1. Influenza virus hemagglutinins play a significant role in which of the following phases of viral replication?

* A. Uncoating
* B. Virion Assembly
* C. Release by budding
* D. Adsorption
* E. Production of mRNA

Correct Answer: D

3. All of the following are true statements regarding viruses EXCEPT?

* A. They contain both RNA and DNA
* B. The nucleic acid may be single or double stranded
* C. They are obligate intracellular parasites
* D. They reproduce using host cell energy
* E. The infectious particle is called a virion

Correct Answer: A

5. All of the following are syndromes associated with enteroviruses EXCEPT?

* A. Conjuctivitis
* B. Coronary artery disease
* C. Myocarditis
* D. Pericarditis
* E. Pleuritis

Correct Answer: B

6. The following statements are clearly true about enteroviruses EXCEPT?

* A. There are many serotypes
* B. They can cause a variety of diseases which imitate bacterial infection
* C. They are an important cause of meningitis
* D. They are an important cause of diarrhea

Correct Answer: D

7. Enteroviruses are most closely related to which of the following viruses?

* A. Herpes simplex
* B. Hepatitis C
* C. Hepatitis A
* D. Rotavirus
* E. Rubella

Correct Answer: C

8. Foscarnet interacts with which of the following viral enzymes?

* A. Pyrophosphate-binding site of the polymerase
* B. Protease
* C. Nucleoside reductase
* D. Reverse transcriptase

Correct Answer: A

9. HIV reverse transcriptase, a critical target in modern antiretroviral chemotherapy, performs which critical function for the virus?

* A. Cleaves polyprotein precursor leading to functional assembly of viral core
* B. Cleaves sialic acid residue from glycoprotein permitting attachment and entry into cell
* C. Transcribes RNA into DNA
* D. Activates 2', 5' oligoadenylate synthetase

Correct Answer: C

10. Which of the following best characterizes antiviral chemotherapy in comparison to bacterial chemotherapy?

* A. Few drug targets, toxicity problematic
* B. Sensitivity tests of limited value
* C. Toxicity a minor problem, multiple enzymatic targets
* D. Many more drug options are available to treat viral infections

Correct Answer: A

11. One of the key differences between amantidine/rimantidine and the newer neuraminidase inhibitor influenza virus drugs is?

* A. drug allergy
* B. antimetabolic effect on host cells due to lack of specificity for viral enzymes
* C. rate of development of drug resistance
* D. drug-drug interactions associated with competition for cytochrome P450 enzymes

Correct Answer: C

12. Serologic conversion to a positive test for HIV infection occurs?

* A. In 2-3 days
* B. In 3-4 weeks
* C. In 3-6 months
* D. May take up to 10 years

Correct Answer: B

13. One of the characteristics of HIV infection is that?

* A. The virus multiplies slowly with a half-life of weeks matching the slow rate of disease progression
* B. There is rapid dissemination of virus within the first few weeks of infection to all tissues
* C. In early infection the virus is most actively multiplying within the bloodstream
* D. There is little if any immune response to HIV infection, and that is why this infection is so overwhelming

Correct Answer: B

15. HIV is the same as?

* A. HTLV III
* B. HTLV II
* C. HTLV I
* D. None of the above

Correct Answer: A

16. A major characteristic of hepatitis C is?

* A. It is transmitted by eating raw oysters
* B. It is highly likely to cause chronic ongoing infection
* C. Most patients have severe symptoms when first infected
* D. It is a DNA virus

Correct Answer: B

18. Hepatitis A can be transmitted by?

* A. Changing diapers on an infected baby
* B. Having sex with someone who is infected
* C. Eating cooked meat
* D. Needle sticks injuries from infected patients

Correct Answer: A

19. Common symptoms of hepatitis include?

* A. Fever, nausea, diarrhea
* B. Malaise, anorexia, jaundice
* C. Nausea, vomiting, right upper quadrant abdominal pain
* D. Clear urine, dark colored stools, anorexia

Correct Answer: B

20. The most frequent cause of viral meningitis in the United States is?

* A. Enteroviruses
* B. Rhabdoviruses
* C. California/Lacrosse virus
* D. Lymphocytic choriomeningitis virus

Correct Answer: A

21. Rabies virus produces infection of?

* A. Astrocytes
* B. Oligodendrocytes
* C. Neurons
* D. Macrophages

Correct Answer: C

22. Creutzfeldt-Jakob disease is caused by?

* A. JC virus
* B. Pumuula virus
* C. Prions
* D. SV40 virus

Correct Answer: C

23. Rabies reaches the central nervous system by?

* A. Hematogenous distribution
* B. Neurotropic spread
* C. Entry into brain within macrophages
* D. Both "A" and "B"

Correct Answer: B

24. The pathogenesis of dengue hemorrhagic shock syndrome is distinguished from that of uncomplicated dengue by?

* A. Excitotoxic injury of neurons
* B. Development of dengue virus meningiits
* C. Immune enhancement of infection
* D. Neurotropic spread of virus

Correct Answer: C

25. The major pathological features in Yellow Fever include?

* A. Midzonal hepatic necrosis and Councilman Bodies
* B. Midzonal hepatic necrosis and Negri bodies
* C. Glomerular and renal papillary necrosis
* D. Midzonal hepatic necrosis and diffuse encephalitis

Correct Answer: A

26. The major groups of arthropod-borne viruses include?

* A. Togaviruses, Flaviviruses, and Bunyaviruses,
* B. Togaviruses, Rhabdoviruses, Reoviruses
* C. Reoviruses, Enteroviruses, Rhabdoviruses
* D. Retroviruses, Enteroviruses, Togaviruses

Correct Answer: A

27. A Chinese male has had right upper quadrant pain for the past 10 years. Workup for gallbladder disease with an ultrasound shows small linear organisms. O&P exam reveals the ovoid, flask shaped egg of Clonorchis sinensis. Which of the following statements is false regarding Clonorchis sinensis?

* A. It is also called the oriental liver fluke
* B. Man is a definitive host
* C. This infection can best be treated with surgical removal of the gallbladder
* D. There are two intermediate hosts - the snail and the fish
* E. Long-term infection has been associated with cholangiocarcinoma (cancer of the bile duct)

Correct Answer: C

28. A student returns from a student teaching assignment in Zimbabwe. On the way home she swam in Lake Malawi. She is found to have schistosomiasis. Four of the following answers are good advice on how to prevent schistosomiasis. Which one is bad advice?

* A. in risk areas, don't swim in fresh water rivers or lakes
* B. Swimming in chlorinated pools is safe
* C. Swimming in ocean salt water is safe
* D. Toweling off vigorously after contact with potentially contaminated water decreases your risk
* E. Wading in water up to your knees is safe for brief periods of time

Correct Answer: E

29. A 22-year old Tibetan female is found to have a large multiloculated cyst of the pelvis that is removed and found to be due to Echinococcus granulosus. This is most unusual since most cysts occur in the liver or lung. Which of the following is false regarding Echinococcus granulosus?

* A. The diagnosis in humans can be made by looking for the eggs in human stool
* B. Dogs are the definitive host
* C. Sheep are intermediate hosts
* D. Humans are incidental hosts
* E. Humans contract disease from eating the eggs excreted in dog feces

Correct Answer: A

30. Taenia saginata and Taenia solium are similar in many ways, but Taenia solium is more dangerous. Which of the following makes T. solium more dangerous?

* A. It has an armed scolex
* B. It has fewer uterine branches than T. saginata
* C. Man can be infected as an intermediate host by eating the eggs from T. solium
* D. The cyst or larvae form ingested from pork is more potent than the cyst from beef
* E. It produces more eggs than T. saginata

Correct Answer: C

31. Humans are the definitive host for Diphyllobothrium latum or the fish tapeworm which competes for Vitamin B12 with its human host. Vitamin B12 deficiency can result in an anemia with production of very large red blood cells, called macrocytic anemia. All of the following would prevent the spread of this disease but one. Which one would not be a method of prevention?

* A. Avoid swimming in fresh waters that are endemic for Diphyllobothrium latum
* B. Cook freshwater fish well before eating
* C. Freeze fish that is going to be consumed raw which will kill the parasite
* D. Provide sewage treatment plants that treat raw sewage before dumping it into fresh water
* E. Avoid eating fresh water fish

Correct Answer: A

32. A physician calls from an outlying hospital to report that his patient has passed a large, white, round worm with pointed ends that is about 8 inches long. He is concerned this could be Echinococcus but the only parasite that matches this description is Ascaris lumbricoides. Which of the following is false regarding Ascaris lumbricoides?

* A. Most infected humans are asymptomatic
* B. Large numbers of larvae passing through the lung can cause asthma type symptoms
* C. Large numbers of adult worms in the gut can cause obstruction
* D. The fertilized unembryonated egg passed in the stool requires a period of time to embryonate before it becomes infectious
* E. Heavy infection has been associated with rectal prolapse

Correct Answer: E

33. An elderly Tongan male was diagnosed with multiple myeloma (a form of cancer) and has been treated with chemotherapy agents for two months. He was then admitted to the hospital with new-onset asthma symptoms that became worse when he was treated with steroids. Many small larvae were found in his sputum and he was found to have a hyper-infection with Strongyloides stercoralis. Which statement is false regarding Strongyloides?

* A. Strongyloides is a common cause of iron deficiency anemia just like hookworm
* B. The initial infection occurs when larvae penetrate the skin from the soil
* C. Auto infection occurs when the ova hatch and mature in the intestinal tract and then penetrate the intestine to establish a persistent infection
* D. Eosinophilia is present during the migrating phase of the life cycle
* E. Recurrent bacterial infections can develop when bacteria are carried by the larvae into sterile areas of the body

Correct Answer: A

35. Trichuris trichiura or whipworm is a frequent parasite found in humans. Which of the following is false for Trichuris trichiura?

* A. Heavy infestations may result in diarrhea sometimes associated with blood
* B. Light infections may be asymptomatic
* C. The eggs have a barrel-like appearance with bipolar plugs
* D. After ingestion the eggs hatch into larvae that migrate through the lung before maturing in the duodenum
* E. Eggs passed in stool are unembryonated, so they require a time to mature in the soil before they become infectious

Correct Answer: D