1
Q
1. A previously healthy 3-year-old boy develops a classic viral childhood illness. Which of the following primary viral infec- tions of childhood is usually symptomatic? (A) Cytomegalovirus (B) Epstein-Barr virus (C) Hepatitis B virus (D) Varicella-zoster virus (E) Parvovirus B19
A
d
2
Q
2. Which one of the following is a recommended therapy for her- pes simplex virus genital infection? (A) Acyclovir (B) Attenuated live virus vaccine (C) Herpes immune globulin (D) Interferon-α (E) Ribavirin
A
a
3
Q
3. Most herpesvirus infections are endemic worldwide. Which one of the following viruses shows marked geographic differ- ences in seroprevalence? (A) Cytomegalovirus (B) Epstein-Barr virus (C) Herpes simplex virus type 2 (D) Kaposi sarcoma herpesvirus (E) Varicella-zoster virus
A
d
4
Q
4. A 19-year-old female college student has a fever, sore throat, and lymphadenopathy accompanied by lymphocytosis with atypical cells and an increase in sheep cell agglutinins. The diagnosis is most likely (A) Infectious hepatitis (B) Infectious mononucleosis (C) Chickenpox (D) Herpessimplexinfection (E) Viral meningitis
A
b
5
Q
5. A Tzanck smear of a scraping obtained from a vesicle on the skin demonstrates multinucleated giant cells. Multinucleated giant cells are associated with which of the following viruses? (A) Varicella-zoster (B) Variola major (C) Coxsackievirus (D) Molluscumcontagiosum
A
a
6
Q
- Which of the following statements about betaherpesviruses is not true?
(A) They establish latent infections and persist indefinitely in infected hosts.
(B) They are reactivated in immunocompromised patients.
(C) Most infections are subclinical.
(D) They can infect lymphoid cells.
(E) They have short, cytolytic growth cycles in cultured cells.
A
e
7
Q
- A 28-year-old woman has recurrent genital herpes. Which of the following statements about genital herpes infections is true?
(A) Reactivation of latent virus during pregnancy poses no threat to the newborn.
(B) Virus cannot be transmitted in the absence of apparent lesions.
(C) Recurrent episodes caused by reactivation of latent virus tend to be more severe than the primary infection.
(D) They can be caused by either herpes simplex virus type 1 or type 2.
(E) Latent herpes simplex virus can be found in dendritic cells.
A
d
8
Q
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 (E) Herpes simplex virus type 2
A
a
9
Q
- A 53-year-old woman develops fever and focal neurologic signs. Magnetic resonance imaging shows a left temporal lobe lesion. Which of the following tests would be most appropriate to con- firm a diagnosis of herpes simplex encephalitis in this patient?
(A) Brainbiopsy
(B) Tzanck smear
(C) Polymerase chain reaction assay for viral DNA in cerebro-
spinal fluid
(D) Serologic test for viral IgM antibody
A
c
10
Q
- Which of the following tumors is caused by a virus other than Epstein-Barr virus?
(A) Posttransplantlymphomas
(B) Hodgkin disease
(C) Kaposi sarcoma
(D) AIDS-related central nervous system non-Hodgkin
lymphomas
(E) Burkitt lymphoma
A
c
11
Q
- An outbreak of a rash called “mat herpes” occurred among high school students who had competed in a wrestling tournament. Which of the following statements is most accurate?
(A) The rash is not contagious among wrestlers.
(B) The causative agent is herpes simplex virus type 1.
(C) The causative agent is varicella-zoster virus.
(D) Lesions typically last 1 month or longer.
(E) Students should be vaccinated before participating in
wrestling tournaments.
A
b
12
Q
12. The shingles vaccine is recommended for which of the follow- ing groups? (A) Healthyadolescents (B) Individuals older than age 60 years (C) Pregnant women (D) Those who never had chickenpox
A
b
13
Q
- The most common congenital infection is caused by
(A) Varicella-zoster virus
(B) Herpes simplex virus type 2
(C) Human herpesvirus 8 (Kaposi sarcoma herpesvirus)
(D) Cytomegalovirus
(E) Parvovirus
A
d
14
Q
- Which of the following groups are at increased risk for herpes zoster?
(A) Persons at advanced age
(B) Patients with atopic dermatitis
(C) Pregnant women
(D) Persons who have been vaccinated with varicella vaccine (E) Infants with congenital infections
A
a
15
Q
- Which one of the following is the best explanation for the selec- tive action of acyclovir (acycloguanosine) in herpes simplex virus (HSV)-infected cells?
(A) Acyclovir binds specifically to viral receptors only on the
surface of the HSV-infected cell.
(B) Acyclovir is phosphorylated by a virus-encoded phospho-
kinase only within HSV-infected cells.
(C) Acyclovir selectively inhibits the RNA polymerase in the
HSV virion.
(D) Acyclovir specifically blocks the matrix protein of HSV,
thereby preventing release of progeny HSV.
A
b
16
Q
- Each of the following statements concerning herpesvirus
latency is correct except
(A) Exogenous stimuli can cause reactivation of latent infec-
tion, with induction of symptomatic disease.
(B) During latency, 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.
A
b
17
Q
- Vaccines have been demonstrated to be efficacious in prevent- ing herpesvirus disease in which one of the following situations?
(A) Herpes simplex virus type 1 primary infection (B) Herpes simplex virus type 2 reactivation
(C) Varicella-zoster reactivation
(D) Cytomegalovirus primary infection
(E) Epstein-Barr virus reactivation
A
c
18
Q
- 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
A
b
19
Q
- Herpes simplex virus type 1 (HSV-1) is distinct from herpes simplex virus type 2 (HSV-2) in several different ways. Which one of the following is the least accurate statement?
(A) HSV-1 causes lesions above the umbilicus more frequently
than HSV-2 does.
(B) Infection by HSV-1 is not associated with any tumors in
humans.
(C) Antiserum to HSV-1 neutralizes HSV-1 much more effec-
tively than HSV-2.
(D) Whereas HSV-1 causes frequent recurrences, HSV-2 infec-
tion rarely recurs.
A
d
20
Q
- Each of the following statements concerning Epstein-Barr virus
is correct except
(A) Many infections are mild or inapparent.
(B) The earlier in life primary infection is acquired, the more likely the typical picture of infectious mononucleosis will be manifest.
(C) Latently infected lymphocytes regularly persist after an acute episode of infection.
(D) Infection confers immunity against second episodes of infectious mononucleosis.
A
b
