1
Multiple Choice Questions - Paper 1
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 thin it is true !T", false !F", or don#t now !$%". &ou &ou must fill in the relevant square with a blac pen. 'ne mar will be (iven for each correct answer and one mar deducted for each incorrect answer. &ou &ou will not be mared for those questions for which you have indicated )don#t now).
1. Viruses
*ontain both $%+ and %+ -ay have an envelope ave their own metabolism -ay contain en/ymes for replication *ell wall
2. The following are DN !iruses
erpesviruses 'rthomyxoviruses Enteroviruses epadnaviruses arvoviruses
". The following are #N !iruses
icornaviruses +denoviruses
2
apillomaviruses habdoviruses otaviruses
$. %i!e attenuated !accines are a!aila&le against the following !iruses
1nfluen/a + 2irus epatitis 2irus ubella 2irus &ellow Fever 2irus 2aricella4oster 2irus
'. The following anti!iral agents is acti!e against the following !irus
6amivudine and 12 6amivudine and 2 +mantidine and 1nfluen/a virus ibavirin and 72 +cyclovir and 72
(. )erpes *i+ple, ncephalitis
*ommonly affect the temporal lobe 1s usually dia(nosed by culture of the *7F -ay be dia(nosed by * of the *7F
3
7hould be treated with 12 (anciclovir -ay be dia(nosed by the findin( of specific antibody in the *7F
. The following state+ents are true of Varicella-/oster Virus
*auses a maculopapular rash espond to +T therapy emains latent in sensory (an(lia followin( primary infection ecurrent episodes of 7hin(les usually occur atients with shin(les are not infectious
0. Cto+egalo!irus CMV3
rimary infection is usually symptomatic +n infectious mononucleosis4lie syndrome may occur durin( primary infection. -ay cause severe infection in immunocompromised individuals 1s terato(enic *auses 8awasai9s $isease
4. pstein-5arr Virus 5V3 is associated with
1nfectious -ononucleosis epatitis uritt9s lymphoma %asopharyn(eal carcinoma 'ral leuoplaia
16. ))V-( is associated with
4
Fifth disease oseala 1nfantum 8aposi9s 7arcoma 1nfectious -ononucleosis4lie illness 'ral leuoplaia
11. deno!iruses
+re associated with (enital cancers -ay cause (astroenteritis -ay cause con:unctivitis -ay cause pneumonia -ay cause warts
12. Papillo+a!iruses
24; and 24<< are associated with (enital cancers 24<; and 24<= are associated with (enital cancers >arts caused by papillomaviruses may respond to interferon therapy apillomavirus infection is commonly dia(nosed by viral culture +re associated with pro(ressive multifocal leucoencephalopathy !-6"
1". Co,sac7ie 5 Virus is associated with the following
aralytic illness -yocarditis
5
ornholm9s disease 7evere con(enital infection -enin(itis
1$. Influen8a Virus
-ay under(o anti(enic shift and anti(enic drift -ay cause pandemics espond to rimantidine espond to neuraminidase inhibitors 2accination confers lifelon( protection
1'. Para+,o!iruses +a cause
*roup -aculopapular rash neumonia ronchiolitis $iarrhoea
1(. #espirator *nctial Virus #*V3
espond to +mantidine -ay cause bronchiolitis -ay cause croup -ay cause pneumonia
6
-ay be prevented by vaccination
1. Par!o!iruses
*auses oseola 1nfantum *auses Erythema 1nfectiousum 1s terato(enic -ay cause abortion -ay cause aplastic crisis in persons with haemolytic anaemias
10. Measles Virus Infection
*auses a vesicular rash -ay cause encephalitis -ay respond to acyclovir -ay be prevented by %1? -ay be prevented by vaccination
14. #u&ella Virus
The rash of rubella is similar to that caused by parvo and enteroviruses 1s terato(enic *on(enital rubella is charaterised by eye, ear and heart defects *on(enital rubella is dia(nosed by the findin( of rubella4specific antibody in the cord blood of infants 1nfants with con(enital rubella poses a (reat infectious ris.
26. )u+an T-l+photropic !irus 1 )T%V-13 is associated with
uritt9s lymphoma +dult T4cell lymphoma
7
Tropical 7pastic araparesis -ultiple 7clerosis od(in9s lymphoma
21. )IV Infection +a lead to
$ementia *hronic $iarrhoea *-2 retinitis 'esopha(eal candidiasis %on4od(in9s lymphoma
22. The following +a &e useful for prognostic purposes in )IV-infected indi!iduals
12 envelope antibody 124p@A anti(en *$A count 12 pro4viral $%+ in leucocytes 12 plasma %+
2". chronic carrier state +a occur in the following9
antavirus 1nfection epatitis + epatitis epatitis *
8
7mallpox 1nfection
2$. The following +ar7ers are usuall present in a hepatitis 5 carrier with chronic acti!e hepat
be+( +nti4c 1(? +nti4c 1(24$%+ bs+(
2'. The following state+ents are true
*hronic 2 infection may respond to interferon therapy *hronic *2 infection may respond to interferon therapy *hronic *2 infection may respond to ribavirin therapy epatitis $elta infection may be prevented by vaccination a(ainst 2 epatitis E 1nfection may be prevented by vaccination
2(. The following !iruses can &e trans+itted & &lood
epatitis + 12 T624< 2 *2
2. #egarding !iral infection of the central ner!ous sste+ CN*3
9
-enin(itis may occur to(ether with encephalitis Enteroviruses are one of the commonest causes of *%7 infections in childhood 72 encephalitis is a postinfectious encephalomyelitis -easles encephalitis is a postinfectious encephalomyelitis The detection of antibody in the *7F is a useful dia(nostic marer
20. The following !iruses are associated with gastroenteritis
+stroviruses %orwal4lie viruses *aliviruses +denoviruses otaviruses
24. The following !iruses are trans+itted fro+ ani+als to hu+ans
abies 2irus olioviruses *-2 antaviruses 6assa Fever 2irus
"6. The following is true of ra&ies !irus
The ma:ority of cases worldwide result from bat bites 1nfection may be prevented by active and passive immunisation abies vaccine is a live attenuated vaccine The animal reservoir differ from country to country -ay be dia(nosed by serolo(y
10
nswers to Mulitple Choice Questions - Paper 1
1. Viruses
*ontain both $%+ and %+ -ay have an envelope
11
ave their own metabolism -ay contain en/ymes for replication *ell wall ts
2iruses contain either $%+ or %+ but not both. 7ome may have an envelope. Bnlie bacteria, they do not have a cell their own metabolism. They may contain en/ymes for replication.
2. The following are DN !iruses
erpesviruses 'rthomyxoviruses Enteroviruses epadnaviruses arvoviruses ts
erpesvirus and epadnaviruses are double stranded $%+ viruses. arvovirus is a sin(le stranded $%+ virus. 'rthomyx and enteroviruses are sin(les stranded %+ viruses.
". The following are #N !iruses
icornaviruses +denoviruses apillomaviruses habdoviruses otaviruses ts
+denoviruses and papillomaviruses are double standed $%+ viruses. icornaviruses and rhabdoviruses are sin(le strande viruses. otaviruses are double stranded %+ viruses.
$. %i!e attenuated !accines are a!aila&le against the following !iruses
1nfluen/a + 2irus epatitis 2irus
12
ubella 2irus &ellow Fever 2irus 2aricella4oster 2irus ts
6ive attenuated vaccines are available a(ainst rubella, yellow fever, and varicella4/oster viruses. 1nfluen/a + viral vaccin either inactivated split or subunit vaccines. The vaccines in current use a(ainst hepatitis are recombinant subunit vaccin
'. The following anti!iral agents is acti!e against the following !irus
6amivudine and 12 6amivudine and 2 +mantidine and influen/a virus ibavirin and 72 +cyclovir and 72 s
6amivudine is a reverse transcriptase inhibitor active a(ainst both 12 and 2. +mantidine is active a(ainst influen/a ibavirin is active a(ainst 72 and acyclovir a(ainst 72
(. )erpes *i+ple, ncephalitis
True
*ommonly affect the temporal lobe
False
1s usually dia(nosed by culture of the *7F
True
-ay be dia(nosed by * of the *7F
False
7hould be treated with 12 (anciclovir
True
-ay be dia(nosed by the findin( of specific antibody in the *7F
*omments
erpes 7implex Encephalitis commonly affect the temporal lobe. *ulture of the *7F is usually u is a much better choice. + dia(nosis can also be made by the detection of 724specific antibodies Encephalitis should be treated with 12 acyclovir.
. The following state+ents are true of Varicella-/oster Virus
13
False
*auses a maculopapular rash
False
espond to +T therapy
True
emains latent in sensory (an(lia followin( primary infection
False
ecurrent episodes of 7hin(les usually occur
False
atients with shin(les are not infectious
*omments
22 causes a vesicular rash. 1t does not respond to +T as it does not possess reverse transcripta sensory (an(lia followin( primary infection. 1t is rare for more than one episode of shin(les to oc infectious.
0. Cto+egalo!irus CMV3
True
rimary infection is usually symptomatic
True
+n infectious mononucleosis4lie syndrome may occur durin( primary infection.
True
-ay cause severe infection in immunocompromised individuals
False
1s terato(enic
False
*auses 8awasai9s $isease
*omments
rimary *-2 infection is usually asymptomatic. 'ccasionally, an infectious mononucleosis4lie primary infection. *-2 is well nown to cause severe disease in immunocompromised individua recipients and patients with +1$7. +lthou(h it may cause severe con(enital infection, it is not tera formed fetal or(ans. 1t is not associated with 8awasi9s disease.
4. pstein-5arr Virus 5V3 is associated with
True
1nfectious -ononucleosis
True
epatitis
True
uritt9s lymphoma
True
%asopharyn(eal carcinoma
True
'ral leuoplaia
*omments
+ll the above
14
16. ))V-( is associated with
False
Fifth disease !erythema infectiosum"
True
oseala 1nfantum
False
8aposi9s 7arcoma
True
1nfectious -ononucleosis4lie illness
False
'ral leuoplaia
*omments
arvovirus is associated with Fifth disease !erythema infectiosum". 24; is associated with 7ixt 24= is associated with 8aposi9s sarcoma. arely, in adults, primary 24; infection may resul mononucleosis4lie illness. E2 is associated with oral leuoplaia
11. deno!iruses
False
+re associated with (enital cancers
True
-ay cause (astroenteritis
True
-ay cause con:unctivitis
True
-ay cause pneumonia
False
-ay cause warts
*omments
uman papillomaviruses are associated with (enital cancers. +denoviruses type A0 and A< are as +denoviruses may also cause con:unctivitis and pneumonia. uman papillomaviruses are associa
12. )u+an Papillo+a!iruses
False
24; and 24<< are associated with (enital cancers
True
24<; and 24<= are associated with (enital cancers
True
>arts caused by papillomaviruses may respond to interferon therapy
False
apillomavirus infection is commonly dia(nosed by viral culture
False
+re associated with pro(ressive multifocal leucoencephalopathy !-6"
15
*omments
24<; and 24<= are associated with (enital cancers. >arts caused by papillomaviruses may althou(h it is rarely used. uamn apillomaviruses cannot be (rown in cell culture. olyomavirus
1". Co,sac7ie 5 Virus is associated with the following
True
aralytic illness
True
-yocarditis
True
ornholm9s disease
True
7evere con(enital infection
True
-enin(itis
*omments
+ll the above
1$. Influen8a Virus
True
-ay under(o anti(enic shift and anti(enic drift
True
-ay cause pandemics
True
espond to rimantidine
True
espond to neuraminidase inhibitors
False
2accination confers lifelon( protection
*omments
1nfluen/a + 2irus may under(o anti(enic shift and anti(enic drift. +nti(enic shifts result in pande respond to rimantidine, which is a similar compound to amantidine. 1t will also respond to newly inhibitors. ecause of constant anti(enic chan(es, vaccination will not confer lifelon( immunityD i
1'. Para+,o!iruses +a cause
True
*roup
False
-aculopapular rash
True
neumonia
True
ronchiolitis
False
$iarrhoea
16
*omments
aramyxoviruses most commonly cause croup. They may occasionally cause bronchiolitis and p
1(. #espirator *nctial Virus #*V3
False
espond to +mantidine
True
-ay cause bronchiolitis
True
-ay cause croup
True
-ay cause pneumonia
False
-ay be prevented by vaccination
*omments
72 will not respond to amantidine. 1t most commonly cause bronchiolitis and pneumonia. 'cca There is no vaccine available.
1. Par!o!iruses
False
*auses oseola 1nfantum
True
*auses Erythema 1nfectiousum
False
1s terato(enic
True
-ay cause abortion
True
-ay cause aplastic crisis in persons with haemolytic anaemias
*omments
arvovirus causes erythema infectiousum. +lthou(h it may cause abortion and stillbirths, it is not aplastic crisis in persons with haemolytic anaemias
10. Measles Virus Infection
False
*auses a vesicular rash
True
-ay cause encephalitis
False
-ay respond to acyclovir
True
-ay be prevented by %1?
17
True
-ay be prevented by vaccination
*omments
-easles causes a maculopapular rash. 1t may cause encephalitis. 1t does not respond to acyclovir. be protected by %1?. + live attenuated vaccine is now (iven as part of universal vaccination in
14. #u&ella Virus
True
The rash of rubella is similar to that caused by parvo and enteroviruses
True
1s terato(enic
True
*on(enital rubella is charaterised by eye, ear and heart defects
True
*on(enital rubella is dia(nosed by the findin( of rubella4specific antibody in the cord blood of in
True
1nfants with con(enital rubella poses a (reat infectious ris.
*omments
The rash of rubella is similar to that caused by parvo and enteroviruses. 1t is terato(enic, the class rubella consists of eye, ear and heart defects. *on(enital rubella can be dia(nosed by the findin( o the cord blood of infants.1nfants with con(enital rubella poses a (reat infectious ris since they m < year.
26. )u+an T-l+photropic !irus 1 )T%V-13 is associated with
False
uritt9s lymphoma
True
+dult T4cell lymphoma
True
Tropical 7pastic araparesis
False
-ultiple 7clerosis
False
od(in9s lymphoma
*omments
uman T4lymphotropic virus < !T624<" is associated with +dult T4cell lymphoma and Tropical
21. )IV Infection +a lead to
True
$ementia
True
*hronic $iarrhoea
18
True
*-2 retinitis
True
'esopha(eal candidiasis
True
%on4od(in9s lymphoma
*omments
+ll the above
22. The following +a &e useful for prognostic purposes in )IV-infected indi!idu
False
12 envelope antibody level
True
124p@A anti(en
True
*$A count
False
12 pro4viral $%+ in leucocytes
True
12 plasma %+
*omments
12 envelope antibody remains hi(h at a constant level throu(hout the period of infection and is marer. 124p@A anti(en had been widely used as a pro(nostic marer in the past but has now bee %+ !viral load". The *$A count provides important information on the sta(e of the disease.
2". chronic carrier state +a occur in the following9
False
antavirus 1nfection
False
epatitis +
True
epatitis
True
epatitis *
False
7mallpox 1nfection
*omments
+ chronic carrier state may occur with 2 and *2 infection.
2$. The following +ar7ers are usuall present in a hepatitis 5 carrier with chroni
True
be+(
True
+nti4c 1(?
False
+nti4c 1(-
19
True
24$%+
True
bs+(
*omments
1n patients with chronic active hepatitis, 2 replication is present and hence 24$%+ and b bc1(- is normally absent althou(h it may occasionally be detected durin( periods of exacerbati
2'. The following state+ents are true
True
*hronic 2 infection may respond to interferon therapy
True
*hronic *2 infection may respond to interferon therapy
True
*hronic *2 infection may respond to ribavirin therapy
True
epatitis $elta infection may be prevented by vaccination a(ainst 2
False
epatitis E 1nfection may be prevented by vaccination
*omments
*hronic 2 and *2 infection may respond to interferon therapy. *hronic *2 infection may however ribavirin is usually (iven with interferon. epatitis $elta infection may be prevented by There is no vaccine available a(ainst E2.
2(. The following !iruses can &e trans+itted & &lood
True
epatitis +
True
12
True
T624<
True
2
True
*2
*omments
+ll the above viruses may be transmitted by blood
2. #egarding !iral infection of the central ner!ous sste+ CN*3
True
-enin(itis may occur to(ether with encephalitis
20
True
Enteroviruses are one of the commonest causes of *%7 infections in childhood
False
72 encephalitis is a postinfectious encephalomyelitis
True
-easles encephalitis is a postinfectious encephalomyelitis
True
The detection of antibody in the *7F is a useful dia(nostic marer
*omments
-enin(itis usually occurs with encephalitis. Enteroviruses are one of the commonest causes of * 72 encephalitis result from invasion of the virus rather than an aller(ic postinfectious event as i detection of antibody in the *7F is a useful dia(nostic marer
20. The following !iruses are associated with gastroenteritis
True
+stroviruses
True
%orwal4lie viruses
False
icornviruses
True
+denoviruses
True
otaviruses
*omments
+lthou(h enteroviruses may be found in faeces, they are not associated with (astroenteritis
24. The following !iruses are trans+itted fro+ ani+als to hu+ans
True
abies 2irus
False
olioviruses
False
*-2
True
antaviruses
True
6assa Fever 2irus
*omments
abies may be transmitted to humans from a variety of mammals. antaviruses and 6assa Fever humans by rodents.
"6. The following is true of ra&ies !irus
False
The ma:ority of cases world4wide result from bat bites
21
True
1nfection may be prevented by active and passive immunisation
False
uman abies vaccine is a live attenuated vaccine
True
The animal reservoir differ from country to country
True
-ay be dia(nosed by serolo(y
*omments
The ma:ority of human rabies cases world4wide result from do( bites. 1nfection may be prevented immunisation. +lthou(h live attenuated vaccines are available for vaccinatin( animals, inactivate for safety reasons. -ay be dia(nosed by serolo(y.
