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Answers to Multiple Choice Questions - Paper 3

 

Instructions for candidates

The examination consists of 30 multiple choice questions, each divided into 5 different parts. Each part contains a statement which could be true or false. Each question will have at least one part which is true. For each part, you should indicate whether you think it is true (T), false (F), or don’t know (DN). You must fill in the relevant square with a black pen. One mark will be given for each correct answer and one mark deducted for each incorrect answer. You will not be marked for those questions for which you have indicated "don’t know".
 

  1. The following are DNA viruses
False Influenza A virus
False Rubella Virus
True Hepatitis B Virus
True CMV Virus
True Parvovirus
   Influenza A virus and Rubella Virus are RNA viruses. CMV Virus and Hepatitis B Virus are double-stranded DNA viruses. Parvovirus is a single-stranded DNA virus
   
  2. The following are negatively stranded RNA viruses
False Picornaviruses
True Orthomyxoviruses
False Coronaviruses
False Flaviviruses
True Rhabdoviruses
  Picornaviruses, coronaviruses and flaviviruses are positively stranded RNA viruses
   
  3. The following viruses have segmented genomes
True Orthomyxoviruses
False Herpesviruses
False Paramyxoviruses
True Bunyaviruses
True Rotaviruses
   The genome of orthomyxoviruses consists of 7 or 8 single stranded RNA segments, bunyaviruses 3 single stranded RNA segments, and rotaviruses 11 double stranded RNA segments.
   
  4. The following are enveloped viruses
True Herpesviruses
False Adenoviruses
False Rotaviruses
False Parvoviruses
True Orthomyxoviruses
   
  5. All viruses
False Contain DNA
False Contain RNA
True Contain protein
False Are susceptible to lipid solvents
True Are intracellular parasites
  Viruses contain either DNA or RNA. All viruses contain protein. Only enveloped viruses are susceptible to lipid solvents. All viruses are intracellular parasites.


 
 
 
 

  6. The following viruses are associated with human cancers
False HSV-2
True EBV
True HCV
False Adenoviruses
True HHV-8
  HSV-2 was associated with genital cancers at one time but this has now been disproved. EBV is associated with Burkitt's lymphoma, nasopharyngeal carcinoma, and large-cell lymphomas in immunocompromised individuals. Although adenoviruses may be oncogenic in vitro, there is no evidence that they are associated with human cancers. HHV-8 is associated with Kaposi's sarcoma.
   
 
  • 7. The following viruses may cause congenital infection
  • True  HSV-2
    True Rubella
    True HIV
    True HBV
    True CMV
       All the above viruses may cause congenital infection. Rubella and CMV are usually transmitted transplacentally in utero, whilst HIV, HBV and HSV-2 are usually transmitted perinatally during the birth process.
       
      8. The following viruses have reverse transcriptase
    True HIV
    False Parvovirus
    True HBV
    False CMV
    True HTLV-1
       HIV and HTLV-1 are retroviruses. HBV is a DNA virus whose replication depend on a reverse transcriptase
       
      9. The following viruses replicate in the nucleus
    True Herpseviruses
    False Poxviruses
    False Picornaviruses
    True Orthomyxoviruses
    False Paramyxoviruses
       All DNA viruses, with the exception of poxviruses replicate in the nucleus. All RNA viruses, with the exception of orthomyxoviruses, replicate in the cytoplasm
       
     
  • 10. The following are viral zoonoses
  • False Rubella
    True Rabies
    True Hantaviruses
    True Lassa Fever
    True Japanese Encephalitis
      Zoonoses are infections which are transmitted from a vertebrate animal to humans either directly, or indirectly through an arthropod vector. Rabies may be transmitted to human from various mammals. Hantaviruses and Lassa fever from rodents. The reservoir of Japanese encephalitis is in birds and pigs and it is transmitted to humans via culex mosquitoes


     
     
     
     

     
  • 11. Reassortment of genes may occur with
  • False HSV-1
    False HBV
    False HIV
    True Influenza A Virus
    True Rotaviruses
       Reassortment of genes occur in influenza A and rotaviruses. It is thought to be responsible for large changes in antigenicity
       
      12. The following statements are true of prions
    False Readily inactivated by autoclave at 121oC
    False Contain
    True Have long incubation periods
    False Highly immunogenic
    False May be readily cultured
      Prions required autoclaving at 134 oC in order to be effectively inactivated.They consist probably solely of protein: no DNA had ever had demonstrated. Prion diseases are characterised by long incubation periods. Being host-derived, prion proteins are not immunogenic. They may not be cultured readily.
       
      13. The following are "slow virus" diseases
    False Herpes Simplex Encephalitis
    True Creutzfeldt-Jacob disease
    True Subacute Scelerosing Panecephalitis (SSPE)
    False Rabies
    True Progressive multifocal leucoencephalopathy (PML)
       "Slow virus infections" refer to viral or prion infections of the brain characterised by a long incubation period which is in terms of years. Human prion diseases, Subacute Scelerosing Panecephalitis (SSPE), and Progressive multifocal leucoencephalopathy (PML) are considered as slow virus infections. Herpes Simplex Encephalitis and rabies are not.
       
      14. HSV-1 infection may result in
    True Encephalitis
    True Gingivostomatitis
    True Genital Herpes
    True Corneal Ulcers
    False Shingles
      HSV-1 infection may result in encephalitis, gingivostomatitis, genital herpes, and corneal ulcers. Shingles arise from a previous infection by VZV
       
      15. The following viruses are associated with a vesicular rash
    False Rubella Virus
    False Measles Virus
    False Parvovirus 
    True HSV-1
    True VZV
       Rubella, measles, and parvoviruses cause a maculopapular rash


     
     
     
     

      16. Cytomegalovirus (CMV)
    True Primary infection is usually asymptomatic
    True An infectious mononucleosis-like syndrome may occur during primary infection.
    True May cause severe infection in immunocompromised individuals
    True May cause congenital infection
    True Reactivate from time to time
       All the above
       
      17. Epstein-Barr Virus (EBV) is associated with
    True Infectious Mononucleosis
    False Kaposi's Sarcoma
    True Burkitt's lymphoma
    True Nasopharyngeal carcinoma
    False Adult T-cell lymphoma
       HHV-8 is associated with Kaposi's sarcoma, HTLV-1 is associated with Adult T-cell lymphoma
       
     
  • 18. HHV-8 is associated with
  • False Fifth disease
    False Roseala Infantum
    True Kaposi's Sarcoma
    False Nasopharyngeal Carcinoma
    False Oral leukoplakia
       Parvovirus is associated with fifth disease, HHV-6 with Roseala Infantum, EBV with Nasopharyngeal Carcinoma and oral leukoplakia
       
      19. The following viruses are thought to cause gastroenteritis 
    False Enteroviruses
    True Caliciviruses
    True Norwalk-like viruses
    True Astroviruses
    False Paramyxoviruses
       Although enteroviruses may be found in the faeces, they are not associated with gastroenteritis. Paramyxoviruses are not associated with gastroenteritis
       
      20. The following statements are true
    True Human polyoma virus JC is associated with progressive multifocal leucoencephalopathy (PML)
    False Human polyoma virus JC is associated with warts
    False HPV-6 and HPV-11 are associated with genital cancers
    True HPV-6 and HPV-11 are associated with Juvenile laryngeal papillomatosis
    True Patients with Epidermodysplasia verruciformis are susceptible to widespread warts caused by HPV
       Human papillomaviruses (HPV) are associated with warts. HPV-16 and 18 are associated with genital cancers. Patients with Epidermodysplasia verruciformis are susceptible to widespread warts caused by a variety of HPV types. These lesions may become cancerous later on in life.


     
     
     
     

      21. The following statements are true
    True Influenza A may undergo antigenic shift
    False Influenza B may undergo antigenic shift
    True Influenza A may undergo antigenic drift
    True Influenza B may undergo antigenic drift
    False Influenza B may respond to amantidine
       Only influenza A is known to undergo antigenic shift. Both influenza A and influenza B may undergo antigenic drift. Only influenza A respond to amantidine
       
      22. Respiratory Syncytial Virus
    False Cause disease mainly in adults
    True May cause bronchiolitis
    False May be prevented by vaccination
    False  May be treated by amantidine
    False  May cause latent infections
       RSV mainly causes disease in infants. It is the main cause of bronchiolitis. There is no vaccine available. It will not respond to amantidine but will respond to ribavirin. It is not known to cause latent infections,
       
       23. HIV may respond to 
    True  Nucleoside analogues
    True  Protease inhibitors
    False  Neuraminidase inhibitors
    True  Reverse transcriptase inhibitors
    True  Acyclovir
      HIV may respond to reverse transcriptase inhibitors, many of which are nucleoside analogues. It may also respond to HIV protease inhibitors which are the most potent agents to date. Neuraminidase inhibitors are used for the treatment of influenza virus infections whilst acyclovir is used for herpesvirus infections.
       
       24. During the incubation period of HIV infection, there is
    False  Little HIV replication
    False  HIV is mainly integrated into the genome of long-lived cell populations
    True  High turnover of CD4 cells
    True  The viral load has a direct bearing on the prognosis
    False  Little antibody against the HIV envelope
       During the incubation period, there is a huge amount of viral replication and consequently a high turnover of CD4 cells. Only a very small proportion of HIV is integrated into the genome of long-lived cell populations. The viral load has a direct bearing on the prognosis. HIV envelope antibody remains at a high level throughout the incubation period.
       
       25. Hepatitis A infection
    False  May result in chronic infection
    True  May be prevented by immunoglobulin
    True  May be prevented by vaccination
    False  Is highly infectious during the jaundice phase
    False May result in cirrhosis
       HAV infection does not result in chronic infection and therefore cirrhosis. It may be prevented by the administration of human normal immunoglobulin (HNIG), and active vaccination by an inactivated vaccine. By the time jaundice appears, there is little viral excretion and thus infectivity.


     
     
     
     

     
  • 26. Hepatitis B infection
  • True May result in chronic infection
    True May result in cirrhosis of the liver
    True May result in hepatocellular carcinoma
    True Is highly infectious when positive for HBeAg
    True May respond to interferon therapy
       HBV infection may result in chronic infection, cirrhosis of the liver and hepatocellular carcinoma. The presence of HbeAg indicates viral replication and thus infectivity. Chronic HBV infection may respond to interferon therapy.
       
      27. The following statements are true of hepatitis B core escape mutants
    True Associated with fulminant hepatitis
    False HbeAg positive
    True anti-HbeAg antibody positive
    True HBV-DNA positive
    False Anti-HbsAg antibody positive
       Hepatitis B core escape mutants are associated with acute fulminant hepatitis. They are anti-HbeAg antibody positive and HBV-DNA positive. HbsAg is present and therefore they should be no anti-HbsAg antibody.
       
      28. Hepatitis C virus
    True May be transmitted by blood
    True Is associated with hepatocellular carcinoma
    True May respond to interferon therapy
    False Has one stable genotype only
    False May cause chronic infection
       HCV is mainly transmitted by blood. It may cause chronic infection and is associated with hepatocellular carcinoma. It may respond to interferon therapy. There are a number of HCV genotypes.
       
      29. The following statements are true
    True Dengue virus infection result from bites by Aedes mosquitoes
    True Cases of dengue haemorrhagic fever usually result from reinfection by a different serotype of dengue virus
    False Pigs act as the reservoir for dengue virus
    False Yellow fever is prevalent throughout Asia
    True Yellow fever may be prevented by vaccination
       Dengue virus infection result from bites by Aedes mosquitoes. Cases of dengue haemorrhagic fever usually result from reinfection by a different serotype of dengue virus: an immunopathological mechanism is thought to be involved. No animal reservoir is involved in the vast majority of dengue cases: transmission arise from a man-mosquito-man cycle. Yellow fever is not found in Asia, it is prevalent in some West African and Central and South American countries. It can be prevented by vaccination with a live attenuated vaccine.
       
      30. Measles virus 
    True Infection may result in pneumonia
    True Infection may result in encephalitis
    False Undergo antigenic drift
    False May respond to acyclovir
    True May be prevented by vaccination
      Measles virus infection may result in pneumonia and encephalitis. There is one stable serotype. Measles will not respond to acyclovir but can be prevented by vaccination.

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