VIRUSES AND RICKETTSIAE

1. The retrovirus responsible for causing AIDS is

known by the name
a.
HSV-I
b.
EBV
c.
HIV
d.
HAV
e.
CMV
2. The appearance of Koplik spots in the oral
mucosa of patients is characteristic of infection
with what viral agent?
a. Rabies
b. Hepatitis
c. Yellow fever
d. Dengue
e. Measles
3. Ornithodoros hermsi is an important vector for
the transmission of the etiologic agaent of what
disease, which id characterized by a febrile
illness, with spontaneous resolution and
subsequent recrudescence days later?
a. Borreliosis
b. Tularemia
c. Leptospirosis
d. Campylobacteriosis
e. Nocardiosis
4. For nonspecific staining of Rickettsia the
recommended stain is
a. Wright stain
b. Kinyoun stain
c. Grocott-Gomori stain
d. Gram stain
e. Gimenez stain
5. Rotavirus is the most common etiologic agent of
a. acute nonbacterial gastroenteritis in
infants and young children
b. chronic nonbacterial retinitis in children
c. chronic nonbacterial pharyngitis in
children and young adults
d. acute nonbacterial encephalitis in adults
6. Kaposis sarcoma and B cell lymphomas are
highly associated with what infectious group of
viral agents?
a. Reoviridae
b. Picornaviridae
c. Parvoviridae
d. Retroviridae
e. Bunyaviridae
7. the largest of the virus believed to cause AIDS is
the
a. Blymphocyte
b. Hepatocyte
c. Granulocyte
d. Erythrocyte
e. T-helper cell

8. The type of cell culture that best supports the

growth of human cytomegalovirus (CMV) is
a. Human fibroblast cells
b. HeLa cells
c. Hep-2 cells
d. Primary monkey kidney cells
e. Chicken embryo cells
9. Which of the ff viruses is predominantly
associated with respiratory disease and the cause
of epidemics of keratoconjunctivitis?
a. Bunyavirus
b. Arenavirus
c. Rotavirus
d. Adenovirus
e. Rhinovirus
10. A patient presented with multiple cold sores in
the mouth. Material from the mucocutaneous lesions
was obtained by needle aspiration and directly
inoculated to human embryonic fibroblasts. After 1
day, the cytopathic effect included foci of ballooned
and lysed cells. These data suggest infection with
a.
b.
c.
d.
e.

Adenovirus
Epstein-Barr virus
Herpes simplex virus
Hepadnavirus
Cytomegalovirus

11. The method of choice for the presumptive

diagnosis of an enterovirus infection with the
exception of group A coxsackieviruses is
a.
b.
c.
d.
e.

Cell culture
Electron microscope
Enzyme-linked immunoassay
Serologic screening
Viral neutralization

12. The highly fatal arena virus first described and

predominantly occurring in Africa is
a.
b.
c.
d.
e.

Yellow fever
Kyasanur fever
Congo-Crimean hemorrhagic fever
Marburg-Ebola hemorrhagic fever
Lassa fever

13. Rocky Mountain spotted fever is transmitted by the

bite of a tick congenitally infected with
a.
b.
c.
d.
e.

Rickettsia akari
Rickettsia conorii
Rickettsia rickettsii
Rickettsia prowazekii
Rickettsia tsutsugamushi

14. The viral disease shingles, which cause extreme

tenderness along the dorsal nerve roots and a vesicular
eruption, has the same etiologic agent as
a. Variola
b. Vaccinia
c. Varicella
d. Rubeola
e. Dengue
15. The etiologic agents of many common colds are
RNA viruses known as
a. orthomyxoviruses
b. paramyxoviruses
c. rhinoviruses
d. togaviruses
e. adenoviruses
16. The disease of domestic fowl and wild birds that is
caused by a paramyxovirus is
a. Newcastle disease
b. Whitepox
c. Avian leukemia
d. Norwalk disease
e. Psittacosis
17. The acidophilic inclusion bodies that are
pathognomonic of rabies are
a. Koplick bodies
b. Negri bodies
c. Owl-eye bodies
d. Donovan bodies
e. Schuffner bodies
18. Which of the DNA viruses is the causative agent of
molluscum contagiosum?
a. Herpesviruses
b. Poxviruses
c. Papovaviruses
d. Iridoviruses
e. Adenoviruses
19. Transmission of the sylavatic form of typhus
infection caused by Rickettsia prowazekii is associated
with
a. Bats
b. Human body lice
c. Rabbits
d. Flying squirrels
e. Parrots
20. The mild type of typhus fever is caused by
recrudescence of an initial attack of epidemic typhus is
known as
a. Sao Paulo typhus
b. Tsutsugamushi disease
c. Brill-Zinsser disease
d. Boutonneuse fever
e. Q fever

21. The causative agent of endemic or murine typhus is

a. Rickettsia typhi
b. Rickettsia prowazekii
c. Rickettsia akari
d. Rickettsia conorii
e. Rickettsia tsutsugamushi
22. Rickettsia akari is the causative agent of
a. Boutonneuse fever
b. Rickettsial pox
c. Siberian tick typhus
d. Rural typhus
e. Trench fever
23. The classic European or epidemic typhus fever is
caused by
a. Rickettsia canada
b. Rickettsia prowazekii
c. Rickettsia typhi
d. Rickettsia rickettsii
e. Rickettsia tsutsugamushi
24. The causative agent of scrub typhus, the rickettsial
disease prevalent in the Far East, which is similar to
spotted fever, is
a. Rochalimaea Quintana
b. Rickettsia tsutsugamushi
c. Coxiella burnetti
d. Rickettsia rickettsii
e. Bartonella bacilliformis
25. The etiologic origin of the South and Central
American diseases Oroya fever and verruga peruana is
the small, motile, aerobic, gram-negative bacillus
a. Bartonella bacilliformis
b. Streptobacillus moniliformis
c. Calynmatobacterium granulomatis
d. Rochalimaea Quintana
e. Branhamella catarrhalis
26. routine bacteriologic and ova parasite examinations
were found to be negative on specimens taken from a
baby who was admitted to the hospital for dehydration
due to severe diarrhea. Which of the ff additional tests
would be most appropriate given the case history to
date?
a. McCoy cell inoculation for Chlamydia
b. Urine microscopic analysis for presence of
CMV cellular inclusion bodies
c. Heterophile antibody test
d. Rotavirus antigen assay
e. Weil-Feli for rickettsial antigen detection
27. The chronic human degenerative viral disease of the
CNS seen among New Guineans that is spread by
ritualistic cannibalism is
a.
b.
c.
d.
e.

Reyes syndrome
Subacute sclerosing panencephalitis
Progressive multifocal leukoencephalopathy
Kuru
Guillain-Barre syndrome

28. Jaundice is a major clinical symptom of which of the

ff viral infections?
a. Infectious mononucleosis
b. Varicella
c. Hepatitis
d. Rabies
e. Colorado tick fever
29. One of the herpesviridae, Epstein-Barr virus, is the
causative agent of
a. Infectious mononucleosis
b. Shingles
c. Fever blisters
d. Molluscum contagiosum
e. Dengue
30. The poliovirus, an RNA virus, is an/a
a. Coxsackievirus
b. Echovirus
c. Rhinovirus
d. Enterovirus
e. Aphthovirus
31. The infectious agent of hepatitis B is presumed to be
a. The Donovan body
b. The Dane particle
c. Schuffners dots
d. The Delat agent
e. Koplicks spots
32. The vast majority of all cases of transfusionassociated hepatitis in the 1980s were attributed to
a. Hepatitis A virus
b. Hepatitis B virus
c. Non-A, non-B hepatitis virus
d. Hepatitis D virus
e. Hepatitis A abd B virus
33. What is a rare but possibly a serious complication ff
a small pox vaccination?
a. Dengue
b. Polio
c. Subacute sclerosing panencephalitis
d. Vacemia
e. Reyes syndrome
34. Warts are characteristically produced when human
are infected with a ___________ virus.
a. Papillomavirus
b. Flavivirus
c. Alphavirus
d. Bunyavirus
e. Morbillivirus
35. Colorado tickfever is a viral disease transmitted by
the
a. Body louse
b. Rat flea
c. Aedes aegypti mosquito
d. Triatomid bug
e. Wood tick

36. The heterozygous class of proteins the possesses the

biologic effect of being able to inhibit intracellular
replication of viruses is called
a. Intrinsic factor
b. Colicin
c. Interferon
d. Pyocin
e. Bacteriocin
37. The tubular cells of the human kidney shed which of
the ff viruses for prolonged periods?
a. Epstein-Barr virus
b. Adenovirus
c. Rubella virus
d. Cytomegalovirus
e. Rhabdovirus
38. The togavirus known to produce fetal defects is
a. Varicella
b. Rotavirus
c. Rubella
d. Dengue
e. Influenza
39. intranuclear inclusions were found in epithelial cells
from the urine of an infant who was admitted from
symptoms of low birth weight, jaundice, and neurologic
defects. The most likely clinical diagnosis in this case
would be
a. Epstein-Barr virus infection
b. Rubella virus infection
c. Herpes-simplex virus infection
d. Cytomegalovirus infection
e. Variola virus infection
40. Herpes simplex virus causes rapidly fatal infections
in
a. Elderly patients
b. Diabetics
c. Neonates
d. Sickle cell patients
e. Sexually active women
41. Select the statement that is correct concerning the
influenza viruses.
a. Pandemics are characteristically produced by
influenza A
b. They are DNA viruses
c. The virus is transmitted by insect vector
d. The incidence of infection peaks in the summer
months
e. Humans are the only animal hosts for influenza
viruses.
42. An example of a latent viral infection in man is
a. Influenza
b. Rubella
c. Varicella-zoster
d. Rotavirus
e. Delta virus

43. The use of cell cultures has enabled microbiologists

to isolate and identify many clinically important viruses.
However, in some diseases the agents are best diagnosed
by serologic testing; such an agent is
a. Dengue
b. Cytomegalovirus
c. Adenovirus
d. Hepatitis A
e. Measles virus
44. Which of the ff may be associated by the rubella
virus?
a. A DNA virus
b. The agent responsible for subacute sclerosing
panencephalitis
c. Able to produce defects in fetuses during the
early stages of pregnancy
d. Transmitted by an arthropod vector
e. A member of the same paxonomic family as
measles virus
45. Steps involved in virus pathology include all of the ff
except
a. Attachment
b. Penetration
c. Replication
d. Release
e. Mitosis

46. Opportunistic diseases that are closely associated

with the AIDS include all of the ff except
a. Plasmodium sp
b. Cryptosporidium sp
c. Cytomegalovirus
d. Pnemocystic carinii
e. Mycobacterium avium-inbacellulare
47. Which of the ff is a progressive neurologic disorder
caused by a viral agent termed a slow virus?
a. Hepatitis
b. Chicken pox
c. Dengue
d. Caeutzfeldo-Jakob disease
e. Yellow fever
48. The genome of a virus may consist of
a. Cytoplasm
b. DNA or RNA
c. Bothe DAN and RNA
d. Amino acids
e. Mitochondria
49. Viruses have been successfully detected by the use of
the ff except
a. EM
b. Immunofluorescence
c. Growth on selective agar media
d. CPE
e. ELISA
50. Herpes labialis is also known as
a. Voncents angina
b. Cold sore
c. Diaper rash
d. Thrush
e. Genital wart

_____________ANSWERS________________________________________________________

1. (C) Retroviruses are RNA tumor viruses, which

were first identified in 1911 as the etiologic agent of
a leukemia in poultry. In human injections with
retroviruses, normal T cells are major target. It is the
human T cell lymphotropic virus (HIV) that has
been isolated in cases of AIDS.
2. (E) Measles is a common childhoods disease.
Infection with this virus is followed by a prodromal
syndrome characterized by cough, coryza,
conjunctivitis, and fever. The most characteristic,
lesions, Koplik spots, are seen on the buccal mucosa.
Koplik sots are diagnostic for measles infection.
3. (A) The soft-shelled tick Ornithodoros hermsi is the
arthropod vector for Borellia hermsii, one of the
etiologic agents of relapsing fever in N.America.
Borellia are species specific in that they perpetuated
and transmitted exclusively by their specific tick
vector.
4. (E) Rickettsia is generally obligate intracellular
parasites that are seen in smears of infected cells as
rod-like forms, which may be in pairs. Direct
microscopic examination is possible using stains
such as Giemsa, Machiavello, or Gimenez.
5. (A) One of the major viral agents associated with
cases of acute gastroenteritis is the rotavirus. In
particular this agent is the cause of epidemic
nonbacterial gastroenteritis in infants and young
children that occurs most commonly during the
winter months.
6. (D) The family of viruses known as the Retroviridae
contains the subfamily Lentiviridae. This subfamily
contains the human T cell lymphotropic virus, HIV,
which causes AIDS. Kaposis sarcoma and B cell
lymphomas are associated with a loss of T-helper
cell function, which predisposes the patient to
assault by a variety of infectious agents.
7. (E) HIV, a human cell lymphotropic virus, is a
member of a group known as retroviruses. The
major target of the virus in this syndrome is the Thelper cells, which could normally function to
control disease.
8. (A) Commercially available cell cultures of human
fibroblasts are optimal for the cultivation of CMV.
The humancytomegalovirus will not replicate in
other standard cell culture systems such as HeLa,
Hep-2, or PMK.
9. (D) Adenoviruses are well known as respiratory
pathogens, having been the cause of acute
respiratory disease among military recruit
populations. Also associated with adenorviral

10.

11.

12.

18.

19.

20.

21.

22.

23.

infection is the severe ocular disease known as

keratoconjunctivitis, which typically occur in
epidemic form.
(C) Cell cultures recommended for the isolation of
herpes simplex virus are human embryonic
fibroblasts. Early detection of CPE at 24 hours is
dependent on the concentration of virus present in
the inoculum.
(A) The diagnosis of enetrovirus infection from
clinical specimens is best accomplished by the cell
culture technique. A dual cell culture system of
primary monkey kidney and human diploid
fibroblast cells is recommended for optimal
sensitivity and rapid recovery.
(E) The first case of Lassa fever occurred in Nigeria
and was described in 1969. It is believed the primary
infection results from contact with infected rodent
urine. Secondary cases have resulted from contact
with an index case or contact with infectious
material such as blood.
13.
14.
15.
16.
17.
(C) Transovarian passage form generation to
generation in the tickas perpetuates Rickettsia
reckettsii for several generations outside an animal
host. A blood meal serves to reactivate the
reckettsiae carried by the arthropos vector.
(C) Zoster and shingles occur predominantly in
adults whereas varicella occurs more commonly in
children. The varicella virus, following the primary
infection, known as chicken pox, remains latent in
the sensory ganglia. Reactivation of this virus, which
may occur years later, is usually associated with an
iimunocompromised state.
(C) Rhinoviruses, members of the picornavirus
group, are a common cause of respiratory disease
known as the common cold.
(A) Newcastle disease is e disease of birds that may
be transmitted to humans by contact with infected
birds. Outbreaks of this disease in domestic poultry
flocks can produce heavy economic losses.
(B) Rabies is a neurotopic virus causing extensive
destruction in the brain. Negri bodies are seen in the
cytoplasm of large ganglion cells and are
demonstrated by Sellers stain and the fluorescent
antibody staining technique.
(B) Molluscum contagiosum is an infectious disease
with worldwide distribution caused by poxvirus.

24. (D) Flying squirrels are associated with cases of the

sylvatic form of typhus in the US. The squirrel louse
transmits the rickettsia among the squirrel
population.
25. Humans who have had the classic form of typhus
fever remain infected with the causative agent
Rickettsia prowazekii. Relapses of recrudescence of
disease may occur in these persons years or decades
after the initial attack. The latent form of infection is
known as Brill-Zinsser disease.
26. (A) Murine typhus is transmitted to man by fleas
with Rickettsia thpyi. Prevalent in the southern US,it
is primarily a disease or rodents that os transmitted
to man.
27. (B) Rickettsia akari, transmitted by mites is the only
rickettsiae of the spotted fever group not transmitted
by ixodid ticks. Rickettsial pox is chacraterized by a
mild fibril disease with a rash and eschar at the bite
site.
28. (B) Epidemic typhus fever is caused by Rickettsia
prowazekii, which is transmitted by the human body
louse Pediculus humanus. A severe headache, chills,
fever, and a rash are symptoms of typhus fever.
29. (B) Rickettsia tsutsugamushi is the causative agent
of this disease, which is characterized by headache,
orbital pain, rash and fever. The organism is carried
by infected rodents and transmitted to man by the
bite of infected mites.
30. (A) Bartonella bacilliformis is a hematotropic
bacterium included in the order Rickettsiales. These
garm-negative coccobacillary organisms are
transmitted to humans by an arthropod vector.
31. (D) Rotavirus is the cause of diarrheal disease in
approximately half of all infants and young children
admitted to the hospital by dehydration requiring
fluid replacement therapy. Since rotaviruses are
difficult to propagate in cell culture, the method of
choice is the direct examination of stool form the
patient for the presence of viral antigen. Rotavirus
antigen assay tests employ a solid phase previously
coated with antibody to which the stool sample is
applied.
32. (D) Kuru, the 1st spongiform encephalopathy proven
to be a viral origin, has an incubation period of from
4-20 years. The ritualistic practice of cannibalism
among highland natives of New Guinea maintained
the incidence of disease.
33. (C) Viral hepatitis is one of several infectious
diseases that damages the liver and produces
jaundice. The appearance of jaundice in the icteric

phase is correlated by liver biopsy with extensive

parenchymal destruction.
34. (A) The double-stranded DNA enveloped,
icosahedral viruses known as the family
herpesviridae contain the Epstein-Barr virus, which
is associated with Burkitts lymphoma and is the
etiologic agent of infectious mononucleosis.
35. 30. (D) all the viruses listed are members of the
family of small RNA viruses known as Picorna
viridae. Poliovirus and enterovirus is shed by both
respiratory and fetal coates. Lab identification relies
on isolation especially from feces an subsequent
virus neutralization in tissue culture. Spread of the
disease is associated with poor sanitary conditions
and crowding.
36. 31. (B) the Dano particle, a DNA-containing
particle, is 42 mm in diameter. The outer envelope
of this particle contains the hepatitis B
surface antigen. There is no cell culture
system known that will support in vitro growth of
this virus.
37. 32. (C) in 90% of all cases of transfusionassociated hepatitis the causative agent is non-A,
non-B hepatittis virus. The majority of these cases
are caused by HCV.
38. 33. (D) vaccinia infection is a possible
complication ff vaccination for small pox. vaccinia
may cause encephalitis or less severe form, such
as erythema multiforme. Contact with recently
vaccinated family members or friends may also
produce cases of vaccinia.
39.
40.
41.
42. 34. (A) the etiologic agents for the numerous
benign cutaneous mucosal lesions known as warts
are the human papillomaviruses. The diagnosis of
lesions caused by theses agents is based on the
clinical appearance and histopathology, since there
are no in vitro systems available for isolation.
43. 35. (E) the wood tick which becomes naturally
infected with the virus is apparently the sole vector
of the infection. Colorado tick fever is a seasonal
problem with the majority of cases being reported
between March and July in the western mountainous
regions in the US.

44. 36. (C) interferon inhibits viral perotein

synthesis, which is required fro replication. The
mode is to induce the host cell to produce at least 2
antiviral proteins. The signal that leads to interferon
production appears to be double-stranded RNA.
45. 37. (D) cytomegalovirus infections in humans
may be asymptomatic for normal healthy hosts.
Infections tend to be more severe in patients who are
immunosuppressed or neonates infected perinatally.
Cytomegalovirus is readily isolated from urine.
46. 38. (C) the rubella virus is an RNA virus. When
a pregnant woman becomes infected, the
consequences are very serious. If the fetus becomes
infected during the 1st trimester, a variety of
congenital defects may result such as cataracts,
deafness, and cardiac problems.
47. 39. (D) infants usually acquire cytomegalovirus
infection before birth or at the time of delivery.
These infections may lead to death during the
1st months of life por may result in residual
neurologic impairment.
48.
49.
50.
51. 40. (C) there are 2 types of herpes simplex
viruses (HSV-1, HSV-2), both are associated with
latent infections. In patients with immune
deficiencies such as neonates and those who are
undergoing immunosuppressive therapy
with anticancer drugs or steroids, HSV infection are
often life- threatening.
52. 41. (A) influenza viruses are RNA viruses that
enter the human body through the respiratory tract.
These important pathogens are associated with
epidemic and pandemic disease.
53. 42. (C) herpes simplex and Varicella-zoster
viruses produce latent infections. The genomes of
these viruses can remain dormant for decades within
host cells. Shingles is a secondary infection due to
reactivation of latent VZV.
54. 43. (D) isolation of hepatitis A virus (HAV) from
clinical material is not sensitive enough for
diagnostic identification and isolation purposes.
Rapid diagnosis of HAV is best achieved by
serologic testing.

55. 44. (C) the rubella virus causes an

exanthematous disease resembling a milder form of
measles in children. It is transmitted form person to
person and is of medical medical importance to
females in childbearing age due to teratogenic
effects it has on fetus. Congenital rubella resulting
form an intrauterine fetal infection is most severe
when contracted during the 1st trimester.
56. 45. (E) lacking essential components for
synthesis of macromolecules, viruses are not able to
produce by binary fission. Host cells are required to
provide the needed mechanisms for the synthesis of
viral components. The replicative cycle has 4 stages:
absorption, penetration, eclipse, and release.
57. 46. (A) the immunologic abnormalities
demonstrated by AIDS patients predispose them to a
variety of opportunistic pathogens. Plasmodium sp
are not opportunistic pathogens
58. 47. (D) Creutzfeldt-Jakob disease has a wide
geographic distribution and is caused by slow virus.
These infections have a long period of latency
between infection and development of illness. The
clinical syndrome produced includes progressive
cerebellar ataxia and tremors. Slow viruses are
atypical in thee characteristics and produce
noninflammatory subacute degenerative disease of
the CNS.
59. 48. (B) viruses are obligate intracellular
parasites consisting of either RNA or DNA, but
never both. The nucleic acid may be single or double
stranded and in many possible forms. Viruses are
divided into families based on the type of NA in
virion.
60. 49. (C) de to their nature of obligate intracellular
parasites, successful cultivation of viruses requires
living cells. Cell culture provides homogenous host
cell systems, which are easily handled, stable for
long periods, and not susceptible to host factors such
as stress and physiologic changes.
61.
50. (B) cold sores and fever blisters are
caused by herpes simplex virus; type I. this recurrent
herpetic infection is characterized but initial
sensations of burning, pain, and irritation at the site
with the rapid appearance of a cluster of
erythematous papules. The papules quickly develop
into thin walled fluid-filled vesicles, which burst or
dry within 6-10 days.