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Basic science Q 1 to Q 100

1 A 23-year-old woman with a natural menstrual cycle is nearing ovulation. The oocyte of a mature follicle will be induced to undergo the first meiotic division as a result of which of the following hormonal stimuli?

A. The cessation of progesterone secretion

B. The gradual elevation of follicle-stimulating hormone (FSH) titers

C. The low estrogen titers associated with the maturing follicle

D. The slow elevation of progesterone produced by luteal cells

E. The surge of luteinizing hormone (LH) initiated by high estrogen titers

2 Cells that form the three primitive germ layers are derived from which of the following?

A. Cytotrophoblast

B. Epiblast

C. Syncytiotrophoblast

D. Hypoblast

E. Yolk sac

3 In the developing human embryo/fetus, most of the internal organs begin to form in which month?

A. First

B. Second

C. Fourth

D. Sixth

E. Ninth

4 The ectoderm is derived directly from which of the following?

A. Hypoblast

B. Epiblastic cells that undergo gastrulation

C. Mesoderm

D. Endoderm

E. Nongastrulated epiblast

5 Fetal blood from the placenta is about 80% oxygenated. However, mix- ture with unoxygenated blood at various points reduces the oxygen content. Which of the following fetal vessels contains blood with the highest oxygen content?

A. Abdominal aorta

B. Common carotid arteries

C. Ductus arteriosus

D. Pulmonary artery

E. Pulmonary vein

6 Which of the following hematopoietic tissues or organs develops from endoderm?

A. Thymus

B. Tonsils

C. Bone marrow

D. Spleen

E. Blood islands

7 Which of the following processes places the developing heart in the presumptive thoracic region cranial to the septum transversum?

A. Gastrulation

B. Lateral folding

C. Cranial folding

D. Neurulation

E. Fusion of the endocardial heart tubes

8 Which of the following is in direct contact with maternal blood in lacunae of the placenta?

A. Cells of the cytotrophoblast

B. Extraembryonic mesoderm

C. Fetal blood vessels

D. Cells of the syncytiotrophoblast

E. Amniotic cells

9 During a visit to her gynecologist, a patient reports she received vita- min A treatment for her acne unknowingly during the first 2 months of an undetected pregnancy. Which of the following organ systems in the developing fetus is most likely to be affected?

A. The digestive system

B. The endocrine organs

C. The respiratory system

D. The urinary and reproductive systems

E. The skeletal and central nervous systems

10 The neural plate forms directly from which of the following?

A. Ectoderm

B. Endoderm

C. Somatopleuric mesoderm

D. Splanchnopleuric mesoderm

E. Hypoblast

11 Which of the following forms from paraxial mesoderm?

A. Adrenal cortex

B. Adrenal medulla

C. Humerus

D. Biceps brachii

E. Masseter

12 The cerebral cortex forms from which of the following?

A. Telencephalon

B. Myelencephalon

C. Metencephalon

D. Mesencephalon

E. Diencephalon

13 The primordial germ cells that eventually form the oogonia and sper- matogonia originate in which of the following?

A. Dorsal mesentery of the hindgut

B. Gonadal ridge

C. Endodermal lining of the yolk sac

D. Primary sex cords of the developing gonad

E. Chorion

14 Monozygotic twins arise by means of which of the following?

A. Fusion of the embryonic blastomeres from two zygotes

B. Fertilization of two oocytes by two sperm

C. Fertilization of one oocyte by two sperm

D. Division of the inner cell mass (embryoblast) into two embryonic primordia

E. Extra cleavage divisions of the zygote induced by the presence of a double chorion

15 In the developing embryo, the edge of the ectoderm is continuous with which of the following?

A. Chorion

B. Amniotic membrane

C. Yolk sac lining

D. Extraembryonic mesoderm

E. Adventitia of the umbilical vessels

16 Which of the following processes is responsible for fusion of the paired dorsal aortae?

A. Lateral folding

B. Craniocaudal folding

C. Looping of the heart tube

D. Neurulation

E. Gastrulation

17 The asymmetry of the cell membrane is established primarily by which of the following?

A. Membrane synthesis in the endoplasmic reticulum

B. Membrane modification in the Golgi apparatus

C. Presence of carbohydrates on the cytoplasmic surface

D. The distribution of cholesterol

E. Flipping proteins between the leaflets of the lipid bilayer

18 Which of the following is the function of the large subunit of the ribosome?

A. Bind messenger RNA (mRNA)

B. Bind transfer RNA (tRNA)

C. Catalyze peptide bond formation

D. Link adjacent ribosomes in a polyribosome

E. Initiate protein synthesis

19 The stability and arrangement of actin filaments as well as their prop- erties and functions depend on which of the following?

A. The structure of the actin filaments

B. Microtubules

C. Intermediate filament proteins

D. Actin-binding proteins

E. Motor molecules, such as kinesin

20 The primary function of intermediate filaments is which of the following?

A. Generate movement

B. Provide mechanical stability

C. Carry out nucleation of microtubules

D. Stabilize microtubules against disassembly

E. Transport organelles within the cell

21 Which of the following mechanisms is used to establish the mito- chondrial electrochemical gradient?

A. The action of ATP synthase

B. Transfer of electrons from NADH to O2 in the intermembrane space

C. Pumping of protons into the mitochondrial matrix by respiratory chain activity

D. Proton-translocating activity in the inner membrane

E. Transport of ATP out of the matrix compartment by a specific transporter

22 Endocytosis of low-density lipoprotein (LDL) differs from phagocytosis of damaged cells in which of the following?

A. Use of membrane-enclosed vesicles in the uptake process

B. Coupling with the lysosomal system

C. Dependence on acidification

D. Use of clathrin-coated pits

E. Use of hydrolases

23 Patients with Cushing’s syndrome often show osteoporotic changes. Which of the following is involved in the etiology of osteoporosis induced by Cushing’s syndrome?

A. Decreased glucocorticoid levels that result in decreased quality of the bone deposited

B. Excess deposition of osteoid

C. Stimulation of intestinal calcium absorption

D. Decreased PTH levels

E. Bone fragility resulting from excess bone resorption

24 A 5-year-old boy sustains a tear in his gastrocnemius muscle when he is involved in a bicycle accident. Regeneration of the muscle will occur through which of the following?

A. Differentiation of satellite cells

B. Dedifferentiation of myocytes into myoblasts

C. Fusion of damaged myofibers to form new myotubes

D. Hyperplasia of existing myofibers

E. Differentiation of fibroblasts to form myocytes

25 Which of the following is the primary regulator of salivary secretion?

A. Antidiuretic hormone

B. Autonomic nervous system

C. Aldosterone

D. Cholecystokinin

E. Secretin

26 A 4-day-old boy weighing 7 lb, 6 oz is brought to the emergency room by his parents. The examining emergency room physician notes that his skin and sclerae are icteric. A blood test indicates elevated unconju- gated bilirubin in the serum. The elevated bilirubin levels in this patient are most likely the result of which of the following?

A. Deficiency of enzymes regulating bilirubin solubility

B. Hepatocellular proliferation

C. Decreased destruction of red blood cells

D. Dilation of the common bile duct

E. Increased hepatocyte uptake of bilirubin

27 A 43-year-old man who recently returned from a trip to rural Peru presents with severe watery diarrhea, vomiting, and dehydration. He also has marked leg cramps and has lost 8 lb since his return from the trip. Fecal culture is positive for V. cholerae. How does this bacterium exert its effect?

A. Activation of enterokinase on the brush border of epithelial cells

B. Activation of cholecystokinin effects on pancreatic secretion

C. Closure of chloride channels in the enterocyte cell membrane

D. Inhibition of cyclic AMP in the enterocytes

E. ADP-ribosylation of GS of the GTP-binding protein in enterocytes

28 The adrenal cortex influences the secretion of the adrenal medulla by means of which of the following?

A. Secretion of aldosterone into the intra-adrenal circulation

B. Secretion of glucocorticoids into the intra-adrenal circulation

C. Autonomic neural connections

D. Secretion of monoamine oxidase into the portal circulation

E. Secretion of androgens into the intrarenal circulation

29 A pituitary adenoma is likely to result in which of the following?

A. Secretion of aldosterone into the intra-adrenal circulation

B. Secretion of glucocorticoids into the intra-adrenal circulation

C. Autonomic neural connections

D. Secretion of monoamine oxidase into the portal circulation

E. Secretion of androgens into the intrarenal circulation

30 Elevated estrogen levels during the menstrual cycle result in which of the following?

A. Decrease LH levels

B. Downregulate FSH receptors on granulosa cells

C. Increase FSH levels

D. Increase the ciliation of the epithelial cells of the oviduct

E. Decrease synthesis and storage of glycogen in the vaginal epithelium

31 Which of the following is independent of testosterone or other androgens?

A. Secretion from the prostatic epithelium

B. The function of the prostatic glands

C. Development of the penis from an indifferent phallus

D. Spermatogenesis

E. Fetal testis development from an indifferent gonad

32 A 26-year-old woman is in her last trimester of a normal pregnancy. Synthesis of milk by her mammary glands specifically requires which of the following?

A. Oxytocin from the neurohypophysis

B. Prolactin from the corpus luteum

C. The influence of vasopressin

D. Placental lactogen

E. Neurohumoral reflexes

33 In a patient with diabetes mellitus of 30 years’ duration, complica- tions related to kidney function may include which of the following?

A. Enhanced selectivity of the filtration barrier

B. Decreased permeability to plasma proteins

C. Increased glomerular filtration rate

D. Decreased secretion of aldosterone

E. Glycation of proteins in the basal lamina

34 Which of the following is found exclusively in the renal medulla?

A. Proximal convoluted tubules

B. Distal convoluted tubules

C. Collecting ducts

D. Afferent arterioles

E. Thin loops of Henle

35 The retinal pigment epithelium (RPE) is characterized by which of the following?

A. The presence of the photoreceptor (rod and cone) perikarya

B. Phagocytosis of worn-out components of photoreceptor cells

C. Origin from the inner layer of the optic cup during embryonic development

D. Presence of amacrine cells

E. Synthesis of vitreous humor

36 Which of the following occurs in diabetic retinopathy?

A. Reduction in the thickness of the basal lamina of small retinal vessels

B. Microaneurysms

C. Decreased capillary permeability

D. Increased retinal blood flow

E. Loss of phagocytic ability of the pigmented epithelium

37 The direction in which vestibular hair cell stereocilia are deflected is important for which of the following reasons?

A. Differentiates between type I and type II hair cells

B. Determines whether cells are depolarized or hyperpolarized

C. Determines whether linear or angular acceleration is detected

D. Determines the direction of blood flow in the stria vascularis

E. Is determined by the frequency of the sound

38 Perilymph is located in which of the following structures?

A. Utricle

B. Saccule

C. Semicircular canals

D. Scala media

E. Scala tympani

39 Which of the following is the function of the vestibular membrane?

A. Maintain the gradient between the endolymph and the perilymph

B. Maintain communication between the tympanic and vestibular cavities

C. Transmit sound to the oval window

D. Maintain the concentration gradient necessary for sensory transduction

E. Dampen the action of the auditory ossicles

40 A carcinoma in the medial portion of the lower lip is most likely to first metastasize via which of the following lymph nodes?

A. Submandibular

B. Parotid

C. Superficial cervical

D. Submental

E. Buccal

41 Which pair of venous structures contributes to the confluence of dural sinuses on the interior surface of the occipital bone?

A. Sigmoid and transverse sinuses

B. Inferior sagittal and cavernous sinuses

C. Occipital and straight sinuses

D. Transverse and inferior petrosal sinuses

E. Superior petrosal and occipital sinuses

42 Which of the following is the most direct route for spread of infection from the paranasal sinuses to the cavernous sinus of the dura mater?

A. Pterygoid venous plexus

B. Superior ophthalmic vein

C. Frontal emissary vein

D. Basilar venous plexus

E. Parietal emissary vein

43 The course of the vertebral arteries is best described by which of the following statements?

A. They arise from the common carotid artery on the left and the arachiocephalic artery on the right

B. They enter the cranium via the anterior condylar canals

C. They enter the cranium via the posterior condylar canals

D. They pass through the transverse processes of several cervical vertebrae

E. They directly give rise to the posterior cerebral arteries

44 In dislocation of the jaw, displacement of the articular disk beyond the articular tubercle of the temporomandibular joint results from spasm or excessive contraction of which of the following muscles?

A. Buccinator

B. Lateral pterygoid

C. Medial pterygoid

D. Masseter

45 Like all endocrine glands, the thyroid is highly vascular. The thyroid gland normally receives its blood supply, in part, from branches off which of the following?

A. Internal carotid artery

B. Lingual artery

C. Subclavian artery

D. Transverse cervical artery

E. Vertebral artery

46 An 85-year old woman comes into your family practice office because she says she is losing weight and she is having trouble chewing. Which of the following muscles is a pure elevator of the jaw?

A. Buccinator muscle

B. Geniohyoid muscle

C. Lateral pterygoid muscle

D. Medial pterygoid muscle

E. Posterior fibers of temporalis muscle

47 Pain referred to the right side of the neck and extending laterally from the right clavicle to the tip of the right shoulder is most likely to involve which of the following?

A. Cervical cardiac accelerator nerves

B. Posterior vagal trunk

C. Right intercostal nerves

D. Right phrenic nerve

E. Right recurrent laryngeal nerve

48 The intercostal neurovascular bundle is particularly vulnerable to injury from fractured ribs because it is found in which of the following locations?

A. Above the superior border of the ribs, anteriorly

B. Beneath the inferior border of the ribs

C. Between external and internal intercostal muscle layers

D. Deep to the posterior intercostal membrane

E. Superficial to the ribs, anteriorly

49 The major venous return system of the heart, the coronary sinus, empties into which of the following structures?

A. Inferior vena cava

B. Left atrium

C. Right atrium

D. Right ventricle

E. Superior vena cava

50 A 36-year-old male office worker comes to the clinic complaining of general weakness and shortness of breath. He also relates a rapid, throbbing pulse after climbing a flight of stairs. Cardiac auscultation reveals a diastolic rumbling murmur attributable to the mitral valve. The mitral valve is best heard where?

A. Left side adjacent to the sternum in the second intercostal space

B. Left side adjacent to the sternum in the fifth intercostal space

C. Left side in the midclavicular line in the fifth intercostal space

D. Right side adjacent to the sternum in the second intercostal space

E. Right side adjacent to the sternum in the fourth intercostal space

51 The first (S1, or “lub”) heart sound and the second (S2, or “dup”) heart sound originate, respectively, from which of the following?

A. Closure of the pulmonary valve followed by closure of the aortic valve

B. Closure of the tricuspid valve followed by closure of the mitral valve

C. Closure of the atrioventricular valves followed by closure of the semilunar valves

D. Closure of the atrioventricular valves followed by opening of the semilunar valves

E. Opening of the atrioventricular valves followed by closure of the atrioventricular valves

52 Structure(s) that normally transit the diaphragm by way of the esophageal hiatus include which of the following?

A. Azygos vein

B. Hemiazygos vein

C. Azygos and hemiazygos veins

D. Anterior and posterior vagal trunk

E. Thoracic duct

53 Gallbladder pain often presents as epigastric pain that then migrates towards the patient’s right side and can even wrap around to the posterior. The referred pain is not the site of the problem. Anatomically where is the gallbladder located?

A. Between the left and caudate lobes of the liver

B. Between the right and quadrate lobes of the liver

C. In the falciform ligament

D. In the lesser omentum

E. In the right anterior leaf of the coronary ligament

54 A 65-year-old male presents with jaundice for 2–3 weeks, fatigue and increasing epigastric pain. He has no history of peptic ulcers and says the pain does not relate to eating in anyway. His epigastric pain is midline and he has had some recent back pain. His urinary bilirubinogen and serum bilirubin are elevated (serum bilirubin 5.8 mg/dl). Helical CT reveals a suspicious mass in the head of the pancreas adjacent to the descending duodenum. The gallbladder is significantly enlarged. Which of the following is the likely cause of the elevated bilirubin?

A. Viral hepatitis

B. Blocked cystic duct

C. Open hepatic duc

D. Blocked duodenal papilla

E. Gilbert syndrome

55 A full-term male infant displays projectile vomiting 1 h after suck- ling. There is failure to gain weight during the first 48 hours. The vomitus is not bile-stained and no respiratory difficulty is evident. Examination reveals an abdomen neither tense nor bloated. Which of the following is the most probable explanation?

A. Congenital hypertrophic pyloric stenosis

B. Congenital absence of a kidney

C. Patent ileal diverticulum

D. Imperforate anus

E. Tracheoesophageal fistula

56 A 19-year-old teenager is brought to the emergency room after a single-car accident just 20 minutes earlier in which she lost control of her car on black ice and hit a retaining column of an overpass at about 45 miles per hour. She was wearing a seat belt but looks pale, has tachy- cardia and positional hypotension, is extremely nauseated, and is lying in the fetal position due to increasingly severe abdominal pain. She has no fractures and a cranial nerve test is normal. You order an abdominal CT because you suspect which of the following?

A. Lacerated kidney

B. Ruptured spleen

C. Ruptured gallbladder

D. Diverticulitis

E. Hemorrhoids

57 A 55-year-old woman arrives at the emergency room the day after St. Patrick’s Day coughing up bright red blood. She has frequented your emergency room before. History includes excessive alcohol consumption. Using abdominal percussion you determine that her liver extends 5 cm below the right costal margin at the midclavicular line. You call in a gas- troenterologist because you suspect that the bright red blood is most likely the result of which of the following?

A. Hemorrhoids

B. Colon cancer

C. Duodenal ulcer

D. Gastric ulcer

E. Esophageal varices

58 A 24-year old man was a passenger in an automobile broadsided by another vehicle. Although he was wearing a seat belt he felt “terrible,” and had left sided abdominal, flank, and shoulder pain. During the ambulance ride into the emergency room his blood pressure kept dropping, he appeared pale, had a rapid heartbeat, with otherwise normal lung and heart sounds. Intravenous saline was started en route. Which of the following abdominal organs is most likely damaged?

A. Stomach

B. Duodenum

C. Pancreas

D. Left kidney

E. Spleen

59 Which of the following is the principal supply to the body and tail of the pancreas?

A. Common hepatic artery

B. Inferior phrenic artery

C. Left gastric artery

D. Splenic artery

E. Superior mesenteric artery

60 During the physical exam of a 52-year-old man you note internal hemorrhoids. He complains of blood in his stool. Which of the following arteries could be the source of his rectal bleeding?

A. Superior rectal artery off the inferior mesenteric artery

B. Middle rectal artery off the internal iliac artery

C. Inferior rectal artery off the internal pudendal artery

D. Both B and C

E. A, B, and C

61 Benign prostatic hypertrophy results in obstruction of the urinary tract. Patients present with weak urine flow, increased difficulty initiating urination, and increase frequency of urination since the bladder often is not fully emptied. Benign prostatic hypertrophy is associated with enlargement of which of the following?

A. Entire prostate gland

B. Lateral/posterior lobes

C. Mucosal and submucosal regions

D. Anterior region

62 Which structure is most susceptible to unintentional damage during a hysterectomy?

A. Uterine artery

B. Ureter

C. Urinary bladder

D. Urethra

E. Kidney

63 Which of the following locations is optimal for fertilization of an ovulated egg by sperm to occur?

A. Ampulla of the oviduct

B. Uterus

C. Infundibulum of the oviduct

D. Isthmus of the oviduct

E. Cervical canal of the uterus

64 An HIV-positive patient asks you if you can tell him the chances of him progressing to symptomatic AIDS. Which one of the following tests would be most useful?

A. CD4 lymphocyte count

B. HIV antibody test

C. HIV RT PCR

D. Neopterin

E. HIV p24 antigen

65 Which of the following viruses causes an acute febrile rash and produces disease in immunocompetent children but has been associated with transient aplastic crises in persons with sickle cell disease?

A. Rubeola

B. Varicella-zoster

C. Parvovirus

D. Rubella

E. Herpes simplex

66 Infection with herpes simplex virus, a common human pathogen, is best described by which of the following statements?

A. The CNS and visceral organs are usually involved

B. It rarely recurs in a host who has a high antibody titer

C. It can be reactivated by emotional disturbances or prolonged exposure to sun- light

D. Initial infection usually occurs by intestinal absorption of the virus

E. Infection with type 1 virus is most common

67 An HIV-positive patient prior to being treated with AZT, DDI, and saquinavir has a CD4 lymphocyte count and an HIV RNA viral load test done. Results are as follows: CD4: 50 CD4 lymphocytes per microliter, HIV RNA: 750,000 copies per ml. Which of the following statements best describes the above patient?

A. This patient is no longer in danger of opportunistic infection

B. The 5-year prognosis is excellent

C. The patient’s HIV screening test is most likely negative

D. The patient is not infectious

E. The viral load of 750,000 copies per ml suggests that the patient will respond to triple therapy

68 Infectious mononucleosis, a viral disorder that can be debilitating, is Characterized by which of the following statements?

A. It is most prevalent in children less than 14 years old

B. It is caused by a rhabdovirus

C. The causative pathogen is an Epstein-Barr virus

D. Affected persons respond to treatment with the production of heterophil anti- bodies

E. Ribavirin is the treatment of choice

69 The clinical picture of arbovirus infection fits one of three categories: encephalitis, hemorrhagic fever, or fever with myalgia. One of the characteristics of arboviruses is that they

A. Are transmitted by arthropod vectors

B. Are usually resistant to ether

C. Usually cause symptomatic infection in humans

D. Are closely related to parvoviruses

70 Delta hepatitis only occurs in patients who also have either acute or chronic infection with hepatitis B virus. The delta agent is

IA. An incomplete hepatitis

B virusB. Related to hepatitis A virus

C. A hepatitis B mutant

D. An incomplet

E. Hepatitis C

71 The most sensitive test for the diagnosis of herpes simplex (HSV)meningitis in a newborn infant is

A. HSV IgG antibody

B. HSV polymerase chain reaction (PCR)

C. HSV culture

D. Tzanck smear

E. Cerebrospinal fluid (CSF) protein analysis

72 Mumps virus accounts for 10 to 15% of all cases of aseptic meningitis in the United States. Infection with mumps virus

A. Is apt to recur periodically in many affected persons

B. Will usually cause mumps orchitis in postpubertal males

C. Is maintained in a large canine reservoir

D. Usually produces severe systemic manifestations

E. Is preventable by immunization

73 The serum of a newborn infant reveals a 1:32 cytomegalovirus (CMV) titer. The child is clinically asymptomatic. Which of the following courses of action would be advisable?

A. Repeat the CMV titer immediately

B. Wait 6 months and obtain another titer on the baby

C. Obtain a CMV titer from all siblings

D. Obtain an anti-CMV IgM titer from the mother

E. Obtain an anti-CMV IgM titer from the baby

74 A 3-year-old child presents at the physician’s office with symptoms of coryza, conjunctivitis, low-grade fever, and Koplik’s spots. The causative agent of this disease belongs to which group of viruses?

A. Adenovirus

B. Herpesvirus

C. Picornavirus

D. Orthomyxovirus

E. Paramyxovirus

75 One of the most common sexually transmitted diseases that may lead to cervical carcinoma is caused by which of the following viruses?

A. Cytomegalovirus

B. Papillomavirus

C. Epstein-Barr virus

D. Herpes simplex virus

E. Adenovirus

76 Which virus is the leading cause of the croup syndrome in young children and, when infecting mammalian cells in culture, will hemabsorb red blood cells?

A. Group

B coxsackievirusB. Rotavirus

C. Parainfluenza virus

D. Adenovirus

E. Rhinovirus

77 Hepatitis E, a recently characterized hepatitis virus, is best described by which of the following statements?

A. It is not a threat to the blood supply

B. It is a major cause of blood-borne hepatitis

C. It is prevalent in North America

D. It is a single-stranded DNA virus

E. The disease resembles hepatitis C

78 meningitis may be caused by a variety of microbial agents. During the initial 24 h of the course of aseptic meningitis, an affected person’s cerebrospinal fluid is characterized by

A. Decreased protein content

B. Elevated glucose concentration

C. Lymphocytosis

D. Polymorphonuclear leukocytosis

E. Eosinophilia

79 Infection with hepatitis D virus (HDV; delta agent) can occur simulta- neously with infection with hepatitis B virus (HBV) or in a carrier of hepati- tis B virus because HDV is a defective virus that requires HBV for its replicative function. What serologic test can be used to determine whether a patient with HDV is an HBV carrier?

A. HBsAg

B. HBc IgM

C. HBeAg

D. HBs IgM

E. HBs IgG

80 Eastern equine encephalitis virus is associated with a high fatality rate. Control of the disease could be possible by eradication of

A. Horses

B. Birds

C. Mosquitoes

D. Fleas

E. Ticks

81 Adults who have had varicella as children occasionally suffer a recurrent form of the disease, shingles. The agent causing these diseases is a member of which of the following viral families?

A. Herpesvirus

B. Poxvirus

C. Adenovirus

D. Myxovirus

E. Paramyxovirus

82 German measles virus (rubella), a common cause of exanthems in children, is best described by which of the following statements?

A. Measles (rubeola) and German measles (rubella) are caused by the same virus

B. Incubation time is approximately 3 to 4 weeks

C. Vesicular rashes are characteristic

D. Onset is abrupt with cough, coryza, and fever

E. Specific antibody in the serum does not prevent disease

83 The presence of Negri inclusion bodies in host cells is characteristic of

A. Mumps

B. Infectious mononucleosis

C. Congenital rubella

D. Aseptic meningitis

E. Rabies

84 A hospital worker is found to have hepatitis B surface antigen. Subsequent tests reveal the presence of e antigen as well. The worker most likely

A. Is infective and has active hepatitis

B. Is infective but does not have active hepatitis

C. Is not infective

D. Is evincing a biologic false-positive test for hepatitis

E. Has both hepatitis B and C

85 An immunocompromised person with history of seizures had an MRI that revealed a temporal lobe lesion. Brain biopsy results showed multinucleated giant cells with intranuclear inclusions. The most probable cause of the lesion is

A. Hepatitis C virus

B. Herpes simplex virus

C. Listeria monocytogenes

D. Coxsackievirus

E. Parvovirus

86 An infant, seen in the ER, presents with a fever and persistent cough. Physical examination and a chest x-ray suggest pneumonia. Which of the following is most likely the cause of this infection?

A. Rotavirus

B. Adenovirus

C. Coxsackievirus

D. Respiratory syncytial virus

E. Rhinovirus

87 Which one of the following groups of people may be at increased risk for HIV infection?

A. Members of a household in which there is a person who is HIV-positive

B. Receptionists at a hospital

C. Factory workers whose coworkers are HIV-positive

D. Foreign service employees who are hospitalized in Zaire for bleeding ulcers

E. Homosexual females

88 A patient has all the gastrointestinal symptoms of infection with hepatitis A virus (HAV), yet all the tests for HAV-IgG and HAV-IgM are non- reactive. A possible cause of this infection is

A. Hepatitis B surface antigen

B. Hepatitis CC. Hepatitis D

D. Hepatitis E

E. Rotavirus

89 Erythema infectiosum (fifth disease), a self-limited disease of children, is caused by

A Measles

B. Parvovirus

C. Rubella

D. Human herpesvirus type 6

E. Norwalk virus

90 Which one of the following viruses may be human tumor virus?

A. Epstein-Barr virus (EBV)

B. HIV

C. Papillomavirus

D. Varicella-zoster virus (VZV)

E. Herpes simplex virus, type 2 (HSV)

91 Cytomegalovirus (CMV) infection is common. Which one of the fol- lowing statements best characterizes CMV?

A. It can be transmitted across the placental barrier

B. While a common infection, CMV is almost always symptomatic

C. The CMV can be cultured from red blood cells of infected patients

D. Unlike other viral infections, CMV is not activated by immunosuppressive ther- apy

E. There is no specific therapy for CMV

92 There is considerable overlap of signs and symptoms seen in congenital and perinatal infections. In a neonate with “classic” symptoms of congenital cytomegalovirus (CMV) infection, which one of the following tests would be most useful in establishing a diagnosis?

A. CMV IgG titer on neonate’s serum at birth

B. CMV IgG titer on mother’s serum at birth of infant

C. CMV IgM titer on neonate’s serum at birth and at 1 month of age

D. Total IgM on neonate’s serum at birth

E. Culture of mother’s urine

93 Which one of the following viruses would be most likely to establish a latent infection?

A. Adenovirus

B. Measles virus

C. Influenza virus

D. Parvovirus

E. Coxsackievirus group B

94 A regimen that includes appropriately administered gamma globulin may be contraindicated in which one of the following diseases?

A. Hepatitis A

B. Hepatitis B

C. Rabies

D. Poliomyelitis

E. Infectious mononucleosis

95 Atypical lymphocytosis is most likely to be found in which one of the following diseases?

A. Encephalitis caused by herpes simplex virus (HSV)

B. Mononucleosis induced by Epstein-Barr virus

C. Parvovirus infection

D. Chronic hepatitis C

E. Rotavirus gastroenteritis

96 A patient has arthralgia, a rash, lymphadenopathy, pneumonia but no fever. Which of the following diseases is most likely based on these symptoms?

A. Dengue fever

B. St. Louis encephalitis

C. Infectious mononucleosis

D. Hepatitis

E. HIV infection

97 Hepatitis C (HCV) is usually a clinically mild disease, with only minimal elevation of liver enzymes. Hospitalization is unusual. Which one of the following statements best characterizes HCV?

A. Few cases progress to chronic liver disease

B. It often occurs in post transfusion patients

C. HBV but not HCV infections occur in IV drug abusers

D. It is a DNA virus

E. Blood products are not tested for antibody to HCV

98 Which of the following markers is usually the first viral marker detected after hepatitis B infection?

A. HBeAg

B. HBsAg

C. HBcAg

D. Anti-HBc

E. HbeAb

99 Which of the following may be the only detectable serological marker during the early convalescent phase of HBV infection (window phase)?

A. HBeAg

B. HBsAg

C. HBcAg

D. Anti-HBc

E. HbeAb

100 Which one of the following markers is closely associated with HBV infectivity and DNA polymerase activity?

A. HBeAg

B. HBsAg

C. HBcAg

D. Anti-HBc

E. HBeAb

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