VIRUSES AND RICKETTSIAE

_____QUESTIONS_______________________________________________________
INSTRUCTIONS: each of the questions
or incomplete statements that follow
comprises 5 suggested responses.
Select the best answer.
1. Tae 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 gastroenterit

6.

7.

8.

9.

is 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
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
the largest of the virus believed
to cause AIDS is the
a. Blymphocyte
b. Hepatocyte
c. Granulocyte
d. Erythrocyte
e. T-helper cell
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
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. Yellow fever
b. Kyasanur fever
c. Congo-Crimean hemorrhagic
fever
d. Marburg-Ebola hemorrhagic
fever
e. Lassa fever
13. Rocky Mountain spotted fever is
transmitted by the bite of a tick
congenitally infected with
a. Rickettsia akari
b. Rickettsia conorii
c. Rickettsia rickettsii

d. Rickettsia prowazekii
e. 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.
b.
c.
d.
e.

Variola
Vaccinia
Varicella
Rubeola
Dengue

15. The etiologic agents of many

common colds are RNA viruses known
as
a.
b.
c.
d.
e.

orthomyxoviruses
paramyxoviruses
rhinoviruses
togaviruses
adenoviruses

16. The disease of domestic fowl and

wild birds that is caused by a
paramyxovirus is
a.
b.
c.
d.
e.

Newcastle disease
Whitepox
Avian leukemia
Norwalk disease
Psittacosis

17. The acidophilic inclusion bodies

that are pathognomonic of rabies are
a.
b.
c.
d.
e.

Koplick bodies
Negri bodies
Owl-eye bodies
Donovan bodies
Schuffner bodies

18. Which of the DNA viruses is the

causative agent of molluscum
contagiosum?
a. Herpesviruses

b.
c.
d.
e.

Poxviruses
Papovaviruses
Iridoviruses
Adenoviruses

19. Transmission of the sylavatic form

of typhus infection caused by
Rickettsia prowazekii is associated
with
a.
b.
c.
d.
e.

Bats
Human body lice
Rabbits
Flying squirrels
Parrots

20. The mild type of typhus fever is

caused by recrudescence of an initial
attack of epidemic typhus is known as
a.
b.
c.
d.
e.

Sao Paulo typhus

Tsutsugamushi disease
Brill-Zinsser disease
Boutonneuse fever
Q fever

21. The causative agent of endemic or

murine typhus is
a.
b.
c.
d.
e.

Rickettsia
Rickettsia
Rickettsia
Rickettsia
Rickettsia

typhi
prowazekii
akari
conorii
tsutsugamushi

22. Rickettsia akari is the causative

agent of
a.
b.
c.
d.
e.

Boutonneuse fever
Rickettsial pox
Siberian tick typhus
Rural typhus
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.
b.
c.
d.
e.

Rochalimaea Quintana
Rickettsia tsutsugamushi
Coxiella burnetti
Rickettsia rickettsii
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. Reyes syndrome
b. Subacute sclerosing
panencephalitis
c. Progressive multifocal
leukoencephalopathy
d. Kuru
e. Guillain-Barre syndrome
28. Jaundice is a major clinical
symptom of which of the ff viral
infections?
a.
b.
c.
d.
e.

Infectious mononucleosis
Varicella
Hepatitis
Rabies
Colorado tick fever

29. One of the herpesviridae, EpsteinBarr virus, is the causative agent of

a.
b.
c.
d.
e.

Infectious mononucleosis
Shingles
Fever blisters
Molluscum contagiosum
Dengue

30. The poliovirus, an RNA virus, is

an/a
a.
b.
c.
d.
e.

Coxsackievirus
Echovirus
Rhinovirus
Enterovirus
Aphthovirus

31. The infectious agent of hepatitis B

is presumed to be
a.
b.
c.
d.
e.

The Donovan body

The Dane particle
Schuffners dots
The Delat agent
Koplicks spots

32. The vast majority of all cases of

transfusion-associated hepatitis in the
1980s were attributed to
a.
b.
c.
d.
e.

Hepatitis A virus
Hepatitis B virus
Non-A, non-B hepatitis virus
Hepatitis D virus
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.
b.
c.
d.
e.

Papillomavirus
Flavivirus
Alphavirus
Bunyavirus
Morbillivirus

35. Colorado tickfever is a viral

disease transmitted by the
a.
b.
c.
d.
e.

Body louse
Rat flea
Aedes aegypti mosquito
Triatomid bug
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.
b.
c.
d.

Intrinsic factor
Colicin
Interferon
Pyocin

e. Bacteriocin
37. The tubular cells of the human
kidney shed which of the ff viruses for
prolonged periods?
a.
b.
c.
d.
e.

Epstein-Barr virus
Adenovirus
Rubella virus
Cytomegalovirus
Rhabdovirus

38. The togavirus known to produce

fetal defects is
a.
b.
c.
d.
e.

Varicella
Rotavirus
Rubella
Dengue
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.
b.
c.
d.
e.

Epstein-Barr virus infection

Rubella virus infection
Herpes-simplex virus infection
Cytomegalovirus infection
Variola virus infection

40. Herpes simplex virus causes

rapidly fatal infections in
a.
b.
c.
d.
e.

Elderly patients
Diabetics
Neonates
Sickle cell patients
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.
b.
c.
d.
e.

Influenza
Rubella
Varicella-zoster
Rotavirus
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.
b.
c.
d.
e.

Dengue
Cytomegalovirus
Adenovirus
Hepatitis A
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.
b.
c.
d.
e.

Attachment
Penetration
Replication
Release
Mitosis

46. Opportunistic diseases that are

closely associated with the AIDS
include all of the ff except
a.
b.
c.
d.
e.

Plasmodium sp
Cryptosporidium sp
Cytomegalovirus
Pnemocystic carinii
Mycobacterium aviuminbacellulare

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.
b.
c.
d.
e.

Cytoplasm
DNA or RNA
Bothe DAN and RNA
Amino acids
Mitochondria

49. Viruses have been successfully

detected by the use of the ff except
a.
b.
c.
d.
e.

EM
Immunofluorescence
Growth on selective agar media
CPE
ELISA

50. Herpes labialis is also known as

a.
b.
c.
d.
e.

Voncents angina
Cold sore
Diaper rash
Thrush
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

5.

6.

7.

8.

examination is possible
using stains such as Giemsa,
Machiavello, or Gimenez.
(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.
(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.
(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 T-helper
cells, which could normally
function to control disease.
(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, Hep2, 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
infection is the severe ocular
disease known as
keratoconjunctivitis, which
typically occur in epidemic
form.
10.(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.
11.(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.
12.(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.(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.
14.(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.
15.(C) Rhinoviruses, members
of the picornavirus group,
are a common cause of
respiratory disease known as
the common cold.
16.(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.
17.(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.
18.(B) Molluscum contagiosum
is an infectious disease with
worldwide distribution
caused by poxvirus.
19.(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.
20.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 BrillZinsser disease.
21.(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.
22.(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.
23.(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.
24.(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.
25.(A) Bartonella bacilliformis is
a hematotropic bacterium
included in the order
Rickettsiales. These garmnegative coccobacillary
organisms are transmitted to
humans by an arthropod
vector.
26.(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.
27.(D) Kuru, the 1st spongiform
encephalopathy proven to

be a viral origin, has an

incubation period of from 420 years. The ritualistic
practice of cannibalism
among highland natives of
New Guinea maintained the
incidence of disease.
28.(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.
29.(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.
30.30. (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.
31.31. (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.
32.32. (C) in 90% of all cases of
transfusion-associated hepat
itis the causative agent is
non-A, non-B hepatittis virus.
The majority of these cases
are caused by HCV.
33.33. (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.
34.34. (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.
35.35. (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.

36.36. (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.
37.37. (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.
38.38. (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.
39.39. (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.
40.40. (C) there are 2 types of
herpes simplex viruses (HSV1, 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.
41.41. (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.
42.42. (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.
43.43. (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.
44.44. (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.

45.45. (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.
46.46. (A) the immunologic
abnormalities demonstrated
by AIDS patients predispose
them to a variety
of opportunistic
pathogens. Plasmodium sp
are not opportunistic
pathogens
47.47. (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.

48.48. (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.
49.49. (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.
50.
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 fluidfilled vesicles, which burst or
dry within 6-10 days.