitis B that progressed to chronic Hepatitis with low infectivity
Which of the following would be present in neonate with congenital rubella Syndrome but not in a neonate with cytomegalovirus
inclusion disease? (C. Micro)
A.
B.
C.
D.
Hearing loss*
Pulmonary artery stenosis
Mental retardation
Hepatosplenomegaly
An infant with microcephaly, jaundice and hepatosplenomegaly was small for gestational age and had
thrombocytopenia. Cataracts are noted. Ultrasound of patient’s heart revealed patent ductus arteriosus. Which one of
the following viruses most likely caused these congenital malformations? (C. Micro)
A.
B.
C.
D.
CMV
Mumps virus
RSV
Rubella virus
E. HIV
Parvovirus infection, the cause
A.
B.
C.
D.
E.
of a mild exanthem in child characterized by (C. Micro)
Acute hemolytic anemia
Epidemic acute respiratory disease
Gastroenteritis
Whooping cough-like disease
Keratoconjunctivitis
42-year-old male with uncontrolled AIDS complains of progressive blurring of vision in his right eye. Eye examination
reveals evidence of retinitis with cytomegalic viral inclusion disease. Risk of this disease is highest, when CD4 T cell
count drops below:
A.
B.
C.
D.
E.
CD4 <100/ microliter
CD4 <300/ microliter
CD4 <400/ microliter
CD4 <50/ microliter
CD4 <200/ microliter
All of the following is associated with chronic Hepatitis C infection. Except: (C. Micro)
A. Severe fatal illness during pregnancy
B. Essential mixed cryoglobulinemia
C. Hepatocellular carcinoma
D. Fulminant Hepatitis
E. Palpebral Purpura
F.
Which of the following set of test result corresponds to the patient with chronic HBV infection and is superinfected with
HDV? (C. Micro)
A.
B.
C.
D.
HBsAg - , HBeAg - , ANTI-HBcAg IgM -, ANTI-HBcAg IgG -, ANTI-HBs Ag +, ANTI-HDV IgM+
HBsAg + HBeAg +, ANTI-HBc IgM+, ANTI-HBc IgG-, ANTI-HBs Ag-, ANTI-HDV IgM+
HBsAg - HBeAg -, ANTI-HBc IgM-, ANTI-HBc IgG+, ANTI-HBs Ag+, ANTI-HDV IgM+
HBsAg + HBeAg +, ANTI-HBc IgM-, ANTI-HBc IgG+, ANTI-HBs Ag-, ANTI-HDV IgM+
Each of the following statements concerning herpesvirus
latency is correct except
(A) Exogenous stimuli can cause reactivation of latent infection,
with induction of symptomatic disease.
During latency
(B)
, antiviral antibody is not demonstrable in
the sera of infected individuals.
(C) Reactivation of latent herpesviruses is more common in
patients with impaired cell-mediated immunity than in
immunocompetent patients.
(D) Virus can be recovered from latently infected cells by
cocultivation with susceptible cells.
Some viruses are characterized by helical symmetry of the
viruses with helical symmetry is most accurate?
(A) All enveloped viruses with helical symmetry are classified
into the same virus family.
(B) Helical nucleocapsids are found primarily in DNA-containing
viral
nucleocapsid. Which of the following statements about
viruses.
(C) All human viruses with helical nucleocapsids possess an
envelope.
(D) Excess empty helical particles containing no nucleic acid
are commonly produced in infected cells.
Type IV hypersensitivity responses
a. are mediated through antibody-antigen complexes
b. typically occur immediatly
dermatitis
c. occur in contact
d. occur in hay fever
Type III hypersensitivity responses
a. are mediated through antibody-antigen complexes
b. typically occur in 15 minutes
c. occur in contact dermatitis
d. are Ig-E mediated
Cytotoxic T cells induced by infection with virus A will kill target cells
a. from the same host infected with any virus.
b. infected by virus A and identical at class I MHC loci of the cytotoxic T cells.
c. infected by virus A and identical at class II MHC loci of the cytotoxic T cells.
d. infected with a different virus and identical at class I MHC loci of the cytotoxic cells
You have a patient who makes autoantibodies against his own red blood cells, leading to hemolysis. Which one of the following
mechanisms is MOST likely to explain the hemolysis
a. Perforins from cytotoxic T cells lyse the red cells
b. Neutrophils release proteases that lyse the red cells
c. Interleukin-2 binds to its receptor on the red cells, which results in lysis of the red cells.
d. Complement is activated, and membrane attack complexes lyse the red cells.
In what manner does a type III hypersensitivity reaction differ from a type II hypersensitivity reaction?
a. Type III is an immediate hypersensitivity, while type II is a delayed hypersensitivity reaction
b. Type III hypersensitivities involve IgD, while type II hypersensitivities involve IgG and IgM.
c. Type III hypersensitivities are B-cell mediated, while type II hypersensitivities are T-cell mediated.
d. The antigens involved in a type III reaction are not bound to a cell's surface, while those involved in a type II reaction are bound
to the surface
Rejection of a tumor may involve which of the following?
a. T-cell-mediated cytotoxicity
b. ADCC
c. complement-dependent cytotoxicity
d. All answer are correct
An antigen found in relatively high concentration in the plasma of normal fetuses and a high proportion of patients with
progressive carcinoma of the colon is
a. viral antigen.
b. carcinoembryonic antigen.
c.IgG
d. bacterial
Which of the following are derived from peripheral blood of a patient and cultured with recombinant IL-2?
TILs
Herpes simplex virus and cytomegalovirus share many features.
Which one of the following features is least likely to be shared?
(A) Important cause of morbidity and mortality in the newborn
(B) Congenital abnormalities caused by transplacental passage
(C) Important cause of serious disease in immunosuppressed
individuals
(D) Mild or inapparent infection
Which of the following viruses
causes a mononucleosis-like
syndrome and is excreted in the
urine?
A 2-month-old infant
developed a respiratory
illness that the pediatrician
diagnosed as bronchiolitis.
The most likely cause
of the disease is
Multiple
Choice
Multiple
Choice
A nurse develops clinical
symptoms consistent with
hepatitis. She recalls sticking
herself with a needle
approximately 4 months before
after
drawing blood from a patient.
Serologic tests for HBsAg,
antibodies to HBsAg, and
hepatitis A virus (HAV) are all
negative; however, she is
positive
for IgM core antibody. The nurse
Multiple
Choice
[Y]Cytomegalovirus
EpsteinBarr virus
(A)
Parainfluenza
virus type 4
Does not
have
hepatitis B
[Y](B)
Respiratory
syncytial virus
Has hepatitis
A
Human
herpesvirus 6
(C) Influenza
virus
Is in the late
stages of
hepatitis B
infection
Varicellazoster virus
Herpes
simplex
virus type 2
(D)
(E) Measles
Metapneumovirus virus
[Y]Is in the
“window”
(after the
disappearance
of HBsAg and
before the
appearance of
anti-HBsAg)
Has hepatitis
C
Human papillomavirus can cause Multiple
cancer in humans and is most
Choice
commonly associated with
Rectal
polyps
Regarding the oncogenes of
DNA tumor viruses, which one
of the following is most
accurate?
They encode
protein kinases
that
phosphorylate
p53 protein.
Regarding prions, which one
of the following is the most
accurate?
Multiple
Choice
Multiple
Choice
The genome
of prions
consists of a
negativepolarity RNA
that has a
defective
polymerase
gene.
Breast
cancer
Prostate
cancer
They interact
with cellular
protooncogenes and
activate them.
[Y]Prion
proteins are
characterized by
having changes
in conformation
from the
alpha-helical
form to the
beta-pleated
sheet form.
[Y]Anogenital
cancers
They encode
cellular
growth
factors that
activate Sphase DNA
synthesis.
Prions are very
sensitive to
ultraviolet (UV)
light, which is
why UV light is
used in hospital
operating
rooms to
prevent their
transmission.
Mesotheliomas
[Y]They
encode
proteins that
bind to the
proteins
encoded by
tumor
suppressor
genes.
The main host
defense
against prions
consists of an
inflammatory
response
composed
primarily of
macrophages
and CD4positive T cells.
Which of the following
statements regarding
virus morphology is true?
Multiple Choice
What is the definition of the eclipse phase?
Which one of the following is
a disease in which the role of
parvovirus B19 has not been
established?
Multiple Choice
Helical
nucleocapsids
are found with
single-stranded
DNA viruses
Multiple Choice
Erythema
infectiosum
(fifth disease)
All RNA
viruses are
spherical in
shape.
Some
viruses with
DNA
genomes
contain a
primitive
nucleus.
[Y] When
the virus
is
developi
ng but
not yet
infectious
Transient
aplastic crisis
When
a virus
mature
s and is
capabl
e of
infectin
ga
new
host
Hydrops
fetalis
[Y] Viral
surface
proteins
protect the
viral
genome
from
nucleases.
When
the
active,
infectio
us viral
particle
escapes
from
the host
Some
viruses
contain
flagella.
When
the viral
DNA
become
s latent
as a
prophag
e
[Y]
Fulminant
hepatitis
Whe
n the
virio
n
enter
s the
host
cell
Each of the following
statements concerning
herpesvirus
latency is correct
except
Multiple Choice
Herpes simplex virus and
cytomegalovirus share
many features.
Which one of the
following features is least
likely to be shared?
Which feature of the
variola virus makes it an
extreme bioterrorism
threat?
Multiple Choice
Multiple Choice
Exogenous
stimuli can
cause
reactivation
of latent
infection,
with induction
of
symptomatic
disease.
[Y]During
latency,
antiviral
antibody is not
demonstrable
in
the sera of
infected
individuals.
Important
cause of
morbidity
and
mortality in
the
newborn
[Y]Congenital
abnormalities
caused by
transplacental
passage
Wide
availability
of the virus
Weaponized
strains
present in
several
laboratories
Reactivation of
latent
herpesviruses is
more common in
patients with
impaired cellmediated
immunity than in
immunocompetent
patients.
Important cause of
serious disease in
immunosuppressed
individuals
[Y] Limited
immunity in
present
population
Virus can be
recovered
from latently
infected cells
by
cocultivation
with
susceptible
cells.
Mild or
inapparent
infection
Low
stockpiles
of effective
drugs for
treatment
Potential
emergence
from animal
reservoir
Regarding viroids, which
one of the following
statements is the MOST
accurate?
Which of the following
viruses is primarily
transmitted by the fecaloral
route?
Your patient is a 27year-old man with a
history of intravenous
drug use who
now is diagnosed with
chronic hepatitis C. He
is HIV antibody
negative. Which
one of the following is
the best choice of drugs
to treat his chronic
hepatitis C?
Cellular oncogenes
represent activated genes
involved in cancer. A
second class of cancer
Multiple Choice
Multiple Choice
Multiple Choice
Multiple Choice
They are
defective
viruses that
are missing
the DNA
coding for
the matrix
protein.
St. Louis
encephalitis
virus
Acyclovir
and
foscarnet
[Y] They
consist of RNA
without a
protein or
lipoprotein
outer coat.
Colorado
tick fever
virus
Ganciclovir
and
enfuvirtide
Protooncogenes
They cause
tumors in
experimental
animals.
[Y]
Coxsackievirus
[Y]
Peginterferon
and ribavirin
[Y] Tumor
suppressor
genes
They require
an RNA
polymerase
in the
particle for
replication to
occur.
Yellow
fever
virus
Dengue
fever virus
Zidovudine
and
lamivudine
Zidovudine
and ritonavir
Transduced
genes
Silent
genes
T antigen
genes
genes is involved in cancer
development only when
both alleles of such a gene
are inactivated. The second
class of genes is called
Regarding
Plasmodium
species, which
one of the following is
most accurate?
Multiple Choice
[Y]These
organisms are
transmitted by
the bite of female
Anopheles
mosquitoes.
The bite of
the vector
injects
merozoites
into the
bloodstream
that then
infect
red blood
cells.
Both male
and female
gametocytes
are formed
in the vector
and are
injected
into the
person at
the time of
the bite.
Hypnozoites
are
produced
by P.
falciparum
and can
cause
relapses of
malaria
after the
acute phase
is over.
Malaria
caused by P.
vivax is
characterized
by a cerebral
malaria and
blackwater
fever more
often than
malaria
caused by
the other
three
species.
prionmediated
Regarding
Multiple Choice
diseases, which one of
the following is the
most accurate?
A 70-year-old woman
with no significant
medical history begins to
experience memory
loss and personality
changes. Over the next
few months, her
symptoms become more
severe, as she
experiences rapid mental
deterioration. She also
starts to have sudden,
jerking movements in
response to being
startled and gait
Multiple Choice
[Y] Prionmediated
diseases are
characterized
by vacuoles in
the brain
called
“spongiform
changes.”
Loss of
dopaminergic
neurons in the
substantia
nigra pars
compacta.
Variant
CreutzfeldtJakob
disease is a
disease of
cattle caused
by the
ingestion of
sheep brain
mixed into
cattle feed.
Kuru is a
prionmediated
disease for
which the
diagnosis
can be
confirmed
in
the
laboratory
by a
fourfold or
greater rise
in antibody
titer.
Autoimmune
inflammation
and
demyelination
of the central
nervous
system.
In
CreutzfeldtJakob
disease, only
neurons
latently
infected by
JC virus
produce the
prion
filaments
that disrupt
neuronal
function.
Autoimmune
inflammation
and
demyelination
of the
peripheral
nervous
system.
CreutzfeldtJakob
disease
occurs
primarily in
children
under the
age of 2
years
because they
cannot
mount an
adequate
immune
response to
the prion
protein.
[Y]
Conversion of
a protein
from an a-
helix to
a ß-pleated
form, which
resists
degradation.
disturbances. Eventually,
she lapses into a coma
and dies eight months
after the onset of
symptoms. What process
likely caused this
woman's illness?
Plasmodium
Neurosyphilis
er
Version 2 questions:
A nurse develops clinical symptoms consistent with hepatitis. She recalls sticking herself with a needle approximately 4 months
before after drawing blood from a patient. Serologic tests for HBsAg, antibodies to HBsAg, and hepatitis A virus (HAV) are all
negative; however, she is positive for IgM core antibody. The nurse (Micro)
A.
B.
C.
D.
E.
She does not have hepatitis B
She has hepatitis A
She is in the late stages of hepatitis B infection
She is in the "window" (after the disappearance of HBsAg and before the appearance of anti-HBsAg)
She has hepatitis C
Regarding hepatitis C virus (HCV) and hepatitis D virus (HDV), which one of the following is MOST accurate? (Micro)
A. HCV is transmitted by blood, but HDV is not.
B. More than half
of HCV infections result in a chronic carrier state.
C. There is an effective vaccine against HCV but not against HDV.
Both HCV and HDV are defective RNA viruses and require concurrent HBV infection to replicate.
The
paramyxoviruses include the most important causes of respiratory infections in infants and young children. Which
of the following is not characteristic of paramyxoviruses? (Micro)
A. Genome is negative-sense RNA.
B.
C.
D.
E.
Envelope contains a glycoprotein with fusion activity.
Paramyxoviruses do not undergo genetic reassortment.
Replication cycle occurs in cytoplasm of susceptible cells.
Genome is segmented.
A 34-year-old
electric company worker presents to the urgent care clinic with a pruritic skin rash on his right
arm. He relates the rash to recent plant exposure while doing a repair job for his company in a wooded area. Physical examination
reveals a linear eruption with vesiculation. Which of the following cells would be found
lesion? (Immune)
A.
B.
C.
D.
E.
F.
earliest in this patient's skin
Mast cells
Eosinophils
Neutrophils
Macrophages
T lymphocytes
Plasma cells
A 71-year-old male who suffers from chronic obstructive pulmonary disease receives yearly shots of a killed viral vaccine. When
he is subsequently exposed to this virus, which of the following is thought to happen? (Immune)
A. Infective dose of the virus is decreased
B. Virus entry into cells is impaired
C. Virus replication inside cells is impaired
D. Viral progeny release from cells is impaired
E. Infected cells are destroyed by sensitized T-lymphocytes
A 4-year-old Caucasian male is evaluated in your clinic for recurrent skin and respiratory infections. He has light
skin and silvery hair. Horizontal nystagmus is present on eye examination. Peripheral blood smear demonstrates giant
cytoplasmic granules in neutrophils and monocytes. The patient most likely suffers from which of the following disorders? (Immune)
A.
B.
C.
D.
Chronic granulomatous disease
Phenylketonuria
DiGeorge syndrome
Wiskott-Aldrich syndrome
E. Chédiak-Higashi syndrome
F. Albinism
Two months after having received an allogeneic stem cell transplant for the treatment of acute lymphoblastic leukemia, a patient
presented with diarrhea and a blistering, erythematous appearance to the skin of his anterior neck and back. Serum chemistry
revealed elevated liver enzymes and billirubin, and the liver and spleen appeared enlarged on physical examination. Which of the
following diseases or pathogenic mechanisms is most likely causing this clinical picture? (Immune)
A.
B.
C.
D.
E.
Rejection of the transplant
Autoantibody production against the patient’s lymphocytes
Deposition of immune complexes in the skin and liver
A reaction to his immunosuppressive drugs
Graft-versus-host disease
Which of the following statements is incorrect (Immune)
A. dsDNA-anti-dsDNA complexes can initiate glomerulonephritis
B. Contact dermatitis due to poison
ivy is an antigen-antibody complex disease
C. Macrophages are activated nonspecifically by IFN-g
D. Cross-linkage by antigen of two or more IgE molecules causes degranulation of sensitized mast cells
anal itching.
A 4-year-old girl is brought to the physician’s office by her mother because of
The mother has noticed her
daughter scratching and rubbing her anal area frequently for the past few days. The child attends day care. Examination of her
perianal area reveals some erythema and excoriation from scratching. You perform a microscopic examination of a sample collected
by touching the perianal region with a piece of clear cellophane tape. What is the most likely diagnosis of this girl? (C. Micro)
E.
F.
G.
H.
I.
Ascaris lumbricoides
Enterobius vermicularis
Dracunculus medinensis
Onchocerca volvulus
Wuchereria bancrofti
A 34 year old nurse with recent onset of malaise is found to have the following set of laboratory findings: Anti HAV IgM - positive, Ant
HAV IgG - negative, HBsAg — negative, HBeAg — negative, Anti-HBsAg — positive, Anti-HBcAg - negative, Anti- HBeAg - negative, Anti
HCV — negative. The patient most likely: (C. Micro)
A. Had an accidental needlestick
B. Had a recent tattoo
C. Had raw
oysters at local restaurant
D. Had unprotected sexual intercourse
Previously healthy and physically active 23-year-old male comes to your office with the complaints of severe dyspnea. He is a
former basketball player and used to exercise regularly until 10 days ago, when he developed flu-like febrile illness. Starting from that
patient gradually developed increasing fatigue and shortness of breath. He also reports occasional paroxysms of “heart racing”. Serum
levels of Troponin-| and CPK are elevated. Echocardiography shows decreased ejection fraction. Which of the
following is the most likely viral cause of his symptoms? (C. Micro)
A.
B.
C.
D.
E.
F.
Enterovirus 71
Calicivirus
Echovirus 31
Parainfluenza virus**
Coxackievirus A
Coxsackievirus B
An otherwise healthy 16 year-old boy develops increasing blurring of vision over the last 2 days. Necrotizing retinal
infiltrates are seen by funduscopic exam. Which of the following is the most likely cause?
A. Toxoplasma gondii
B. Balamuthia mandrilaris
C. Measles virus
D. CMV
E. Acanthamoeba species
F. Giardia lamblia
Parvovirus infection, the cause
F.
G.
H.
I.
J.
of a mild exanthem in child characterized by (C. Micro)
Acute hemolytic anemia
Epidemic acute respiratory disease
Gastroenteritis
Whooping cough-like disease
Keratoconjunctivitis
42-year-old male with uncontrolled AIDS complains of progressive blurring of vision in his right eye. Eye examination
reveals evidence of retinitis with cytomegalic viral inclusion disease. Risk of this disease is highest, when CD4 T cell
count drops below:
F.
G.
H.
I.
J.
CD4 <100/ microliter
CD4 <300/ microliter
CD4 <400/ microliter
CD4 <50/ microliter
CD4 <200/ microliter
Your patient is a 75-year-old woman with fever, chills, and myalgias that began yesterday. It is January and an outbreak of
influenza is occurring in the retirement community in which she lives. A rapid test for influenza antigen is positive. Which one
of the following is the best choice of drug to treat the infection? (Micro)
A.Oseltamivir
B. Interferon
C. Amantadine
D. Acyclovir
Which one of the following is a disease in which the role of parvovirus B19 has not been established? =
fulminant hepatitis
Arboviruses are transmitted by bloodsucking arthropods from one vertebrate host to another.
Arboviruses are found in the following virus families except which of the following?
(A) Togaviridae
(B) Flaviviridae
(C) Bunyaviridae
(D) Reoviridae
(E) Arenaviridae
Herpes simplex virus and cytomegalovirus share many features.
Which one of the following features is least likely to be shared?
(A) Important cause of morbidity and mortality in the newborn
(B) Congenital abnormalities caused by transplacental passage
(C) Important cause of serious disease in immunosuppressed
individuals
(D) Mild or inapparent infection
The clinical picture of arbovirus infection fits one of three categories: hemorrhagic fever, or fever with myalgia. One of the characteristics of
arboviruses is that?
-
They are closely related to parvoviruses
Majority of them are RNA viruses – I think
They usually cause symptomatic infection in humans
They are only transmitted by mosquitos – no by more insects
Frok book:
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
Are closely related to
parvoviruses
[Y]Are
transmitted by
arthropod
vectors
Are usually
resistance to
ether
Usually cause
symptomatic in
humans
All of the
above
A 10-year-old child develops fever and headache. Acute viral meningitis is diagnosed. What is the most likely cause of this child’s infection?
-
HSV-1
Rubella
EBV
Mumps virus
Enterovirus
N. Meningitis
A nurse develops clinical symptoms consistent with hepatitis. She recalls sticking herself with a needle approximately 4 months
before after drawing blood from a patient. Serologic tests for HBsAg, antibodies to HBsAg, and hepatitis A virus (HAV) are all
negative; however, she is positive for IgM core antibody. The nurse (Micro)
F.
G.
H.
I.
J.
She does not have hepatitis B
She has hepatitis A
She is in the late stages of hepatitis B infection
She is in the "window" (after the disappearance of HBsAg and before the appearance of anti-HBsAg)
She has hepatitis C
A 72-year-old patient comes to your office and complains of fever 38.2 C evening, athralgia and myalgia for 3 days. She also has dry cough, sore
throat and rhinorrhea. Sense of smell and taste is somewhat decreased. Which of the following tests is reasonable to perform this time?
-
CT scan of the lungs
PRP, VDRL
SARS-COV-2 PCR
Blood culture
Lumbar puncture
Risk factors for severe MERS coronavirus infection include which of the following?
-
Recent camel exposure
Seasonal allergies
Prior corona virus infection
Chronic obstructive pulmonary disease
Regarding
Multiple Choice
Plasmodium
species, which
one of the following is
most accurate?
[Y]These
organisms are
transmitted by
the bite of female
Anopheles
mosquitoes.
The bite of
the vector
injects
merozoites
into the
bloodstream
that then
infect
red blood
cells.
Both male
and female
gametocytes
are formed
in the vector
and are
injected
into the
person at
the time of
the bite.
Hypnozoites
are
produced
by P.
falciparum
and can
cause
relapses of
malaria
after the
acute phase
is over.
Malaria
caused by P.
vivax is
characterized
by a cerebral
malaria and
blackwater
fever more
often than
malaria
caused by
the other
three
species.
Double Positive T Cells Express?
- Both CD4 and CD8 cells
Which of the following HLA subtypes are associated with insulin-dependent?
-
HLA-DR3 – HLA-DR-4
39-year-old otherwise healthy patient develops chills and high fever of 39.2 C. Next day he complains of cough productive of yellow sputum. He
is diagnosed with community acquired pneumonia. Which of the following is the most likely causing agent?
H.Influenza
M. Pnemonia
L.pnemonia
S.Pneumonia
But H.Inf and M.Pnemonia could also be ….
A 15-year-old girl presents with fever, sore throat, odynophagia and a number of grayish-white papulo-vesicular lesions on the soft palate,
uvula and tonsils. Which of the following is the most likely diagnosis of this patient?
-
Hand foot and mouth disease
EBV
Herpangina
Primary herpes
CMV esophagitis
Strep throat
This from book:
5.
Outbreaks of hand-foot-and-mouth disease, characterized by oral ulcerations and vesicular rashes, occur and may result in infant deaths. The
disease is caused by
(A) Foot-and-mouth disease virus
(B) Chickenpox virus
(C) Nonpolio enteroviruses
(D) Rhinoviruses
(E) Rubella virus
A 7-year-old girl is brought to the office due to diffuse rash. The father says she developed a lace-like, erythematous rash this morning on her
stomach, back and extremities. Two days ago, the girl developed red, flushed cheeks. She also had congestion, headache, and a low-grade fever
for 3 days earlier this week. Last week, her youngster brother had similar symptoms that resolved spontaneously. The infection agent most likely
responsible for this patient’s disease replicates in progenitors of which of the following cell lines?
?????????????
A 15-year old female develops fever myalgia and headache an outbreak of an illness with similar symptoms caused by a echovirus is known to be
occurring in the community the primary anatomic site of echovirus multiplication in the human host is?
-
GI tract
The blood and lymph system
The muscular system
The respiratory system
The central nervous system
From Q bank:
One month after school has been let out for the summer, a 16-year-old girl develops fever, myalgia, and headache. An
outbreak of an illness with similar symptoms caused by an echovirus is known to be occurring in the community. The primary anatomic
echovirus multiplication in the human host is (Micro)
A.
B.
C.
D.
E.
The muscular system
The central nervous system
The alimentary tract
The blood and lymph system
The respiratory system
site of
A 45-year old man recent immigrant from Bostwana is brought to the emergency room with a cough productive of bloody sputum he first
noticed a cough approximately two months ago. He reports having lost approximately 5 kg in this timeframe as well. He also notes that he's had
drenching night sweats two or three nights a week for the past month. Which of the following is the most likely cause of his condition?
-
S. Pneumonia
M.tuberculosis
HIV
Chronic … ?
A 32-year-old sexually experienced female complained of increased vaginal discharge and vaginal pruritus. Increased PMN cells are found in her
vaginal swab which of the following is the most likely cause of her symptoms?
-
M.Pneomonia
Herpes simplex virus
Syphilis
Acute HIV syndrome
Papillomavirus
C.Trachomatis (chlamydia trachomatis) – I think
Risk factor for severe MERS coronavirus infection include which of the following?
-
Recent Camel exposure
-
Severe allergies
Prior corona virus infection
Chronic obstructive pulmonary virus
Once they leave the marrow, in order to survive mature naive B cells must enter the
a. circulation
b. lymph microenvironment.
c. primary lymphoid follicles.
e. thymus.
Which of the following viruses causes infectious mononucleosis and becomes latent in B-cells?
-
Varicellar-zoster virus
EBV (Ebstin-Bar-Virus)
Cytomegalovirus
Human herpesvirus 6
Herpes simplex virus type 2
A 30-year old asymptomatic woman is found to have a positive VDRL (
Venereal disease research laboratory
test) test she denies having had sexual contact with a partner who had symptoms of venereal disease. What is the next step?
-
Reassure her the test is a false-positive if she doesn’t have any symptoms
Perform FTA-ABS test on a specimen of her serum
Treat her with penicillin
Trace her sexual contacts for serologic testing
Which of the following is NOT true about TCR?
-
CDR3 of TCR has the most sequence variability from molecule to molecule
All TCRs on a particular T Cell have identical idiotypes
TCR has binding sites for both antigen and self MHC
All 3 answers provided are true
A 31-year-old man is admitted to the hospital due to the new onset seizures. He has no
significant medical history. Vital signs are normal. Neurologic examination shows no
abnormalities. CT scan of the head reveals a 3 cm cystic lesion in the temporal lobe. The
mass is excised and histopathology is shown in the image below. Which of the is the likely
diagnosis?
-
Helminth infection
Meningioma
Metastatic disease
Tuberculosis
Where are the M cells focused in GI tract exactly located?
-
They are found in every layer of GI tract wall
They are not found in the gut at all
Follicles as Peyer's patches
Follicle associated keratinized epithelium
1. Your patient is a 75-year-old woman with fever, chills, and myalgias that began yesterday. It is January and an outbreak
of influenza is occurring in the retirement community in which she lives. A rapid test for influenza antigen is positive.
Which one of the following is the best choice of drug to treat the infection? (Micro)
E. Oseltamivir
F. Interferon
G. Amantadine
H. Acyclovir
You are a patient is a 30-year old woman with non-bloody diarrhoea for the past 14 hours which one of the following organisms is least likely to
cause this illness?
A 30-year woman has non-bloody diarrhea for the past 14 hours. Which one of the following organisms is least likely to cause this illness?
a. Streptococcus pyogens
b. Clostridiodes difficile
c. Shigella dysenteriae
d. Salmonella enteritidis
- Listeria Monocytogens
A 25-year old female medical student report that she had lunch at fish restaurant in the afternoon she reports eating sushi and seafood she's
presented in the emergency department of hospital with the complaints of abdominal cramps nausea and vomiting culture and gram stain
reveal no pathologic bacteria which of the following is the most likely cause of this infection?
-
Clostridium Difficile
E.coli (ETC)
Rotavirus
Clostridium botulinum food poisoning
Listeria monocytogens
Norovirus
???????????????????????????
Laryngeal papilloma in children can be caused by which of the following viruses?
-
None of the above
Caliciviridae
Molluscum contagiusom virus
Polyomavirus JC
Papillomavirus
From book:
Laryngeal papillomas in children are generally caused by the same viruses that cause benign genital condylomas. These viruses are
-
Papillomaviruses, types 6 and 11
Polyomavirus JC
Epstein-Barr virus
Molluscum contagiosum virus
Papillomaviruses, types 16 and 18
An 11-year old boy develops sore throat headache, tearing and bilateral conjunctivitis. After medical exam he's found to have a fever of 37
Celsius degree and mild preauricular lymphadenopathy. Within the next 2 days several of his classmates develop similar symptoms which of the
following is the most likely cause?
-
HSV-1
Parvovirus B19
Adenovirus
Chlamydia
S. Aureus
Mumps Virus
From book:
2. An otherwise healthy 11-year-old child presents with low-grade fever, sore throat and red, irritated eyes. On
examination, the patient is noted to have
pharyngitis and bilateral conjunctivitis.
Which of the following is the most likely etiologic agent?
A.
B.
C.
D.
E.
Rhinovirus
Adenovirus
Metapneumovirus
Coronavirus
Influenza virus
What is the function of ficolins (1-3)?
-
All answers are correct
Agglutinin
Op…
-
… compelemnt
Which of the following clinical scenario most likely explains the following serologic markers found in the 17-year-old body: Anti-HAV IgM + AntiHAV IgG – HbsAg + HBeAg – Anti Hb … Anti-HBeAg + Anti-HCV –
-
Acute Hepatitis E
Acute hepatitis A plus chronic HC
Acute Hepatitis B plus acute HDV
Acute hepatitis C
Acute hepatitis A Plus Hepatitis B
From book:
43-year-old nurse has a following reading of serologic markers for viral hepatitis: Antti HAV igM -Negative, Anti HAV igG – positive, HBsAG –
Negative, HBeAg – Negative, Anti HBs – positive, Anti-HBc – negative, Anti-HBe – negative, Anti- HCV – negative. The patient most likely:?
= has recovered from HBV recently, has been vaccinated against HBV
A 9-year old boy is admitted to ER with complaints of severe pain of left leg. He is unable and refuses to walk. He has fever of 38.7 C. WBCs are
elevated. Which of the following is the most likely cause of his symptoms?
-
N.Meningitis
B. burgdorferi
S. aureus
Coxackivirus b
M.tuberculosis
Meningitis is inflammation of the tissues around the brain. ... Leg pains. The pains can become severe and prevent a child from standing
or walking.
?????????????????????????/
ACE 2 is a receptor for which of the following viruses?
-
SARS-CoV2
HTLV 1
Herpes simplex
HIV
Ebstein-Bar Virus
A woman was
hiking
in an isolated area
when a skunk
Multiple Choice
appeared and bit her on
the leg. She now presents
to your emergency room
about an hour after the
bite. Which one of the
following is the most
appropriate thing to do?
Which of the following viruses can be transmitted through blood?
-
Human T-lymphocytic virus
Hepatitis D Virus
Hepatitis C virus
HIV
All of the above
[Y] Give rabies
vaccine and
hyperimmune
globulin
immediately.
Test the
patient’s
serum for
antibodies
now and in
10 days to
see if there is
a rise in
antibody titer
before
treating her.
Reassure
her that
rabies is not
a problem
because
skunks do
not carry
rabies.
Quarantine
the animal
for 10 days
and only
treat her if
signs of
rabies
appear in the
animal.
IgA as well as IgM is an antibody that can be secreted. Majority of it actually exists in a second form in GI and respiratory tracts. What is the
essential factor that makes it possible to secret IgA?
-
IgA needs to polymerize and afterwards undergo enzymatic cleavage inside plasma cells in order to get secreted from mucosal epithelial
cells
G chain produced from plasma cells that converts monomeric IgA into dimeric form
There is no pre-existing requirement for IgA to get secreted
Poly-Ig receptor that binds to the J chain of dimeric IgA
Chagas disease is especially feared in Latin America because of the damage that can occur to the heart and parasympathetic nervous system and
the lack of an effective drug for the symptomatic later stages. Your patient is planning to reside in a Venezuelan village for 1–2 years. Which one
of the following suggestions would be of special value for avoiding Chagas disease?
(A) Boil or treat all of your drinking water.
(B) Sleep under a bed net.
(C) Do not keep domestic pets in your house.
(D) Never walk barefoot in the village compound.
(E) Do not eat lettuce or other raw vegetables or unpeeled fruit.
Which of the following is not a special anatomic structure of the gastrointestinal tract?
-
Peyer’s patches
-
Keratinizing stratified squamous epithelium
Lamina proper follicules
Tonsils – they are part of immune system
Which of the following best describes available HPV vaccines?
-
Live attenuated virus
mRNA
none of the above
live recombinant virus
toxoid
From internet:
Which of the following best describes available HPV vaccines?
Select one:
a. Live attenuated virus
b. Live recombinant virus
c. Inactivated whole virus
d. Noninfectious subunit
e. Toxoid
Noninfectious subunit
Herpes simplex virus and cytomegalovirus share many features.
Which one of the following features is least likely to be shared?
(A) Important cause of morbidity and mortality in the newborn
(B) Congenital abnormalities caused by transplacental passage
(C) Important cause of serious disease in immunosuppressed
individuals
(D) Mild or inapparent infection
Your patient is a 25-year-old man with fever and weight loss for the past 3
weeks. He is a soldier in the U.S. Army who recently returned from a tour of duty
in the Middle East. Physical exam was noncontributory. Laboratory tests revealed
anemia and leukopenia. Multiple blood cultures for bacteria and fungi were
negative, as was a test for the p24 antigen of HIV. CT scan of the abdomen
revealed splenomegaly. A bone marrow biopsy was performed, and a stained
sample revealed amastigotes within mononuclear cells. Of the following, which
one is the most likely cause?
[Y]L. donovani
P. falciparum
T. gondii
T. brucei
T. cruzi
African Sleep Sickness
Toxoplasmosis
Malaria
Visceral leishermiasis – I think
Chaga’s disease
Antibody Fc Fragments contain?
Fc (50,000 daltons) fragments contain the CH2 and CH3 region and part of the hinge region held together by one or more
disulfides and noncovalent interactions. Fc and Fc5µ fragments are produced from fragmentation of IgG and IgM, respectively.
??????
Which is NOT true of virions?
-
Are extracellular
May have an envelope
Contain DNA and ribosomes – they don’t have ribosomes
-
Contain RNA
A 15-month-old is referred to a pediatric immunologist by his pediatrician for further workup of recurrent sinopulmonary infections which
have not abated despite adequate treatment. During the workup flow cytometry demonstrates a decrease in normal CD40L cells. Based on
these findings, the immunologist decides to pursue a further workup and obtains immunoglobulin levels. Which of the following
immunoglobulin profiles is most likely to be observed in this patient?
-
Decreased IgE, IgM, Iga, IgG
Increased IgM, Decreased IgG, IgA, IgE
Increased IgE, IgA, Decreased IgM
Increased IgE, Decreased IgG, IgM
Regarding poliovirus, which one of the following is MOST accurate?
Regarding
poliovirus, which
one of the following
is MOST accurate?
Multiple Choice
Poliovirus remains
latent within sensory
ganglia, and
reactivation occurs
primarily in
immunocompromised
patients.
[Y] When
the live,
attenuated
virus in the
oral vaccine
replicates,
revertant
mutants can
occur that
can cause
paralytic
polio.
Human papillomavirus can cause cancer in humans and is mot commonly associated with?
The
widespread
use of the
killed vaccine
in the
countries of
North and
South
America has
led to the
virtual
elimination
of paralytic
polio in
those
areas.
The current
recommendation
is to give the live,
attenuated
vaccine for the
first 3
immunizations to
prevent the child
from acting as a
reservoir,
followed by
boosters using
the killed
vaccine.
-
Breast cancer
Mesothelioma
Prostate cancer
Cervical cancer
Rectal polyps
From book:
Human papillomavirus can cause Multiple
cancer in humans and is most
Choice
commonly associated with
Rectal
polyps
Breast
cancer
Prostate
cancer
[Y]Anogenital
cancers
Mesotheliomas
----Your patient is a 20-year-old
woman with chronic
hepatitis B that was
diagnosed
by detecting hepatitis B
antigen in her blood more
than 6 months after her
acute
infection. Which one of the
following is the best choice
of drug to treat her
chronic
B?
hepatitis
Multiple Choice
Acyclovir
Foscarnet
[Y]Entecavir
Ritonavir
Zidovudine
A 70-year-old woman
with no significant
medical history begins to
experience memory
loss and personality
changes. Over the next
few months, her
symptoms become more
severe, as she
experiences rapid mental
deterioration. She also
starts to have sudden,
jerking movements in
response to being
startled and gait
disturbances. Eventually,
she lapses into a coma
and dies eight months
after the onset of
symptoms. What process
likely caused this
woman's illness?
Multiple Choice
Loss of
dopaminergic
neurons in the
substantia
nigra pars
compacta.
Autoimmune
inflammation
and
demyelination
of the central
nervous
system.
Autoimmune
inflammation
and
demyelination
of the
peripheral
nervous
system.
[Y]
Conversion of
a protein
from an a-
helix to
a ß-pleated
form, which
resists
degradation.
Your patient is a 30-year-old man
with persistent watery diarrhea for
2 weeks.
He is HIV antibody positive with a
CD4 count of 10. Routine stool
culture
revealed no bacterial pathogen.
Ova and parasite analysis revealed
cysts that
stained red in an acid-fast stain. Of
the following, which one is the
most likely
cause of this infection?
Multiple
Choice
[Y]C.
hominis
Your patient is a 30-year-old man with persistent watery diarrhea for 2 weeks.
He is HIV antibody positive with a CD4 count of 10. Routine stool culture
revealed no bacterial pathogen. Ova and parasite analysis revealed cysts that
stained red in an acid-fast stain. Of the following, which one is the most likely
cause of this infection?
-
Entamoeba – this
Cryptococcus
Trichomonas
Giardia – or this – maybe this more
E. histolytica
G. lamblia
T. vaginalis
One month after school has been let out for the summer, a 16-year-old girl develops fever, myalgia, and headache. An
outbreak of an illness with similar symptoms caused by an echovirus is known to be occurring in the community. The primary anatomic
echovirus multiplication in the human host is (Micro)
A.
B.
C.
D.
E.
The muscular system
The central nervous system
The alimentary tract
The blood and lymph system
The respiratory system
site of
An 8-year old boy is brought into the office when at 3-day history of fever and mild sore throat. The rash started on his face and spread to his
arm the legs on examination his temperature is 37.7 Celsius degree and his other vital signs are normal. His cheeks are notably red, pharynx is
normal appearing. On his extremities there is a fine, erythematous, maculopapular rash but no vesicles or petechiae. What is the most likely
diagnoses?
-
Erythema nodosum
Erythema marginatum
Erythema induratum
Erythema multiforme
- Erythema infectiosum
Your new patient is young female from Ireland who came to visit Georgia 4 days ago she complains of diarrhea crampy abdominal pain and
nauseated stool analysis doesn't show RBC or white blood cells which of the following pathogenic bacteria is most commonly associated with
this condition?
-
Campylobacter jejuni
Salmonella Typhimurium
E. coli ETEC
Shigella
???
A 3-year-old Cuban-american male has a history of recurrent pseudomonas and candida infections. Laboratory analysis reveals no electrolyte
abnormalities. Examination of his serum shows decreased levels of igG and CT scan reveals the absence of a thymus. The child likely has? = -
severe combined immunodeficiency syndrome
Regarding human papillomavirus (HPV), which one of the following is MOST accurate?
-
Medications can effectively cure HPV infected cells – Not curable
HPV is an enveloped virus with genome composed of double-stranded RNA (Doesn’t have envelop)
HPV is associated with penile cancer development
-
Blood and blood products are an important mode of transmission of HPV – Sexual contact