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Question 1

1. A patient presents to the emergency room with vesicular lesions on both hands potentially resembling smallpox. A public health investigation is begun to rule out smallpox. The patient is an immigrant working as a shepherd in several states. What is the most likely cause of his skin lesions?
(A) Vacciniavirus
(B) Variola virus
(C) Monkeypox virus
(D) Tanapox virus
(E) Orf virus

Answer 1

e

Question 2

2. An emergency services worker is considering smallpox vaccina- tion because of the potential for bioterrorism. Which one of the following conditions is not a contraindication for the use of vac- cinia (smallpox) vaccine under routine nonemergency conditions?
   (A) Immunosuppression
   (B) Severe allergy to a component of the vaccine
   (C) Household contact with a person with eczema
   (D) Pregnancy
   (E) Previous smallpox vaccination

Answer 2

e

Question 3

3. Which of the following poxviruses infects only humans?
(A) Monkeypox
(B) Molluscum contagiosum
(C) Tanapox
(D) Cowpox
(E) Yaba tumor virus

Answer 3

b

Question 4

4. A 7-year-old boy has pox-like lesions on his left hand and arm. He has a pet rodent imported from West Africa. Monkeypox is diagnosed in the boy and the rodent. Which of the following statements about monkeypox virus is most correct?
   (A) Clinical disease resembles smallpox.
   (B) Human infections are never fatal.
   (C) Smallpox vaccination is not protective.
   (D) Infections are readily transmitted among family members.
   (E) Virus particles can be distinguished from smallpox virus
   by electron microscopy.

Answer 4

a

Question 5

5. Which of the following best describes the currently licensed smallpox vaccines?
   (A) Live attenuated smallpox virus
   (B) Inactivated smallpox virus
   (C) Live vaccinia virus
   (D) Inactivatedvacciniavirus
   (E) Reassortant vaccine containing both vaccinia and small- pox viruses

Answer 5

c

Question 6

6. Which of the following does not apply to vaccinia virus replica- tion in cultured cells?
   (A) Viral replication cycle takes place in the cytoplasm of infected cells.
   (B) The uncoating step leading to release of the viral genome requires a newly synthesized viral protein.
   (C) Early transcription of more than 50 viral genes occurs within viral cores and precedes viral DNA replication.
   (D) Newly formed virus particles mature by budding through
   the nuclear membrane.

Answer 6

d

Question 7

7. Which feature of the variola virus makes it an extreme bioter- rorism threat?
   (A) Wide availability of the virus
   (B) Weaponized strains present in several laboratories
   (C) Limited immunity in present population
   (D) Low stockpiles of effective drugs for treatment
   (E) Potential emergence from animal reservoir

Answer 7

c

Question 8

8. A patient presents with skin lesions similar in appearance to molluscum contagiosum. How is diagnosis of this condition typically made?
   (A) Viralculture
   (B) Rapid antigen test
   (C) PCR for viral DNA
   (D) Clinicalappearance
   (E) Inoculation of chorioallantoic membrane of chick embryos

Answer 8

d

Question 9

9. Which of the following does not fulfill the criteria for exposure to vaccinia?
   (A) Smallpox vaccination
   (B) Close contact with a recent smallpox vaccine
   (C) Intrauterine exposure
   (D) Injection of vaccinia immune globulin

Answer 9

d

Question 10

10. A researcher wishes to obtain a full-length genome of variola virus for vaccine studies. Which of the following is the appro- priate source of the viral DNA?
    (A) The Centers for Disease Control and Prevention.
    (B) A World Health Organization collaborating center.
    (C) The American Type Culture Collection.
    (D) A colleague with a variola virus clone.
    (E) Distribution of a full-length viral genome is prohibited.

Answer 10

e

Question 11

11. Laboratory scientists who work with vaccinia virus-infected cultures or animals are at risk of accidental exposure to the virus. Which of the following procedures by the laboratory worker is of least benefit in protecting against inadvertent infection with vaccinia virus?
    (A) Proper use of personal protective equipment such as gloves and goggles
    (B) Cleaning of laboratory work space before experimentation
    (C) Smallpox vaccination
    (D) Safe needle-handling practices
    (E) Use of biosafety hoods

Answer 11

b

Question 12

12. Vaccinia virus has all of the following attributes except
    (A) Can cause severe localized or disseminated disease.
    (B) Is a live, attenuated smallpox virus.
    (C) Can induce immunity that lasts only a few years.
    (D) Has been in use for more than 200 years.
    (E) Gene sequences coding for other viral proteins can be
    inserted into its genome.

Answer 12

b

Question 13

13. The eradication of smallpox was facilitated by several features
    of the virus. Which one of the following contributed least to eradication?
    (A) It has one antigenic type.
    (B) Inapparent infection is rare.
    (C) Administration of live vaccine reliably induces immunity.
    (D) It multiplies in the cytoplasm of infected cells.

Answer 13

d

Question 14

14. Vaccination with the vaccinia (smallpox) vaccine protects against infections by the following poxviruses except
(A) Molluscumcontagiosum
 (B) Variola
(C) Cowpox
(D) Monkeypox

Answer 14

a